The Age Penalty in the GOP Health Bill: Will Seniors be Stuck with a Bigger Bill?

Group employment insurance expert weighs in

Many Americans are upset that older people are going to face a ‘age penalty’ under President Trump’s healthcare plan, but not everyone sees the situation as problematic. In fact, some experts think that it won’t be the unfair cost that Americans fear it will be.

Rob Wilson, President of Employco USA and group employment insurance expert says, “For many years, insurers have been able to charge older people higher premiums, as it is understood that they will generally have higher health costs and require more doctor’s visits. This reality has been folded into insurance costs for older people for a significant period of time, so President Trump’s so-called age penalty won’t be changing things too much. The only difference is that Obamacare only allowed insurers to charge older folks three times as much as they what they would charge other people for the same coverage, whereas President Trump’s plan allows for them to charge up to five times as much.”

Still, Wilson doesn’t believe that this means that millennials will be getting a free ride, as he explains that President Trump’s  “continuous health insurance coverage incentive” will hit younger people the hardest.

“Younger people are disproportionately likely to suffer a lapse in insurance coverage,” says Wilson. “And President Trump is asking that people who drop in and out of the insurance market be faced with penalties for doing so. This continuous coverage incentive applies to anyone who opts to go without insurance for longer than 63 days and then desires to resume coverage. The idea is that young people can’t cherry-pick when they want insurance, leaving older folks stuck with a hefty bill.”

For more on this topic, please contact Rob Wilson at rwilson@thewilsoncompanies.com.

The Truth About Health Insurance Penalty Within the American Health Care Act

Group health insurance expert weighs in

The American Health Care Act is President Trump’s answer to President Obama’s hotly-debated Affordable Care Act. While many political experts are excited about the new plan, others wonder if the proposed penalty is similar in nature to the dreaded Obamacare penalties, which many complained laid an undue financial hardship on those least able to foot the bill.

Rob Wilson, group health insurance expert and President of Employco USA, says, “President Trump’s plan is exciting for employers for many reasons, including the removal of the taxes, the mandate penalties and the subsidies that were a cornerstone of Obamacare. As for the new proposed penalty, it only applies to anyone who opts to go without insurance for longer than 63 days and then desires to resume coverage.”

The purpose of this penalty, Wilson explains, is to keep people from dropping in out and of the market. However, it also allows for healthy individuals to opt not to buy a healthcare plan if they so desire.

“Part of the problem with Obamacare was that it forced people to buy coverage even when they did not need it or use it,” says Wilson. “Under President Trump’s plan, people can opt to buy insurance only when they actually need it. Even if a person were to take a penalty for not buying insurance and retaining it, it would still amount to less under The American Health Care Act than Affordable Care Act, so Americans still save big.”

For more on this topic, please contact Rob Wilson at rwilson@thewilsoncompanies.com.

Rising Healthcare Costs

New Survey Reveals that Middle-Class Families Must Choose Healthcare Over Food, Clothes

risinghealthcarecosts_image

Healthcare trends expert discusses these disturbing findings

Recent numbers show that middle-class families have increased their spending on healthcare by 25 percent since 2007. As these expenditures have increased, families have tightened their belt in other areas—with spending dropping on essentials such as food and clothing.

“These numbers are very disturbing,” says Rob Wilson, President of Employco USA and healthcare trends expert. “The Affordable Care Act was supposed to offer healthcare savings for Americans across the board, but instead it seems that middle-class families have been the hardest hit by our unstable economy.”

Wilson says that many Americans are reporting that their premiums are now so high that they cannot afford to go to the doctor. “With Obamacare, Americans are now facing deductibles of $3,000 a year or more,” he says. “Meanwhile, other Americans are losing their insurance as companies are forced to shut down as a result of the Affordable Care Act—not to mention, the amount of jobs that are going to be lost due to these company shutdowns.”

Wilson continues, “The whole point of President Obama’s plan was so that people would not have to choose between a doctor’s visit and paying for groceries. But now, thanks to these high premiums, we are right back in that same situation.”

For more on this topic, please contact Rob Wilson at rwilson@thewilsoncompanies.com.

Confusion Runs Rampant as Millions Pay Obamacare Penalty

7.5 million Americans were required to pay a penalty last year due to not having health insurance. This is a higher number than the government predicted, and many worry it is a sign that the country is not prepared for Obamacare.

Rob Wilson, CEO of Employco USA, says “The Affordable Care Act is causing issues across the board. Not only did the IRS collect $1.5 billion dollars in penalty fees from hardworking Americans, but many people also were confused about filling about their tax forms. Taxpayers who paid a penalty to the IRS should have claimed an exemption on their tax forms, but thousands and thousands did not, simply because they were not informed. As a result, they overpaid the government on their taxes.”

Additionally, about five million Americans claimed no health insurance status on their forms, leaving the government struggling to find out how to categorize these folks. “We don’t know how millions of Americans in this country are able to pay for healthcare, or if they are receiving healthcare. It’s scary business.”

Why “Obamanomics” is Bad for Business

From new minimum wage rulings to proposed overtime changes to the Affordable Care Act, President Obama has made significant changes in the way companies in this country can do business. According to Rob Wilson, employment expert and CEO of Employco USA, “Obamanomics” could spell disaster for many employers.

“It started with Obamacare,” explains Wilson. “Since many companies couldn’t afford to offer their staff health insurance, they slashed employees’ hours and made them part-time instead of full-time, thereby forcing Americans to cobble together multiple part-time jobs in order to make ends meet. Now, companies face another issue: Overtime.”

Currently, the Obama administration is proposing changes to overtime regulations, changes which would offer more employees the chance to earn this extra income. However, not everyone thinks this is such a good plan.

Wilson says, “Economists don’t think the proposed plan is tenable in the long-term. Overtime wages are projected to be $1.3 billion. The FICA taxes associated with the OT wages alone is roughly $200 million (employer and employee combined). Plus, many people fear that employers will simply dump employees rather than face the prospect of paying multiple people overtime. Others will decrease their employees’ salaries in order not to lose money as a result of all the overtime they will have to pay. It’s a lose-lose for everyone.”

Supreme justice ruling on Same-Sex marriage may mean a loss of benefits for Domestic Partners

Friday’s ruling by the Supreme Court overturned all bans of Same-Sex marriage across the nation and afforded gay and lesbian spouses equal rights under both state and federal law. For many this is a victory of human rights and a landmark that will pave the way for further equality. It was only a few years ago when public sentiment was quite the opposite. 2012 marked the defining year when public opinion swayed in favor of gay and lesbian marriage and since then that favor has grown to a strong majority. ‘Gallup Gay & Lesbian Rights Statistical Poll – 1977-2015’

While it is clear that the majority of Americans are in favor of the ruling passed down, it is fair to say that the long term affects will be significant, especially for employers in states where gay marriage was banned previously. Employers in all states should take this time to review their handbooks and company policy and update any terminology around spousal relationships especially where it refers to employee benefits and legally protected rights such as FMLA.

It is still unclear as to how companies will handle the upcoming surge of spousal inclusions to their healthcare plans, whether some will offer early open enrollments, if the ruling from the Supreme Court will, in effect, create a “qualifying life event,” or if employers will simply allow for longer enrollment periods to sort out the changes. You can expect guidance from healthcare carriers to arrive soon.

Companies that adopted a domestic partner policy to their healthcare plans and corporate policy will most likely begin phasing those out over the next year. For most states, even where gay marriage was legal, companies were given the option of allowing a domestic partner clause onto their healthcare – essentially allowing individuals with long term live-in partners to gain health benefits. While the tax benefits were not the same as they were for married individuals, it afforded the employee the ability to give his or her partner coverage and allowed the employer to support their own personal beliefs without the concern of state legality.

As of the ruling on Friday, 5 states have ceased to offer civil unions and domestic partnerships* and that list is expected to grow. According to the 2010 census, 6.8 million households are unmarried, opposite-sex partners (5.9 percent of all households), compared with about 650,000 households with unmarried, same-sex partners (0.6 percent of all households). What does this mean? The vast majority of individuals receiving domestic partner benefits are opposite-sex couples.

This “curb-cut” effect (when an accommodation or law is passed to support one group of people but becomes beneficial to the population at large) will quickly become void for many individuals as employers and states move to discontinue benefits to unmarried domestic partnerships. Many rights were afforded the gay and lesbian population on Friday, but for those individuals taking advantage of the domestic partner/civil union benefits their employer provided, it may be time to look at a more formal and legal option to the relationship.

*Connecticut, Delaware, New Hampshire, Rhode Island and Vermont

Why Obamacare Means Americans Need 2 Jobs to Stay Afloat

Employment Expert Explains Why Obamacare Has Led To Job Losses And Slashed Hours

Under the Affordable Care Act, companies with 50 or more employees are required to provide health insurance to their staff if these employees work 30 hours or more a week.

Rob Wilson, President of Employco USA, says, “Since many companies cannot afford to provide health insurance for their staff, employers have instead opted to cut their employees’ hours so that they can limit their number of full-time staff and avoid costly health insurance plans. That means that many families will be forced to have working parents with not one but two jobs…and still no insurance!”

The bad new doesn’t end there, according to Wilson. As companies hunt for the most affordable plans and try to juggle all these new costs, something has to give.

Wilson explains, “To save money, employers might select an insurance plan that has higher out-of-pocket spending or even an insurance plan that does not place a cap on individual spending. This means that employees might now get stuck with a high-cost insurance plan for the next year, potentially spending thousands of dollars out-of-pocket on their healthcare.  Numerous organizations have already seen their out-of-pocket expenditures skyrocket, and everyone from college students to families have seen their healthcare costs become an expensive luxury…if not completely unaffordable.”

Obamacare Could Lead to Hefty Premium Increases in Illinois and Other States

Employment expert explains what Illinoisans can expect in 2016
Numerous health insurers are seeking approval for rate increases in 2016. Illinois will certainly be one of the states that are affected by these premium hikes. In fact, Blue Cross and Blue Shield of Illinois is asking for an average 29 percent increase for their plans. Pennsylvania, New Mexico, Tennessee, Maryland and Oregon will request similar increases.
Rob Wilson, CEO of Employco USA, says, “It is no wonder that so many health insurers are seeking rate increases. This is the major concern that people had when Obamacare was first introduced to the nation. The reality is that money doesn’t come from nowhere: Someone was going to have to pick up the tab for the millions of Americans who are newly insured under the Affordable Care Act, and sadly, that is going to be the American people.”
The new rates will not be approved and finalized until early October. “Currently, the new premiums are still up in the air,” says Wilson, “We don’t yet know how much rates will go up or which insurers will offer the most cost-affordable plans. November 15 is the date when people can begin to sign up for new plans, so after the rates are announced, people will have some time to research their options and discover if they can still afford their current plans.”
Wilson continues, “Unfortunately, these increases are exactly why people were strongly opposed to Obamacare from the beginning. It’s not fair that the average American now has to carry the tab for the mistakes made by millionaires on Capitol Hill.”

Reviewing Renewal Options

How to approach health benefits plans on a tight budget

Rob Wilson President Employco Group

Rob Wilson
President
Employco Group

The time to renew health benefits plans is upon many businesses. With all the cutbacks and troubling economic news employers have had to contend with lately, the option of varied benefits choices is a welcome one. The variety of plan structures and additional programs that exist allow employers and their employees to take greater control of a system where costs have historically been experiencing double-digit increases for some time now.

“When business owners face a health benefits renewal with an increase of 10 percent, even 20 percent, what can they do?” says Rob Wilson, president of Employco Group. “Neither the business owner nor the employees have discretionary dollars for that now.”

Smart Business asked Wilson about ways to lessen the impact of rising benefits costs by offering employees more choices.

How can business owners approach open enrollment season?

Employers can decide to absorb premium increases if they’re in the financial position to do so. If there’s absolutely no room in the budget for an increase in premium, they may consider passing it along to the employee. Another consideration may be to split the increase between the employer and employee so both parties can shoulder the burden.

Employers can also quote other insurance carriers. It is typical in the industry for carriers to have different sales strategies, depending on where they are in the business cycle. Premiums may be higher at certain times to increase revenue and lower at other times to obtain more market share. Since each carrier has its own approach, it may be possible to find the same coverage at lower premiums if you take the time to look. It is a good idea to compare rates with different carriers at least once a year.

What are different plan structures to consider?

It’s always beneficial to consider different plan structures whether you’re staying with the same carrier or switching. Do a comparison between a preferred provider organization (PPO) plan and a health maintenance organization (HMO) plan or consider offering both.

Conduct a thorough evaluation between plans in terms of co-pay, deductible, coinsurance, prescription drug card and pick the plan that’s best suited for your group and budget. You may be able to significantly reduce your premiums by increasing your deductible, co-pay, co-insurance and/or prescription drug card.

Keep in mind employers have the option to review their policies every year before renewal so changes are not permanent and may just be for the upcoming year.

Aside from the traditional PPO and HMO plans, are there other non-conventional options that can be considered?

The health savings account (HSA) is becoming more popular. It’s a high-deductible plan, so typically the premium would be lower. Other benefits of HSAs are:

  • Tax deductions when individuals contribute;
  • Tax-free withdraws for qualified medical expenses;
  • Portability — the account belongs to the individual.

Another option to help employees with health-related expenses is a flexible spending account (FSA). An FSA account allows employees to put away pretax dollars that can be applied toward employee-chosen medical expenses such as premiums, copays, deductibles, prescriptions, over-the-counter medicines or even day care.

For example, if your employees pay $500 toward health care premiums, deductibles, etc., using an FSA, they can use pretax dollars instead of after tax dollars. That equates to a tax savings of $178 for every $500 of premiums paid.

Are there options specifically for small businesses?

Small to midsize businesses may choose to look into industry associations or partnerships with human resource organizations (HRO). By joining an HRO, businesses that might otherwise be too small to obtain competitive pricing can now get the same buying power as bigger companies. When an employer joins an HRO and bands together with all the other companies comparable in size, the number of the group increases exponentially to hundreds or thousands of employees. The buying power now lies in the hands of a much bigger pool, which, to insurance carriers, is more attractive. The pricing may be more competitive through an HRO than on a stand-alone basis since the insurance is bought in volume at a reduced rate.

How should employers communicate with employees about plan changes?

Employers need to communicate honestly with their employees during open enrollment time, especially if there will be changes in the benefits plans. If, due to the decrease in revenue, the existing PPO plan has to be changed to a HMO plan or the deductible increased, reassure the staff that these changes may not be permanent.

For more on this topic, please contact Rob Wilson at rwilson@thewilsoncompanies.com.