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2014 Healthcare Reform Insurance Rates: Vindication or Condemnation?

Depending on who you listen to, when California announced its 2014 individual health insurance rates for its state-sponsored marketplace, Covered California, it was either a “pretty good deal,” with “no sticker shock” that proved that the healthcare reform naysayers were crying wolf, or “Rate Shock” from a “blizzard of regulations and mandates [that] drives up the cost of insurance” demonstrating that the Democrats were driving the ship of state off a waterfall.

As usual, this discussion about healthcare reform starts from a partisan posture, with, on the one side, a healthcare expert from a left-leaning publication putting a positive spin on the news, and a healthcare expert from a right-leaning think tank spinning negative. So if everything you read out there is just political partisans trying to score points for their side, what’s the straight story?

With one minor exception, I was delighted to read Emily Maltby’s and Sarah E. Needleman’s thoughtful article* in the Wall Street Journal on April 8, 2013: “Some Small Businesses Opt for the Health-Care Penalty.”

The minor exception and my feedback: let’s use the government’s own language of “Shared Responsibility Payment” instead of “Penalty” to describe the fee for not offering employer-sponsored healthcare coverage.

FAQs

Who are Benefitter’s customers?

Benefitter serves employers of all sizes, many of whom have traditionally offered employer-sponsored health coverage to their employees. Clients who capture the most value from the Benefitter solution have workforces in the United States that are mostly compensated between 133% to 400% of federal poverty level (FPL) (where 400% of FPL is about $92,000 for a family of four). Our clients have businesses in a wide rage of industries, including retail (e.g., department stores), hospitality (e.g., restaurants), and consumer services (e.g., repair service).

What are the challenges American employers are facing?

American employers are scrambling to understand all the requirements of the Affordable Care Act in time for benefits enrollment season this fall. They are faced with significant decisions, particularly whether to offer employer-sponsored healthcare coverage. If they choose not to offer employer-sponsored health care, they are faced with the new challenges of communicating their decision to employees, guiding the employees to individual exchanges for healthcare coverage, and providing reimbursement to employees where appropriate.

What is Benefitter’s solution?

Benefitter provides employers with a three-part solution for employee health coverage. First, Benefitter Employer Analytics outlines a full range of strategic options under the new healthcare laws and helps employers select the approach that offers them and their employees the most savings for the benefits they need. Second, Benefitter Employee Navigator educates and guides employees through the insurance selection process on the individual market. And third, Benefitter Accounts and Management helps determine financial contributions to employees and manage the flow of finances for employers. Benefitter also partners with brokers and other service providers to ensure employers and employees receive knowledgeable, local assistance.

NEWS

Average Rock Health startup now worth $5.2M

“…Rock Health companies have the third highest average valuation of any incubator according to Angel List, at $5.2 million (behind StartX and Y-Combinator). Rock says the incubator’s portfolio companies have raised $43 million to date, not including investments from Rock itself, averaging about $900,000 per startup. The current class accounts for $13.9 million of that total…”

Read full article at MobiHealthNews

Rock Health’s New Class: Daring to be Useful

“If Wednesday’s Rock Health demo day is a representative guide, it would appear that digital health is starting to gain some real traction, focusing on discrete pain points and delivering potentially useful, appropriately-scoped solutions. There’s clearly been some excellent coaching and helpful guidance received along the way.”

CASE STUDIES

JULIA’S SITUATION

In 2014, Julia’s employer will offer healthcare coverage, disqualifying her from more than $8,000 in federal support and costing both her and her employer more. How can you manage a tough situation like this?

Resources

Overview of Affordable Care Act provisions
IRS “Q&A” on Employer Shared Responsibility Payment.
Updates on Family Eligibility for Government Assistance
Kaiser Family Foundation, subsidy calculator
Healthcare.gov