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Small businesses at center of healthcare debate

Posted by Jason Keith  April 3, 2012 08:30 AM

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It's been nearly impossible to ignore the topic of healthcare over the past two weeks.

With the Supreme Court hearing arguments on the Patient Protection and Affordable Care Act, everyone in the country is waiting to hear whether or not they will be required to purchase health insurance in the future. Small businesses are not excluded from this, and in some instances have been at the center of the debate. Many will be affected by the legislation if it's allowed to push forward as written, as well as if it's repealed. Part of the anxiety small businesses are feeling about the legislation is based on uncertainty of what's inside of it, and specifically how it will effect them.

There are a few things to keep in mind about the new healthcare law, which wouldn't even "kick in" until 2014 even if unheld. The first is that it doesn't affect those that employ less than 50 people - a huge number of small businesses in the United States. If you fall into this category it's your choice to offer health insurance or not, without penalty. The second is that even if you have more than 50 employees, the first 30 are exempt. The fine if over 50 employees but not offering health coverage is $2,000 per employee, so theoretically the cost to your business could be less than actually offering health insurance. Depending on the plan and who is covered, premiums for small businesses could be in the tens of thousands.

The good news is, it appears small businesses are or will be providing health coverage for employees regardless. According to a the Small Employer Health Insurance Survey released by eHealth last week, 60% of businesses still said they would offer coverage to workers if the law were to remain intact. Nearly all of the respondents (95%) said affordability is one of their two most important factors when choosing a plan to offer.

A further 44% cited a ?moral obligation? to offer coverage to employees, but the majority (79%) said they spend $200 or more a month per insured employee. Morality aside, many small businesses looking to grow and hire talent often have to offer health insurance as a benefit. If they don't, competitors will. It's important that all small business owners keep up with the outcome of this case and educate themselves on healthcare overall. In this case the knowledge will be powerful, especially if a business plans to continue to grow and recruit talent.

But assuming a small business is least considering offering a health insurance plan, the question becomes: what are the basic steps to take? As with any major business decision, it involves research, planning and tenacity over time to ensure that the best plan and the best deal is being offered and taken advantage of. Here are some tips on how to get started:

Conduct an "internal audit" first:
"The research (small businesses) should do is more internal," said Michael J. DeFelice, an independent financial advisor with the firm Lee, Nolan, and Koroghlian, LLC in New York. "Answer questions for themselves such as how often do we go to the doctor, what sort of pre-existing conditions do we have, what sort of budget can we assign to a plan or package of benefits and do any of the employees have benefits currently (you can?t have two health insurances working at the same time)? Most times brokers will ask for a census which is a record of the employees? names, birthdays, incomes, marital and family statuses.

Research and find a good broker to work with:
"Finding a top-notch broker/consultant is the most important step in deploying a successful benefits program," said Ron Filice, President & CEO of Filice Insurance Agency. "A broker will facilitate a thorough plan review, ensure plan compliance, educate employees, help navigate the implementation process and support the ongoing needs of the organization. These services are crucial, particularly since many small businesses do not have dedicated and experienced HR personnel."

Hold a plan review annually:
"Small businesses should review their health insurance plans with their brokers and make adjustments every year," Defelice continued. "Look for if the health insurance company has increased the premium or made changes to the plan because of a renewal period which is dictated in the insurance contract. They should also look if the health insurance company can decrease their premium due to any changes in their business in the last year."

Other alternatives:
Traditional brokers and insurance firms aren't the only option for small businesses. For example, many local Chambers of Commerce offer healthcare programs to its members. "Many Chambers, such as ours, offer affordable health insurance for small businesses," said Jill Harrison of the Greater Oklahoma Chamber of Commerce. "Ours is called "Chamber Choice" and is through Blue Cross Blue Shield. It is available for companies with 2 - 50 employees. It doesn't require medical underwriting and offers PPO or HMO coverage." Other companies, such as Intuit, offer products like a health care debit card, designed to help small business owners and their employees pay for care. So it's worth exploring some of them if you don't want to go the "traditional" route.

Do you currently offer health insurance to your small business employees? What advice would you give a small business owner looking to offer a plan in 2012?


This blog is not written or edited by or the Boston Globe.
The author is solely responsible for the content.

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About this blog

Jason Keith has been working for and with small businesses in the New England area for more than 10 years, specifically small, micro businesses. Born and raised in Massachusetts and a former journalist, he provides a unique perspective on the issues facing small businesses locally and nationally.To reach him directly email

This is a personal blog. The opinions expressed here are the author's alone.

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