Under the Affordable Care Act, we have seen many health insurance agencies turn away from servicing small groups in favor of those with more participants. This has left a hole in the marketplace for small groups looking for a personalized touch when it comes to their staff and ongoing benefits programs. At Axiom, we believe it’s more important than ever to provide benefits service to groups of all sizes.
Though the reasons have been debated, the fact is more and more carriers are leaving the individual marketplaces. In many states, there are few, if any, carriers willing to sell guaranteed issue products on the exchanges for individual coverage.
This trend comes as more small employers have moved away from providing coverage to employees in favor of increased wages—reasoning that employees can now purchase coverage on the individual markets regardless of pre-existing conditions, limits, and other situations that used to make securing individual coverage more difficult. This may have been acceptable strategy five years ago. But employers who made choices based on that premise should take a fresh look at the individual market landscape.
What has been overlooked is that carriers are generally for-profit organizations with shareholders and boards of directors to answer to. From the carrier perspective, the individual marketplaces are far underperforming the group marketplaces. In fact, many carriers have experienced massive losses offering guaranteed issue products on the individual marketplace exchanges. Whether because healthy people aren’t participating, or because a simple miscalculation has occurred, carriers are turning their backs. The choices left for individuals seeking coverage through the marketplaces are shrinking.
So what does this mean for your business? If you have been counting on exchanges to provide insurance coverage options for your employees, it may be time to rethink that strategy. Are your employees being squeezed for more of their post-tax dollars and getting plans that are hard to use, expensive, and often misunderstood? It’s worth your time to find out.
We’re now seeing employers with fewer than 50 employees, who dropped healthcare or who moved to marketplace aggregator-type systems, coming back to look at group plans for their staff members. The group markets still have several decent carrier options and offer full networks of hospitals and doctors.
The good news is that it’s very easy to secure quotes under ACA that no longer require collection of health data on employees. All that a business under 50 employees needs is a basic census and an agent willing to spend time servicing small groups. If you are with a payroll provider who is set up to provide this service or who is licensed to provide such support, you will likely not need to do much of anything to analyze the numbers.
If you have any questions or concerns regarding the strategy or process involved, please do not hesitate to reach out to Axiom Human Resource Services directly.