Many questions await health care implementation

May 27, 2013


By Art Edelstein, Correspondent

Green Mountain Care, the state-mandated health care program that will affect businesses with less that 50 employees when implemented in 2014, has many in the business community confused and apprehensive about what the new law means for their companies.

“It’s confusion wrapped up in mystery,” asserts George Malek, who heads the Central Vermont Chamber of Commerce.

“There is a lot of competing advice out there,” agreed Don Mayer, the owner of Small Dog Electronics, an Apple products distributor in Waitsfield, Rutland, and South Burlington. His company has more than 50 employees so the Green Mountain Care program does not affect it. He is also a member of the Governor’s Business Advisory Council on Health Care Finance. However, he said, he has a keen ear for what business owners are going through as they try to understand how the law will affect them. Since the law essentially provides health care exchanges, he feels insurance brokers “would prefer that employers not go through the exchanges. That could be the brokers’ last gasp, they could be out of a job.”

“Our concern is we won’t know the details until we have to sign up people and the rates come out in October and November,” said Lilli Cain, the CFO of the 48- employee Capitol Plaza Hotel and Conference Center in Montpelier.

She worries about how late it will be before the new rates are announced, shortly before the program takes effect in the new year, and how well the company will be able to advise their workers about the new health care options before them and the choices they’ll need to make. “We won’t have enough time to inform our staff about the benefits in a short time, ” said Cain.

“We haven’t been able to grasp the whole concept,” admitted Debbie Richer at L&D Safety Markings in Berlin, a highway marking company. L&D employs 55 people, but not all of them are year-round workers. And to complicate matters, 18 of those employees are from other states.

“It’s confusing,” she explained. “Do you know anything that government is involved in isn’t confusing?”

“We have a lot of questions. Some key pieces of data are not known yet and that’s frustrating,” said Lee Lauber with the Family Center of Washington County, a nonprofit with a budget of $2.4 million and 60 employees — 39 of them full-time. “What are going to be the rates?”

“The biggest issue is: what it will cost us, will it cost more?” asks Floyd Dickinson, the chief operating officer at Barry T. Chouinard Inc. in Northfield. With 43 employees this fabric dying company is looking for many answers. “Will we have the same type of coverages? (As its current insurance plan has.) “Who do we go to when we do have problems? If we have issues with the insurance without having a broker, like we have now? How much will Green Mountain Care side with the employer if you have problems with claims? Who helps you out trying to get (it) resolved? Who’s going to help the employer when there are problems?” Dickinson asks.

The signing of H.202, the legislation that led to the creation of Green Mountain Care, has been described as “a state-funded-and-managed insurance pool that would provide near-universal coverage to residents with the expectation that it would reduce health care spending.”

Under the new laws next year, small businesses with 50 employees or fewer will use Vermont Health Connect to find coverage. In 2016, small businesses with 100 or fewer employees will be able to offer coverage for their employees through Vermont Health Connect.

Small businesses with 25 or fewer employees who currently offer health coverage may already qualify for a federal tax credit. A business with 50 employees or fewer deciding not to offer coverage to its employees will not be subject to a federal penalty as employees will be able to purchase a plan through Vermont Health Connect as an individual or family. Starting in 2014, there will be a federal penalty for large employers (more than 50 employees) that do not provide what is termed “affordable” health coverage.

“The most common comment is ‘I don’t know about offering or dropping insurance — people can’t figure it out,’” said Malek.

“We are seven months away and nobody is clear what will happen, and next to wages the second most expensive item on an expense sheet is health care,” he explained. Since costs for Green Mountain Care are not defined yet, he says businesses are apprehensive as they try to decide if they should carry insurance or allow their employees to obtain it through the new marketplace. Many businesses, he said, do not yet know what is best for them and their employees “And when it’s hard to calculate, that is scary and your most important item is your people, and when you could get them angry that is not good.”

“There is no good outcome, no ideal way to do it, only the lesser of not goods,” says Malek.

“The biggest thing I’m hearing is confusion on whether a company should drop coverage and give the money they would have spent to employees to buy their own,” said Mayer. “The rates in health care exchanges are means-based,” he explained. “Lower-waged employees may quality for substantial subsidies through exchanges and overall costs to employee may be less.”

To learn more about Green Mountain Care and what is the best implementation strategy, companies are relying on the state and their current insurance agents. “The state is starting to have meetings as well as our agent,” said Cain, who will continue using her agent for information.

“I’ll probably go to my industry associations, the state chamber, and Associated General Contractors,” said Richer. “I just don’t know enough about it to know what to do. I do know I can’t afford more costs with all the other increases such as the gas tax.”

“I really have a lot of homework to do,” she admitted.

“We have participated in a Blue Cross Blue Shield webinar,” said Lauber. She’s also using the state website and attending small business seminars to familiarize herself with the new law.

As she sees it, “The information is extremely complex.” Lauber is depending on the state, her current insurance carrier, and the soon-to-be-in-place “navigators” the state is hiring “to help us sort out the decisions.”