Ben Cole

Stone Industry Consultant

The United States health care system has been going through a major overhaul and you need to do your homework and make sure that your healthcare plan is the right fit for your company.      

The new Health Care Market Place, which was created and backed by the federal government to compete against private health insurers, presents an entirely new aspect to healthcare that needs to be studied and understood. There is also a third party, state provided healthcare or charity care, which you should also explore for the sake of your employees and the welfare of the company. 

The New Affordable Care Act is the new law that led to the creation of the Health Care Market Place (www.healthcare.gov) where it is now possible to find and buy healthcare insurance directly through the government.  Although this new market place is fairly easy to navigate, it has taken what was already one of my least favorite tasks of managing our company healthcare, and made it even more complex. 

For my company, the beginning of September is our renewal date for our healthcare plan. This year my provider informed me that our previous healthcare plan was no longer available and gave me a list of new options that were offered. 

As it has been for every year that I can remember, the new plans cost more while offering less coverage and have higher deductibles. Fed up with the endlessly increasing costs, I decided to explore all the new and old options that are available.  

My first stop was going to check out the newly created and government sponsored Health Care Market Place. I wanted to see if it made more sense to pay our employees the money we were paying for our current premiums so that they could purchase healthcare through the government on their own. This option does eliminate a lot of complexities including allowing the employee to decide on how much or how little coverage they would opt to pay for. 

However, there are two important factors to consider. The first consideration: do you know if your company is eligible for tax credits if you pay for your employee’s health insurance through a private insurer? Eligibility for the tax credit mainly depends on the average salary of all of the employees in the company. 

The second factor to be considered is the cost to the employee. The government does offer tax breaks to the employee who is buying their coverage through the government, but the tax break depends on their income level. The employee is also being taxed on their personal income prior to paying for health insurance. These factors need to be weighed, as what is best for each individual or company can be different when these factors are figured and calculated. 

The next area that I began to explore was the state sponsored charity care. I had known very little about this form of insurance as it was something that never crossed my mind. In the past we covered most of our long tenured employees and there was typically a waiting period for newer employees before they would be eligible for healthcare. I have to admit I never looked into or counseled employees to see how or if they had coverage. 

For these employees, most of who are not the highest paid, state-backed charity care (it often has different names in different states) can be a great option for a low cost or free healthcare coverage. More information about state-backed insurance can easily be found by searching the internet.  

It also pays to study and ensure that your employees also review many of the changes that the new laws have enacted. Just a few of the new changes are: low cost or free preventative care; the addition of dental coverage–this varies from plan to plan but most now have some basic dental coverage; now, people with preexisting conditions can no longer be denied by their insurance companies; young adults up to the age of 26 can be kept on their parents health insurance plan; and many more changes that could effect you and your team members. 

Also worth noting, depending on your company’s plan, there is a good chance that the deductible for the plan has increased. Again, making employees aware about possible increases is important so that they can properly budget for these added expenses.

Health insurance as we know it is changing and evolving. Whether you agree with the changes or not, something needed to be done to try and control the year over year double-digit percentage increases in healthcare costs. And as if you needed something else on your plate, you now need to study and educate yourself on the changes being made so that you can properly care for the health of your employees and your company! 

Ben Cole grew up in the stone industry working in his family’s shop and currently manages a family-owned fabrication shop in southern New Jersey.