Although most small businesses in Arizona aren’t dropping their healthcare insurance plans right now, some are thinking about doing it when the Obama administration’s Affordable Patient Care Act is fully implemented in 2014.
Meanwhile, many small business owners are also looking for new plans that will save them money, but may also slash benefits for their employees.
“We’re not seeing a dramatic drop in coverage as of today, but small businesses are asking a lot of questions about the health care reform act,” says Jeff Stelnik, senior vice president of strategy, sales and marketing for Blue Cross Blue Shield of Arizona, which has more small group customers than most other health insurers in the state.
“Companies with from two to 49 employees are also thinking about whether it makes sense for them to drop their coverage. Those with from 50 to 100 employees and beyond are less likely to do that.”
On one hand, the smallest companies — from two to 49 workers — are not required to provide insurance for their employees in 2014 and are not subject to any penalties. Those with 50 or more employees will face fines for failing to do so. So that in itself makes it easier for the smallest firms to cancel coverage.
Another incentive for small businesses to end insurance benefits is that many now offer plans with high deductibles, ranging from $3,000 to $5,000, and requiring “strong” co-payments. These types of plans don’t meet the minimum requirements under the Affordable Patient Care Act. That means that as of 2014, they must upgrade their plans at great expense in order to keep insuring employees. Although some federal tax subsidies will be available to help small companies, it is still expected to be costly for small businesses to provide more generous health benefits to employees.
But even though the smallest businesses are considering dropping health insurance, “they absolutely would like to keep it if they can,” Stelnik says.
“If small employers drop coverage, they will probably give employees a bump in pay — another $50 to $75 in their paychecks,” says Thomas Katsenes, president of Katsenes Insurance in Phoenix. “But that’s not going to help those employees much when they go out to buy health insurance.”
One of his clients, who owns several fast-food franchises, is considering canceling an insurance plan it has for managers; the business does not cover other employees. The franchise corporate office provides no health insurance. “Those businesses most affected are the ones with fewer employees,” Katsenes says.
The full impact of the health reform legislation may not hit until 2014, but some changes already phased in have helped raise current health insurance costs by 15 percent and more, according to Katsenes.
“They’ve already phased in the mandated no-cost wellness benefits (like free mammograms for women) and the unlimited lifetime maximum costs for the insured, and they’re requiring coverage up to age 26 for children,” he says. “All these changes translate into higher premiums.”
Another broker, Bob Padgett, president of the Padgett Insurance Agency in the Phoenix area, hasn’t seen any cancellations yet, but some of his clients are looking at plans with $10,000 deductibles as well as partially self-funded insurance plans.
“Some businesses are reducing coverage for their employees, passing more of the cost on to them or no longer offering coverage,” says Donna Davis, CEO of the Arizona Small Business Association, a group in which 85 percent of the membership has 100 or fewer employees.
“In a recent survey of our members, 74 percent indicated that the cost of healthcare was a significant challenge to the future of their businesses,” she says. “Most businesses have seen consistent year-over-year increases even before the Affordable Patient Care Act was enacted.”
Some employers are investigating defined benefit plans that allow six doctor visits per year and pay a limited amount per day for hospitalization, Katsenes says. “I may have a client who will be going for that soon. He has 15 employees to insure.
“It’s unknown what lies ahead for small businesses,” Katsenes adds. “So far we’ve dealt with about 900 pages of regulations and another 100,000 pages lie ahead.”