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N.H. small businesses frustrated, confused, hesitant about Affordable Care Act

Last modified: 3/30/2014 11:45:26 PM
Today’s the day! March 31, the red-letter day, the deadline for enrolling in a health insurance plan through the Affordable Care Act.

Except, for a huge segment of the country, it’s not.

Yes, individuals without employer-sponsored coverage were supposed to secure health insurance by today. And businesses with more than 50 employees who don’t provide health insurance after today face a penalty of up to $2,000 per worker.

But only about 4 percent of American companies employ more than 50 workers.

For the other 96 percent of American businesses?

Things are a bit different. There are more options, an indefinite enrollment period, and there’s work being done locally to help business owners sort it all out.

Last Wednesday, about 50 business owners gathered for breakfast at the Red Blazer for an event sponsored by CoveringNewHampshire and the Greater Concord Chamber of Commerce.

Bill Davis, an insurance broker and partner in Manchester-based Truncellito and Davis Financial Services, answered questions.

“How much will coverage for my employees cost, on average?” one person asked. That depends on a lot of factors, but mostly their ages, Davis said.

“What happens if I fall on Main Street and break my hip, if Concord Hospital isn’t on my network?” asked another. No matter what network your insurance plan uses, emergency care is always covered as if you were at home, Davis said.

“Is there a penalty for my business if my employee doesn’t take the coverage I offer?” asked a third. No, as long as at least 75 percent of the employees take it. And if you have fewer than 25 employees, you have no obligation to offer coverage at all, Davis said.

“The 30,000-foot-view is interesting,” he said afterward, “but we’re really at the point of, ‘How does it affect me?’ ”

When Jean Fiske opened TLC Medical Daycare for Adults on the Heights 16 years ago, she had exactly one employee – herself.

She had health insurance through her husband’s job, and still does.

And even though her business has grown to employ about 12 people full time, the company can’t offer health insurance on the thin margins of Medicaid payments.

“I looked, a while ago, and it was just way too much to afford,” Fiske said.

She attended the chamber’s roundtable discussion to find out whether the tax credits being offered might help her in the future, and to get more information about encouraging her employees without insurance to sign up before today passes.

Fiske, and several business leaders at the event, said they are nervous about signing up for insurance through a marketplace that doesn’t include their local hospital.

This year, Anthem Blue Cross Blue Shield is the only company selling plans on the marketplace where businesses and individuals can access tax credits to defray the cost of coverage.

To keep costs low, Anthem said, the network for those plans excludes Concord Hospital and nine other of the state’s 26 hospitals.

Darragh Madden owns Hopkinton-based Irish Electric, just 2 or 3 miles from Concord Hospital.

He’s been meeting with his 17 employees regularly, keeping them up to date about their health insurance. For now, he has extended their Anthem policy off the exchange, forgoing tax credits in favor of access to their local doctors, including the one who delivered his own two children.

He had been getting an Affordable Care Act tax credit toward the cost of coverage for the past two years because then he had more than 25 employees; and because most of them are licensed electricians, they make on average more than $50,000 a year.

He used last year’s tax credit to cover the increase in this year’s health insurance premiums and to start matching contributions to his employees’ retirement plans, he said.

“I feel like one of the lucky ones, because I’ve been able to keep growing despite the downturn,” Madden said. “But I’m bracing for an increase again, and I’m getting frustration from employees. Their wages are staying stagnant because what would go to wages is going to the insurance.”

He expects to renew the current insurance plans on his September anniversary with Anthem, and wait to see what other businesses do with the marketplace and whether any of the regulations change.

“I’d just like them to figure out what direction they’re going in. It seems like it’s being made up as it goes along and they keep changing things,” he said.

Businesses have had several changes to the law to adapt to in the past year.

One week before the marketplace’s scheduled Oct. 1 opening, federal officials announced it wouldn’t be ready for online small-business applications; pushing it back to November. In February, the mandate that employers of between 50 and 99 employees offer insurance was delayed until 2016. In March, businesses were told they could keep their existing health plans, even if they didn’t meet new standards, at least for this year.

Tim Sink, president of the Greater Concord Chamber of Commerce, said he’s been hearing the response to all those changes. “The impression I’m getting is people are very frustrated because of the changes in rules and deadlines and the difficulty in getting answers to basic questions – ‘What is the deadline for me? What fines or penalties could I be assessed?’ It’s a moving target, and it’s frustrating,” he said.

The chamber offers health insurance to its five full-time employees, and Sink said he considered seeing whether the marketplace plans could save the organization money but decided the benefit of keeping access to the local hospital was worth it for at least this year.

“We have that luxury, and we know not everyone is in that same boat,” he said.

“This may be a benefit to businesses, in the long run,” he said, then added, “When the bugs get worked out. But for now, it’s, ‘Let’s see what happens.’ ”


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