Presentation by Terry Gardiner Small Business Majority National Academy for State Health Policy February 16, 2011 Exchanges – Attracting Small Businesses
Jan 23, 2016
Presentation by Terry Gardiner
Small Business Majority
National Academy for State Health Policy
February 16, 2011
Exchanges – Attracting Small
Businesses
• Public policy advocacy organization – founded and run by small business owners
• National – based in Bay Area – with offices in Sacramento, Washington, DC and New York
• Research and advocacy on issues of top importance to small businesses (<100 employees) and the self-employed
• Very focused on healthcare over the past 3 years – top issue in all of our research
About Small Business Majority About Small Business Majority
SBM Exchange Model BillSBM Exchange Model Bill
• Built on foundation of NAIC Model Bill
• We conducted focus groups, listening tours and webinars to get small business owner feedback about exchanges
• We are active participants with other business and policy groups working on exchange designs
• Policy choices and additions based on our research that serve small businesses
SBM Model Bill: Lessons Learned
Utah Exchange 2010 80 Employers
Massachusetts Connector
2009 4,200 Employers
HealthPass, NY 1999 4,000 Employers
CBIA, CT 1995 6,000 Employers
PacAdvantage, CA 1993-2006 10,000 Employers
COSE, OH 1983 11,000 Employers
Federal Employees (FEHBP)
1960 8 Million People
We studied and interviewed representatives from exchanges to understand the successes, failures and lessons learned
• Only half of employers belong to a business group
• Trusted Advisors – their brokers, accountants, peers
• Communication – business press, business groups, trade groups
• Navigators need to be trusted messengers
Effective Outreach & EducationEffective Outreach & Education
• Purchase health coverage through the exchange
• Purchase health coverage in the outside market
• Maintain a “grandfathered” health plan
• Do not offer health coverage
Employer Health Coverage ChoicesEmployer Health Coverage Choices
Will the exchange offer “value” – lower price;
better coverage; better services?
• An independent exchange will create the greatest trust and support
• “Active purchaser” model can provide value for employers and employees
• “Employee choice” model is needed to differentiate from outside market and drive consumer choice and value
Trust, Value and Choice Trust, Value and Choice
Meeting the Needs of EmployersMeeting the Needs of Employers• 5.9 million employers with fewer than 100
employees employ 43 M nationallyo 80% (4.8 M) have fewer than 10 employeeso 54% (2.6 M) of employers with fewer than 10 employees
do not offer health coverage
• Most small businesses are very small and lack sophisticated HR departmentso Average employer in
Connecticut exchange has 8 employees
• All necessary information for employer and employees to make decisions on coverage
• One application
• One premium payment & detailed accounting
• One source for enrollment changes
Single Point of Entry for EmployersSingle Point of Entry for Employers
• Qualification and calculation of the small business tax credit; state programs
• Coverage of out-of-state employees
• Coordinating coverage of Medicare-eligible employees
• Provides additional “HR” services such as Cobra administration, Section 125 service, HSA/FSA/HRA
Full Array of ServicesFull Array of Services
• Recognize different role of brokers for individual and small group markets
• Brokers will have ongoing role with small business selling other products
• Initial launch and reception has proven critical for both employers and brokers
• Balancing broker compensation and services with competitive cost to employers will be challenging
• Successful models train and support brokers on ongoing basis
Brokers Working for Exchanges not Against
Brokers Working for Exchanges not Against
• Defined contribution option – NY, Utah & Montana
• Contributions by multiple employers for part-time workers – Utah
Other Measures to Attract BusinessOther Measures to Attract Business
• “Free choice” voucher
• Support of larger businesses
Frequently asked questions:http://smallbusinessmajority.org/hc-reform-faq
Small business healthcare reform summary:http://smallbusinessmajority.org/_docs/resources/
SBM_whats_in_it_for_small_biz.pdf
Small Business Resources Small Business Resources
For more information:
Terry GardinerNational Policy Director Email: [email protected]