New Health Insurance Bill (HR 1628) Has Issues

Everyone has heard that the House passed some form of a health care repeal bill (HR 1628). Here is more stuff surrounding this bill to consider.

1. The Senate has already said that if they pass a bill, it will be different than the House version. Some have even hinted that they'd start with a fresh page and then build up a bill from there.

2. It will be difficult to have all 52 Republicans agree to vote in the Senate for any bill. If they lose just 2 votes, the bill is DOA.

3. Insurers have until June 21st to say whether they will be in or out of the exchanges. With so much up in the air, don't be surprised if there are several areas of the country that won't have any insurers participating (areas in TN and IA are the most at risk at this point in time). But if there is just one carrier, they can set whatever rates they choose. Welcome back to monopolies. Note that one part of a Senate bill may be to allow subsidies from carriers outside of the exchange, but that doesn't mean that insurance companies would want to take those subsidies.

4. The bill that passed harms medicaid recipients most, those with pre-existing conditions second. Having friends with special needs children agonize over this has been painful. My cousin, Fran Cannon Slayton spoke about her fears in a New York Times article this week as being a cancer survivor. https://www.nytimes.com/2017/05/02/health/obamacare-patients-preexisting-conditions.html?hpw&rref=health&action=click&pgtype=Homepage&module=well-region&region=bottom-well&WT.nav=bottom-well&_r=0

5. What needs to be fixed is the underlying problem. The COST of healthcare is too much. The QUALITY of healthcare is questionable (my estimate is that 40% of the studies that doctors rely on to indicate what care to give are either falsified, cannot be replicated, or do not actually apply to the population they are applying them to). If you read all of the problems with studies and what the academic world is doing to fix this, you'll see what I mean. My family has been the recipient of BAD healthcare as recently as 6 weeks ago (luckily we got a second opinion). It is out there, it is prevalent, it needs to be fixed.

Many Business Owners Overpaying for Health Insurance by 40% - 60% (Small Business)

Written by Peg Reid.

Robert Slayton, of Robert Slayton & Associates, Naperville, reports, “My small business clients regularly report premium savings of 40-60%.”  For the same or better plan.  With additional savings and benefits to the business.

How do I save 40% - 60% on my Health Insurance Premiums?

His small business owner clients opened up a group health insurance plan.

Along with the lower premiums, small employee groups enjoy more choices, better choices and broader networks. 

If You’ve Ever Run Into one of these Problems? The Solution is Simple.

• ·         My employee said she would have to resign so she could get a job with health benefits.
• ·         I make too much to get a subsidy so my premiums are outrageous.
• ·         My employee would prefer to work for me full-time (and I’d love to have him) but he has to keep his other job because it offers a health plan.
• ·         My personal premiums are more than my mortgage payment!
• ·         My wife can’t see her doctor at Northwestern without being in an HMO (we want a PPO) with a PCP out of Winfield or St Charles.  We live in the city, a few blocks from Northwestern!
• ·         My twenty years of mammogram films are at Rush and now I have to go to someone who doesn’t know my history.

Can’t See Your Doctor? Can’t Go to the Hospital of Your Choice?

Were you frustrated that you couldn’t get access to the providers you wanted?  Small group PPO options include hospital systems such as Northwestern Medicine and NorthShore University Health System not widely available in the individual market or in the case of Rush University Medical Center, not at all. 

I Thought I Couldn’t Qualify?

The old rules around plan sponsorship which had caused small business owners to reject the idea out of hand have become more accommodating.   Participation requirements have largely been eliminated; businesses with as few as one employee are eligible with certain carriers, even if only the owner opts into the plan.  In a few cases, businesses with no employees can qualify to open a plan.  And the contribution requirement (which varies by carrier) is often dwarfed by the small business owner’s personal savings, savings to the business and gain in competitive advantage.  Corporation, S-Corp, LLC or sole proprietor can all be eligible.

Slayton himself was on an individual family health insurance plan paying $880/month.  His renewal was $1543/month - over $600/month more for the same coverage.  He opened a small group health insurance plan for his business covering only his family (his two employees aren't eligible as part-timers but even if they were, they would have waived group coverage as they have their own coverage) and the new cost was $839/month – less than his 2016 cost!  If he had wanted the larger network that included all of the doctors and hospitals, it would have been $1100/month, still significantly less than his current plan renewal.

I Thought I could only sign up during open enrollment?

You can start a group health plan at any time during the year.  You and your employees can drop your current plan if the group plan makes more sense.  The best part is that when you are looking for quality hires, you will be on a more level playing field with larger companies when it comes to recruitment and retention.   If you start your plan May 1^st, your rates are fixed until May of next year.  If you decide not to renew the plan next year, you will qualify for a special enrollment to return to individual coverage.

Contact Peg Reid at peg@slaytonins.com, 630-779-1144 x103, for a worksheet to estimate your savings. If Peg is out of the office, contact Robert Slayton at x101