How to bridge the health insurance knowledge gap for younger employees

More often times than not, when younger employees are searching for their own health insurance plans, they make common and costly mistakes due to the lack of education in regards to health care plans. Proper education could help the young generation of employees for their health, wellness, and future. Read this blog post to learn more.


With the passage of the Affordable Care Act, young adults were able to stay on their parents health insurance plans until the age of 26. But once they get their own health insurance, many young employees make common and costly mistakes because they don’t have the proper education when choosing their own programs.

This information gap could result in employees being hesitant to seek care, resulting in higher medical expenses for employees and reduced productivity from sick leave.

“It’s a challenge— there’s a fair number of employees that will come off of their parent's insurance at the age of 26,” says Amanda Baethke, director of corporate development at Aeroflow Healthcare. “There's not a lesson that you go through in order to understand insurance.”

How can employers help younger workers avoid health insurance mistakes?
It's beneficial for HR to do a training where they're going over what co-pays, premiums, deductibles and coinsurance are. When signing up for insurance, employees are trying to decide which insurance to pick and may not understand the full impact of that decision. Employees could pick the cheapest one because they want less out of their paycheck. There's just not a lot of discussions happening and employees are left blind.

What mistakes do young workers make when it comes to health insurance?
I’ll get a lot of questions from my team like ‘What’s an HSA and what’s the benefit?’ It's truly a lack of understanding, because nobody teaches it. A lot of mistakes will happen with out-of-network providers. They don't realize that there are insurance networks and then within those networks, there are more narrow networks underneath.

For example, an employee can call a doctor's office and ask if that office is in-network and the receptionist may respond that they are — especially for the national brands like UHC, Aetna, Cigna, Humana. However, many of those plans have narrow networks under them that allow them to better control cost. So the employee would want to ensure their particular group/plan is in-network.

Another thing is making sure employees know that even though they have a deductible, some preventative care is likely covered under their insurance. This will help them choose the right physician so if they do get sick later on, they can see that physician, rather than going to a hospital which would be more costly for them.

What specific role should HR take when it comes to educating younger employees about health insurance?
HR is responsible for making sure that employees understand the benefits that they're offering. HR works incredibly hard to deliver the best benefits possible and advocate for each and every employee. So why not just go the extra step and have a consultation with the insurance company to explain what the benefits mean, what is covered, what may not be covered, how to really navigate through the insurance company and work back with them.

SOURCE: Schiavo, A. (19 October 2020) "How to bridge the health insurance knowledge gap for younger employees" (Web Blog Post). Retrieved from https://www.employeebenefitadviser.com/news/how-to-bridge-the-health-insurance-knowledge-gap-for-younger-employees


Study Shows Value of Benefits Begins to Erode for Employees

Originally posted February 27, 2014 on http://ifawebnews.com

While benefits remain a critical part of the overall employee experience, the perceived value of workplace benefits among employees who participate in both health and retirement plans is starting to erode, according to a new report by global insurance consultancy Mercer.

The trend was revealed in the latest edition of the Mercer Workplace Survey, a broadly cited study that measures attitudes and perceptions of benefit plan participants nationwide.

Mercer reports that despite the concern, the firm has identified ways to enhance both benefit delivery and choice, thereby improving employee perception of benefits.

With benefit coverage cost, reach and adequacy seeming to dominate U.S. news headlines, this drop in perceived value should be of major concern to employers, legislators, regulators and other concerned parties, Mercer suggests. The firm reports that a closer examination of the findings shows that the decreased value perception is being driven by concerns about rising out-of-pocket health costs. And, perhaps of most concern, workers under 50 years of age who say their benefits are “definitely worth it” in terms of what they pay out of pocket has dropped precipitously in just two years from 45% to 30%.

Even with these concerns, participants overall see benefits as critically important. In fact, 93% agree with the statement “my health benefits are as important as my salary,” while 86% disagree with the statement “my benefits don’t matter much to me.”

“Year after year, we find our survey respondents ranking benefits as one of the most important components of their employment value proposition,” said Kerry Donoghue, partner, health and benefits business leader for Mercer’s benefits administration business. “We feel strongly, however, that there are some areas of concern that plan sponsors must take into account as they evaluate and design their benefit plans, particularly as it relates to discontent about rising out-of-pocket expenses and an overall level of relative dissatisfaction among younger employees.”

“Out-of-pocket expenses for employees are likely to continue to rise,” said Beth Umland, director of research for Mercer’s Health and Benefits business. “We’re seeing more cost-shifting and rapid growth in high-deductible consumer-directed health plans as employers are asked to cover more employees under health reform. So it’s critical for sponsors to explicitly communicate the value of the overall benefits program they provide and consider offering educational resources and tools to help participants better manage their health care spending. Giving employees more choice can also help build perceived value.”

Mercer encourages plan sponsors to address the erosion in perceived benefits by designing and implementing benefit plans that are more relevant and customizable to the individual participant. A full array of plan options, such as consumer-directed health plans and private exchanges, can give plan sponsors and their participants potential savings and greater flexibility that more closely aligns with their personal situation and lifestyles.

 

 


In 2020, Workers Will Decide Health Benefits

Originally posted by Bill Toland February 09, 2014 on http://insurancenewsnet.com

By the end of the decade, the majority of American workers will be selecting their health benefits from an online menu of plans and paying for those benefits with a stipend from their employer, according to experts in the field.

If and when that day comes, it would mark a major shift for the nation's health care apparatus and a reversal of the method by which health insurance has been furnished to American workers for decades -- through a defined-benefits plan selected by an employer.

In 2020, private health "exchanges" will be the predominant way that health care benefits are delivered in this country, said Eric Grossman, a senior partner at Mercer and the exchange business leader in his company's benefits division.Mercer, based in New York with an office in Pittsburgh, is a global human resources, benefits and financial services consultant.

Mr. Grossman, like many other experts in the field, likens the transition in health insurance to the ongoing transition in retirement planning -- where once the "defined-benefit" pension was commonplace, now many companies offer "defined contributions" which employees can steer to a 401(k) or an investment mix of their choice.

That transition took two decades, but now, for anyone under the age of 35, employer-subsidized retirement -- where it still exists, that is -- generally means a defined contribution.

"Our prediction in health care is that a similar transition will happen, [but] it will happen more quickly," Mr. Grossman said.

Private health insurance exchanges -- some of which already exist -- work like this: Instead of an employer negotiating a standard benefits plan or two for its employees, companies instead make a defined cash contribution to employee accounts. Employees then use the cash to select from a menu of a half-dozen or so health plans, with varying price levels of coverage.

Exchanges are set up and managed by health insurers (such as Highmark), benefits consultants (such as Mercer), traditional benefits brokers and online brokers. Plans included in exchanges can be a mix of plans from regional and national insurers, depending on who is the sponsor. A Highmark exchange would offer only its own plans, for example, while a Mercer exchange would offer plans from several companies.

Businesses have dozens of plans to choose from within the exchange "universe" -- health as well as dental, vision and others -- but that list is whittled down to a handful before the plans are finally offered to employee groups.

These are called private, or closed, exchanges because the policies are available only to company employees -- not to the population at large, as is the case with the national and state-based marketplaces that came online Oct. 1 as part of the Affordable Care Act.

Right now, said Bill Brown, Highmark's manager of digital distribution, national marketplace penetration for private exchanges is about 3 percent and adoption rate among Highmark's client base is about the same. Large companies with more than 250 employees have been particularly cautious.

Highmark began offering large employers access to its "MyBenefits" exchanges Jan. 1.

"There's a lot of interest," Mr. Brown said. "But they're not ready to jump."

That's partly because, despite the 401(k) analogy, there's not much immediate cost savings in a health exchange, particularly for large groups. When big employers moved away from pensions and toward defined contributions, the point was to reduce immediate retirement costs and unload a major financial liability going forward. Today, less than 30 percent of Fortune 100 companies offer a defined-benefit retirement plan to new salaried employees.

But with health exchanges, big, self-insured employers that now pay all of their own medical claims will continue to do so. The impetus to move to an exchange, at least among larger employers, won't come from claims savings but rather the opportunity to offer a wider array of health plans to employees and to offload some of the benefits administration now handled by human resources departments.

The real savings will come for fully-insured small-and-mid-sized groups, Mr. Brown said.

They'll be able to offer far more variety to employees, and the entire process will happen online. "It really streamlines administration," he said.

If they "move onto [the] exchange, they get five medical options, four dental, four vision" plans, he said. Employees can choose the plan that is best for them and their family.

While the pension analogy is the one most commonly used to describe the shift, Mr. Brown said a comparison to the world of retail shopping might be more appropriate. Where once customers went to a store and were able to select from whatever the store had in stock, now they can go to Amazon.comand buy anything.

A decade or so ago, people might have been skeptical of the online shopping process, but not anymore -- at least, not in retail.

Mr. Brown believes that will be proven true in health insurance: 14 years ago, Highmark test-launched an online ("paperless," the press release described it) defined-contribution platform called BlueChoice. "It kind of fizzled out. Nobody was ready at that time."

But they soon will be. Part of it is just the ubiquity of the Internet. Part of it is getting used to health care as a retail market. And part of it, said Mr. Grossman of Mercer, is getting people to separate work from health insurance. If people don't buy auto or mortgage insurance through their employers, why do they get health insurance that way?

"The mindset for decades was, for most people, 'My employer provides it,' " Mr. Grossman said, and employers have done so, and continue to do so, for competitive reasons. Employer-sponsored health insurance became the norm in the U.S. following World War II, driven by recruiting needs and labor unions.

That era is ending, and Mercer is of the opinion that the "employee is in the best position to decide the best plan," Mr. Grossman said.

Mr. Brown predicted that in the next 18 months, up to 40 percent of small employers will be offering benefits through some kind of exchange and up to a quarter of midsized companies will do the same.

"The one thing I'm waiting for is someone really big to make a move [to exchanges] -- Walmart, McDonald's," Mr. Brown said. "That's the tipping point. And the entire market is going to start to switch."


Why you can’t afford not to offer health benefits

Originally posted January 14, 2014 by Larry Boress on http://ebn.benefitnews.com

The debate continues on the future of employer-based health benefits as employers continue to be challenged by the economy, the health care delivery system and changes resulting from the Affordable Care Act. There are some who believe this is the beginning of the end for employer-based health care benefits. I’m not one of them.

Why are employers still offering health care benefits and increasing worksite wellness activities? It’s not rocket science. Employers don’t offer benefits because they are altruistic. They do so primarily to recruit and retain talent and to ensure workers have the mental and physical capacity to perform their best on the job.

With benefits being the second highest expense after payroll, and the foreboding 2018 excise (“Cadillac“) tax on benefits above a certain dollar level, there is a great need for employers to reduce their outlay for medical expenses. Businesses are addressing this in multiple ways, including increasing programs to identify disease and health problems early in their progress and to reduce the risks for those with chronic conditions.

Employers have increased deductibles and co-pays of their health benefit programs, with close to 30% now offering only health savings accounts and health reimbursement accounts. In a new development, according the Private Exchange Evaluation Collaborative, close to half of all employers will be considering using private health insurance exchanges to offload their benefit administrative costs, while still offering benefits to their employees.

Increasingly, we also find employers are taking a deeper dive into providing direct health programs and services to their covered populations to respond to a health system that fails to offer easy access, effectively focus on prevention or management of chronic conditions and one that doesn’t incentivize individuals to take responsibility for own their health.

The nonprofit National Association of Worksite Health Centers found that close to a third of employers today make medical services available onsite so they are easily accessible to their employees. This allows them to reduce costs while minimizing lost work time due to absenteeism

The existence or even the unlikely repeal of the ACA does not change the value of offering benefits for employers. When you look at Europe, where many countries do not offer health benefits to their citizens, you still find companies offering wellness and preventive services to keep people safe, healthy and productive.

In surveys conducted by the Midwest Business Group on Health, the vast majority of employers agree that there is a link between an employee’s health and their productivity. They believe that health benefits are a necessary cost of doing business and view health benefits as an investment in human capital with measurable outcomes, not just an expense against the bottom line.

If employers are to remain attractive to new talent and retain their existing human capital, they will need to continue to offer health benefits to their workforces. But to do so, businesses must develop comprehensive, integrated strategies that reduce their costs and make employees more responsible for decisions they make about their medical care.

Many employers have already begun to move in this direction by increasing use of outcome-based incentives to motivate lifestyle choices, encouraging use of preventive care, and paying only for high quality providers and high-value, cost-effective treatments and services.

At the end of the day, dropping health care coverage is not an option, especially for employers who are focused on the health and productivity of their workforce. An employer-based system can and should continue if we recognize the value of our human capital being as important as the technology, machinery and plants that develop our products. Regardless of a company’s size, in a global marketplace, a business can’t afford to lose its most important assets – its people.

 


The Great American Smokeout Day is Today

Originally posted on http://www.cancer.org

The American Cancer Society marks the Great American Smokeout on the third Thursday of November each year by encouraging smokers to use the date to make a plan to quit, or to plan in advance and quit smoking that day. By quitting — even for one day — smokers will be taking an important step towards a healthier life – one that can lead to reducing cancer risk.

This year, we’re celebrating quitters and their supporters with a series of fun characters designed for social sharing on Facebook, Twitter and Pinterest. We’ve also got lots of other resources and information to help you quit for good.

Have a question about how to quit smoking? Want to know how lawmakers can help in the fight against tobacco use? Sharecare & the American Cancer Society team up to host a Great American Smokeout Twitter Chat. On Wednesday, Nov. 20 and Thurs. Nov 21, ask your question on Twitter and Facebook using the hashtag #quitforgood. Go online Thurs, Nov 21, 11 am to 4 pm EST to see the answers roll in from the American Cancer Society and other experts!

Get tips on how to kick your smoking habit during the American Cancer Society’s Great American Smokeout on Thursday, Nov. 21st from 1-2pm ET during Everyday Health’s #HealthTalk: http://www.everydayhealth.com/healthtalk/great-american-smokeout.aspx

Tobacco use remains the single largest preventable cause of disease and premature death in the US, yet about 43.8 million Americans still smoke cigarettes — Nearly 1 in every 5 adults. As of 2010, there were also 13.2 million cigar smokers in the US, and 2.2 million who smoke tobacco in pipes — other dangerous and addictive forms of tobacco.

Why Quit?

The health benefits of quitting start immediately from the moment of smoking cessation. Quitting while you are younger will reduce your health risks more, but quitting at any age can give back years of life that would be lost by continuing to smoke. View sources.

More Information About Quitting

Quitting is hard, but you can increase your chances of success with help. The American Cancer Society can tell you about the steps you can take to quit smoking and provide quit-smoking programs, resources and support that can increase your chances of quitting successfully. To learn about the available tools, call us at 1-800-227-2345. You can also find free tips and tools below.


Employers taking 'bold steps' with health benefits

http://www.benefitspro.com/2013/03/04/employers-taking-bold-steps-with-health-benefits

By Kathryn Mayer

Don’t count on employers to stop offering health benefits altogether, but do count on big changes in how they offer the benefits.

That’s the main finding from recent analysis by Aon Hewitt. The vast majority of large and mid-size U.S. employers — 94 percent — say they’ll continue to offer health benefits to their employees in the next three to five years, but almost two-thirds plan to move away from a traditional “managed trend” approach to one that requires participants to take a more active role in their health care planning.

The consulting firm surveyed nearly 800 large and mid-size U.S. employers covering more than 7 million employees.

“The health care marketplace is becoming increasingly complex,” says John Zern, executive vice president for Aon Hewitt. “New models of delivery, new approaches to managing health and new compliance requirements are challenging employers to think differently about their role in owning health insurance responsibilities for employees and their dependents.”

Aon Hewitt says the amount employers spend on health care has increased by 40 percent in the past six years to approximately $8,800 per employee. Meanwhile, employee premium and out-of-pocket costs have increased 64 percent to almost $5,000 per year. Aon Hewitt estimates that health care costs for both employers and employees will continue to rise 8 percent to 9 percent per year for the foreseeable future.

Zern says though employers are staying in the health benefits game, they are taking “bold and assertive steps to achieve more effective results” — and they are doing so at a faster pace than has been seen in previous years.

Almost 40 percent of employers expect to migrate toward a “house money/house rules” approach in the next three to five years. For example, participants who take health risk questionnaires and biometric screenings may be rewarded in the form of lower premiums or access to broader health coverage. Other employers may waive prescription drug co-pays if an employee demonstrates they are following their doctor’s orders with regard to a chronic condition. Lastly, some leading-edge employers are working with health plans to incentivize participants to use a small provider network of high quality, cost-efficient providers, Aon Hewitt finds.

Though just 6 percent of employers plan to exit health care completely in the next three to five years, 28 percent say they’re planning to move to a private health care exchange.

Jim Winkler, chief innovation office the U.S. Health & Benefits practice at Aon Hewitt, says that private exchanges are an “increasingly attractive option” to organizations that want to offer employees health care choice while lowering future cost trends and lessening the administrative burden associated with sponsoring a health plan.

“The allure of exiting completely is strong until you look at the numbers,” Winkler said. “Between the Affordable Care Act penalties for failing to offer coverage and the ensuing talent flight risk, most employers believe they need to continue to play a role in employee health, but want a different and better outcome.”

 


Additional proposed regulations addressing open issues under PPACA

The Department of Health and Human Services (HHS), the Internal Revenue Service (IRS) and the Department of Labor (DOL) have recently issued more FAQs and proposed rules that address several employer obligations under the Patient Protection and Affordable Care Act (PPACA).

Notice of Exchange Has Been Delayed

On Jan. 24, 2013, the DOL issued a FAQ that delays the due date for providing employees with a notice about the affordable health exchanges.  The notice had been due March 1, 2013 but the due date has been delayed until late summer or early fall of 2013.  The delay will result in the notice being provided closer to the start of open enrollment for the exchanges, which will begin Oct. 1, 2013, for a Jan. 1, 2014, effective date.

To read the FAQ, click here: http://www.dol.gov/ebsa/faqs/faq-aca11.html

HRA Restrictions

Because PPACA prohibits annual dollar limits on essential health benefits, HRAs that are not integrated with other group health coverage (usually a major medical plan) will not be permitted after Jan. 1, 2014.

The Jan. 24, 2013, DOL FAQ also addresses HRAs, and states that an employer-provided HRA will not be considered integrated (and therefore will not be allowed) if it:

  • Provides coverage through individual policies or individual market coverage; or
  • Credits amounts to an individual when the individual is not enrolled in the other, major medical coverage

Existing HRAs that cannot meet the 2014 requirements generally will be allowed to reimburse expenses incurred after 2014, in accordance with the terms of the plan.

Premium Tax Credit/Subsidy

On Feb. 1, 2013, the IRS issued a final regulation that provides the long awaited answer of whether family members of an employee who has access to affordable self-only coverage are eligible for a premium tax credit/subsidy.  The answer is that they are not – if the employee has access to affordable self-only coverage, the spouse and children are also considered to have access to affordable employer-sponsored coverage, and therefore the spouse and children are not eligible for premium tax credits/subsidies.  To read the final IRS rule, click here:
http://www.gpo.gov/fdsys/pkg/FR-2013-02-01/pdf/2013-02136.pdf

Minimum Essential Coverage

On Feb. 1, 2013, HHS and the IRS issued two proposed regulations that provide details on the individual shared responsibility requirement.

PPACA requires that non-exempt individuals obtain “minimum essential coverage” or pay a penalty. Minimum essential coverage includes individual insurance, Medicare, Medicaid, CHIP, TRICARE, VA and similar government programs, and employer-sponsored coverage.  The proposed IRS rule defines minimum essential “employer-sponsored” coverage as an insured or self-funded governmental or ERISA welfare benefit plan that provides medical care directly or through insurance or reimbursement. (An HMO is considered an insured plan.)

Generally, any policy offered in the small or large group market that meets the above requirements will be minimum essential coverage. The proposed IRS regulation states that these types of coverage will not qualify as minimum essential employer-sponsored coverage:

  • Accident only
  • Disability income: Liability, including general, automobile, and supplemental liability;
  • Workers compensation
  • Automobile medical payment
  • Credit only
  • On-site medical clinics
  • Limited scope dental or vision
  • Long-term care, nursing home care, home health care, community-based care or any combination of these
  • Specified diseases or illness
  • Hospital indemnity or other fixed indemnity insurance
  • Medicare supplement
  • Similar limited coverage

Public comments are due March 18, 2013.  To read the proposed IRS rule, click here: http://www.gpo.gov/fdsys/pkg/FR-2013-02-01/pdf/2013-02141.pdf

The HHS proposed rule provides details on how an individual can claim an exemption from the individual shared responsibility penalty.

Public comments on this rule also are due March 18, 2013.  To read the proposed HHS rule, click here: http://www.gpo.gov/fdsys/pkg/FR-2013-02-01/pdf/2013-02139.pdf

Women’s Preventive Care Services

Proposed rules that would make it simpler for religious organizations and religious-affiliated not-for-profit organizations like hospitals and schools that have a religious objection to providing contraceptive services were released by the DOL on Feb. 1, 2013. These employers would notify their insurer of their objection, and the insurer automatically would be required to notify the employees that it will provide the coverage without cost sharing or other charges through separate individual health insurance policies.

For religious-affiliated workplaces that self-insure, the third party administrator would be expected to work with an insurer to arrange no-cost contraceptive coverage through separate individual health insurance policies.

The administration believes the cost of free contraceptive coverage will be offset by fewer maternity claims, but is exploring allowing an offset of the cost against federally facilitated exchange user fees.

The proposed rule offers no exemption for private employers that object to covering contraceptive services on religious or moral grounds.

The proposed rule is here: http://www.ofr.gov/OFRUpload/OFRData/2013-02420_PI.pdf

Important: Some of these rules are still in the “proposed” stage, which means that there may be changes when the final rule is issued.  Employers should view the proposed rules as an indication of how plans will be regulated beginning in 2014, but need to understand that changes are entirely possible.

 

 


IRS Issues Three Proposed Regulations Addressing Open Issues Under PPACA

On Nov. 20, 2012, the Department of Health and Human Services issued three sets of proposed rules that provide some of the needed details on how PPACA will probably unfold.  The proposed rules address:

  • Wellness programs under PPACA
  • Essential health benefits and determining actuarial value
  • Health insurance market reforms
All three rules are still in the "proposed" stage, which means that there may - and likely will - be changes when the final rules are issued.  There is a 30-day public comment period on the essential health benefits and market reforms rules, and a 60-day comment period on the wellness rule.
Nondiscriminatory Wellness Incentives
The proposed rule largely carries forward the rules that have been in effect since 2006.  There still would not be limits on the incentives that may be provided in a program that simply rewards participation, such as a program that pays for flu shots or reimburses the cost of a tobacco cessation program, regardless whether the employee actually quits smoking.  Programs that are results-based (which will be called "health-contingent wellness programs") still would need to meet several conditions, including a limit on the size of the available reward or penalty.  Beginning in 2014, the maximum reward/penalty would increase to 50 percent for tobacco nonuse/use and to 30 percent for other health-related standards.
Essential Health Benefits (EHBs) and Actuarial Value
The proposed rule confirms that nongrandfathered plans in the exchanges and the small-group market will be required to cover the 10 essential health benefits and provide a benefit expected to pay 60, 70, 80 or 90 percent of expected allowed claims.  The proposed rule also says that self-funded plans and those in the large employer market would not need to provide the 10 EHBs; instead, they would need to provide a benefit of at least 60 percent of expected allowed claims and provide coverage for certain core benefits.  The proposed rule would consider current year employer contributions to a health savings account (HSA) or a health reimbursement arrangement (HRA) as part of the benefit value calculation.
Market Reforms
The proposed rule confirms that nongrandfathered health insurers (whether operating through or outside of an exchange) would be prohibited from denying coverage to someone because of a pre-existing condition or other health factor.  The proposed rule also provides that premiums for policies in the exchanges and individual and small-group markets could only vary based upon age, tobacco use, geographic location, and family size and sets out details on how premiums could be calculated.
Important: These rules are still in the "proposed" stage, which means that there may be changes when the final rule is issued.  Employers should view the proposed rules as an indication of how plans will be regulated beginning in 2014, but need to understand that changes are entirely possible.

Most small businesses don’t offer health coverage

Source: www.benefitspro.com

By Kathryn Mayer

A new study finds only 49 percent of workers in small businesses with fewer than 50 employees were offered and eligible for health insurance through their employer in 2010, down from 58 percent in 2003.

Larger firms are much more likely to provide health benefits. About 90 percent of workers in firms with 100 or more employees were offered and eligible for health insurance in both 2003 and 2010, according to the report from the Commonwealth Fund.

Low-wage workers in small businesses were the least likely to be offered and eligible for coverage: Just one-third of workers making less than $15 an hour in small firms were both offered and eligible to enroll in their employer’s health plan, compared to 70 percent of small firm workers making over $15 an hour.

Report coauthor and Commonwealth Fund Vice President Sara Collins says the report “highlights a nearly decade-long trend of declining health insurance coverage and rising costs for workers in small businesses, particularly those who make less than $15 an hour.”

“As a result, many people who work for small businesses can’t afford the health care they need or have medical bills they are unable to pay,” she says.

About half small business employees (45 percent) reported trouble paying medical bills in 2010, and 46 percent reported that they skipped needed medical care because of cost, the report says. That’s about ten percent higher than those workers working in larger firms.

Small business workers were also more likely to be dissatisfied with their health insurance, with 29 percent rating it fair or poor, compared to 16 percent of those at larger businesses. They also don’t have as much choice when it comes to health plan options.

But Commonwealth researchers say health reform should help address and solve some of these problems by offering premium tax credits to certain small businesses and by granting subsidies to many uninsured workers toward their purchase of health insurance beginning in 2014.

“The Affordable Care Act should mitigate this trend by improving the affordability and comprehensiveness of health insurance both for small-business owners who want to offer health benefits and for workers in small businesses who can't get coverage through their jobs.”

The Commonwealth Fund is a nonpartisan research foundation that supports PPACA. Though they argue the law will help small businesses, opponents say the law will burden small businesses while raising taxes.


Most small businesses don’t offer health coverage

Source: www.benefitspro.com

By Kathryn Mayer

A new study finds only 49 percent of workers in small businesses with fewer than 50 employees were offered and eligible for health insurance through their employer in 2010, down from 58 percent in 2003.

Larger firms are much more likely to provide health benefits. About 90 percent of workers in firms with 100 or more employees were offered and eligible for health insurance in both 2003 and 2010, according to the report from the Commonwealth Fund.

Low-wage workers in small businesses were the least likely to be offered and eligible for coverage: Just one-third of workers making less than $15 an hour in small firms were both offered and eligible to enroll in their employer’s health plan, compared to 70 percent of small firm workers making over $15 an hour.

Report coauthor and Commonwealth Fund Vice President Sara Collins says the report “highlights a nearly decade-long trend of declining health insurance coverage and rising costs for workers in small businesses, particularly those who make less than $15 an hour.”

“As a result, many people who work for small businesses can’t afford the health care they need or have medical bills they are unable to pay,” she says.

About half small business employees (45 percent) reported trouble paying medical bills in 2010, and 46 percent reported that they skipped needed medical care because of cost, the report says. That’s about ten percent higher than those workers working in larger firms.

Small business workers were also more likely to be dissatisfied with their health insurance, with 29 percent rating it fair or poor, compared to 16 percent of those at larger businesses. They also don’t have as much choice when it comes to health plan options.

But Commonwealth researchers say health reform should help address and solve some of these problems by offering premium tax credits to certain small businesses and by granting subsidies to many uninsured workers toward their purchase of health insurance beginning in 2014.

“The Affordable Care Act should mitigate this trend by improving the affordability and comprehensiveness of health insurance both for small-business owners who want to offer health benefits and for workers in small businesses who can't get coverage through their jobs.”

The Commonwealth Fund is a nonpartisan research foundation that supports PPACA. Though they argue the law will help small businesses, opponents say the law will burden small businesses while raising taxes.