The Daily Item, Sunbury, PA

April 29, 2013

Seminar prepares regional brokers for health insurance changes

By Robert Stoneback
The Danville News

DANVILLE — Forty-one insurance brokers from across the Susquehanna Valley region gathered at Pine Barn Inn for a seminar preparing them for next year’s healthcare changes brought about by the Affordable Healthcare Act.

The seminar was hosted by Geisinger Health Plan, with one of the main events being a presentation from Vince Phillips, a Harrisburg lobbyist who has represented several health insurance associations. Attendees came from nearby counties with other traveling from as far as Harrisburg, State College and Wilkes-Barre.

Phillips addressed several issues that employers will be facing when certain parts of the healthcare act trigger on Jan. 1, 2014.

“The employers are relatively clueless about how any of this stuff works,” he said in a conversation after the presentation. “They should look to a broker to talk them through how this will work,” as a broker’s job is to guide people through the maze of insurance law.

He suggested employers start reading email newsletters such as the Kaiser Family Foundation and Employee Benefit News, which compile headlines and articles from the health insurance field. Business owners need “to get their own information as to what’s going on,” said Phillips. “The more education they can get on this, the better.”

Points brought up by Phillips to the brokers were that employers with 50 or more full-time equivalent employees must offer coverage to 95 percent of their employees. If they do not at least offer the coverage, the employer will be fined $2000 for each of its full-time employees, with the first 30 exempted.

If an individual employee turns down the company policy, the employer is not affected so long as the insurance was offered. The employee could still be financially penalized for not later obtaining a health insurance plan through another provider, using a specialized insurance marketplace known as an exchange.

Employer-offered plans have to meet certain government regulations, said Phillips. For example, an employer with more than 50 full-time equivalent employees cannot force those employees to contribute more than 9.5 percent of their household income to the plan. Should an employer’s plan do so, they will have to pay a fine of $3000 for each employee that gets their insurance from an outside provider.

This, said Phillips, is one of the problems with the new legislation, in that there is no way for the government to tell if an employer’s provided plan meets regulations unless its employees go to an outside source. If employees aren’t aware of the requirements that an employer’s plan must meet, then there is no way to trace that back to the employer.

“They’re creating a huge governmental apparatus to implement this law. Its cumbersome, it’s complex, it’s mostly unintelligible and unfathomable for just plain people and businesses who want to meet their healthcare needs,” said Phillips, after his presentation.

He also questioned the bill’s effectiveness of using an unelected federal board, the United States Preventative Services Task Force, to determine whether certain preventative care procedures are medically appropriate or not, thereby dictating standards of coverage for insurance providers. Phillips said that while the group’s advice was not always wrong, he would rather have a medical group make the decision rather than Washington.

 

Email questions or comments to rstoneback@thedanvillenews.com.