Businesses seek ACA advice through forums

Overwhelming, confusing, cumbersome and uncertain are just a few adjectives businesspeople use to describe the federal Affordable Care Act.

“We can’t say what we are going to do,” said Julie Guillebeau, chief advancement officer at The Arc of the Ozarks. “We are still in the information-collecting mode.”

Also unsure of the legislation’s impact is Shannon Kittleman, director of payroll and employee benefits at Family Pharmacy.

“Health care is a pretty large expense, anyway, and I don’t see it getting any smaller,” she said.

The ACA has been law for more than three years, with the last installment of deadlines for many of the new or revised requirements on the horizon. For businesspeople trying to meander through the new or uncharted territory of health insurance under ACA, there are several avenues to find help.

Gulliebeau said she and many of her colleagues attended local seminars hosted by The Whitlock Co. – a local certified public accounting and consulting firm – and Kittleman also has attended seminars, luncheons and webinars hosted by a variety of health insurance brokers, agents and providers.

“With help from the seminars, it’s clicking. I’m no expert, but I know what the terms mean and generally what they’re talking about,” Kittleman said of the forums by insurance agencies and health insurance brokers.

Missouri Foundation for Health policy analyst Thomas McAuliffe, who hosted a March Cover Missouri forum in Springfield, advised businesspeople to seek information from nonpartisan group forums.

“Once people come and hear MFH speak, they say, ‘Oh, my gosh, that was nonpartisan, I learned so much; we should have another,’” McAuliffe said, adding a few dozen people turned out to the Springfield event, but he expects the St. Louis-based nonprofit philanthropic foundation with a mission to improve Missourians’ health to return to further educate people about ACA rules and regulations.

Additional advice
McAuliffe also noted the importance of insurance brokers, who know the day-to-day changes in the industry but might not offer a nonpartisan outlook.

Mark Speake, agency director for Infinity Group Solutions, an employee benefit and insurance agent education firm, said insurance agents might charge a consulting fee and have affiliations that influence their advice.

“Some feel compensated agents may lead people to the wrong company or coverage because of alliances to one company over another,” he said.

Health insurance brokers have an important role to fill as elements of the health care law go into effect, said Mary Timmel, Midwest outreach manager from Small Business Majority, an organization that advocates for small businesspeople’s interests in public policy.

“Most of the small groups are concerned they do not have as many options as large groups,” Speake said. “In fact, for the most part they do, they just have to find the broker who knows those options available to them.”

Speake said most insurance agencies, consulting firms and accounting companies host educational forums, which are typically free, and aren’t necessarily confined to the sponsoring organization’s clients.

Kittleman said informational timelines including what regulations are coming and what rules have been postponed, as well as definitions, such as that of a full-time employee, have been some of the most helpful tools provided at the forums.  

Employers’ concerns
Even while changes are coming into effect, many small businesses will continue to be exempt from providing health care insurance to employees.

Most small businesses won’t be affected by the 2014 requirement that businesses with more than 50 full-time employees offer health coverage, Timmel said, adding 96 percent of all small businesses have fewer than 50 full-time employees and coverage would be voluntary.

McAuliffe said the top concern he’s noticed among employers, and most notably small-business owners, pertains to insurance requirements and potential fines. Beyond those apprehensions, McAuliffe has noticed a concern for employees. He said employers are asking questions on behalf of their employees: “What if they can’t afford insurance, how will they get help? Will my employees be able to get subsidies?”

During an ACA presentation last week at the Springfield Metropolitan Bar Association monthly luncheon, University of Missouri law professor Joshua Hawley said seven challenges of the employer mandate are currently on file.

Health care subsidies for employees can be a double-edge sword for employers. While employers that don’t offer health insurance have the assurance that employees can receive subsidies to help pay for their out-of-pocket health insurance expenses, some of the same employers risk having to pay a fine if too many employees qualify for a subsidy.

For example, McAuliffe said an employee without employer-provided health insurance is eligible for a subsidy if that employee earns below 400 percent of the poverty level. If an employer with less than 50 employees doesn’t offer insurance and no employees qualify for a subsidy to help offset their out-of-pocket insurance costs, the employer won’t be fined, McAuliffe said.

Timmel said the health insurance marketplace is the most important part of the health care law for small businesses. However, only about 31 percent of small businesses are familiar with the exchanges, according to a Small Business Majority poll.

Details about the health insurance exchanges offered through the marketplace are currently muddled, McAuliffe noted, especially concerning how they will work within Missouri as the federal government is dotting the i’s and crossing the t’s about the program.

No insurance company has signed the dotted line to accept the risks with the health insurance exchanges, leading to uncertainty about the program, said Michael Greenlee, a health insurance adviser with Springfield-based Ollis & Co.

“Although the exchanges are set to be operational by October, we’re concerned about how functional they will be and when they will be ready for use,” he said.  

McAuliffe expects further clarification ahead of the October open-enrollment date, likely in August or September.