Ignorance will not be bliss come October when state and federal exchanges begin enrollment for individuals and small group employees. While brokers are experiencing anxiety about their role in such exchanges, employees of all types may be confused about their options — thus providing brokers the chance to come to the rescue with targeted communication on the subject.
“Most employees don’t think [health reform] impacts them yet,” says Mike Thompson at PricewaterhouseCoopers’ human resource services. But, when more information begins to come out on public exchanges, “employees are very likely to be very confused,” he adds. “It’s one of the reasons that HHS deferred employers communicating about the exchanges to their employees.”
Jim Blaney, CEO, human capital practice, Willis North America, says employees are concerned about costs the Patient Protection and Affordable Care Act might pass on them, and how exactly PPACA’s exchanges will affect them. “I get the feeling that employees might start to think that their employer will just throw them out on the exchanges for coverage,” he says. “That will bring around a whole set of communications opportunities for the broker and the employer.”
According to a Kaiser Family Foundation analysis in fall 2009, about 2% of uninsured people could purchase health insurance through a workplace plan, but simply chose not to do so. These same employees are likely to have questions about exchange eligibility come this fall, and turn to their HR department (and broker) for answers. For example, according to a Lake Research and Enroll America survey compiled last fall, 78% of all uninsured were not aware that they may qualify for subsidies and will have coverage options in 2014.
“There's a lot of need for targeted education by state, versus federal campaigns,” says Mollyann Brodie, director of public opinion and media research at Kaiser Family Foundation.
The Department of Health and Human Services in late January launched Health Insurance Marketplace, a website and marketing campaign designed to educate people about exchange open enrollment. According to HHS spokesman Fabien Levy, the agency is targeting both uninsured and insured people through email and text message updates, as well as social media conversations on Twitter, Facebook, Tumblr and YouTube. He points out that the Congressional Budget Office predicts that 9 million Americans will obtain coverage through the exchanges in 2014.
State organizations vary drastically in the level of education and tools provided to residents. Some of the most active states so far are Maryland and California. Both have informational websites dedicated to their respective exchanges. Willis’ Blaney says confusion for employees will likely increase when more states begin their awareness campaigns.
There is also a need for education in the small business market, says Sarah Dash, a researcher at Georgetown University’s Center on Health Insurance Reforms. “The vast majority of small businesses won’t be affected — but think they might,” she says. “Something like 96% won’t have to do anything as a result of the law.”
With so much still undetermined, and many more HHS regulations and communications to come, Kaiser’s Brodie says moving forward with an education campaign is more important than ever. “If we wait until the public is perfectly informed” on the details of PPACA, she says, “we’ll be waiting forever.”
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6 Comments
Posted by: ocampoch | February 6, 2013 3:55 PM
David, the Exchanges will be open to all individuals - not just ones meeting certain income requirements. Subsidies within the Exchanges will be available to everyone meeting certain income requirements regardless of whether or not their employer offers them sufficient and affordable coverage.
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Posted by: ocampoch | February 6, 2013 3:53 PM
David, the Exchanges will be open to all individuals - not just ones meeting certain income requirements. Subsidies will be available to anyone meeting the income requirements regardless of whether or not the coverage offered by their employer is sufficient or affordable.
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Posted by: MARTI | February 5, 2013 9:27 PM
rI am an independent life/health agent, 23 yrs experience, previously licensed Series 6/63, Variable Products to include Mutual Funds, Property & Casualty, Life and Health. I began on the Debit Distribution, for those who might not know, you met the client at their kitchen table, face to face. My clients turned away door bell ringers and phone callers while I was in their presence, saying "can't talk now, my insurance agent is here." I am required to carry errors and omissions insurance, but I choose to carry $3 million aggragate. My value to any prospect during the ACA selection process, whether an individual employee or a Small Business Employer, is far greater than any contractor Navigator at a Call Center, or a face-to-face In-Person advocate. I must be self educated on this ACA, searching the internet to read these articles and snippets in HHS announcements to the press. Sunday about midnight, I stumbled upon the Glossary of Terms for the Federal Exchanges, in a few days I shall have new Scrabble words. Now, I am not going to be negative here. I am trying to find a way to work with what is before my prospects. Yes, they are mine, because I worrk in rural KY, among people who have known me for over 40 yr; admitting now to being 64 yrs old, plan to work another 6 yrs or longer. In existing Part D Drug Card, I forego commissions and use the www.medicare.gov website so my friends can see all 31 drug cards in our zip code, apply for SSAExtra Help, send those suspected of eligibility back to Comm Based Svcs, assist calls to Medicare and Social Sec. Now if that sounds like an advocate, then I am, but guess I am an independent advocate 16 weeks a yr. During all this honest advocacy, and no commission, 450 Medicare Supplements went on my book of business over the past 4 yrs; good deeds are rewarded. Agents might see their Individual and Small Group Markets eroding or being stolen from them...I say this...Ins Co's must have their products certified, agents must be certified to be on this Health Ins MarketPlace...so agents embrace it, work with it. To HR, Plan Admin, agents are not your enemy, we are your neighbors in you community. To HHS, 80,000 applicants out of 342,000 targeted during PCIP is not a success; if you want ACA to be purposeful you will find a way to embrace licensed agents and make PCPACA a success. We can forget this infield fighting and get on with it.
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Posted by: David M | February 4, 2013 5:33 PM
Dear Employee: As your public employee Navigator who works 9 to 4 I can help you with your decisions.1. If your employer offers you affordable coverage for Self Only that meets essential benefits. You are not eligible for a subsidy within the exchange. 2. Dependents, they are not eligible for coverage in the exchange either. 3. But that is ok, because the IRS just ruled you will not have to pay a penalty for not obtaining coverage for spouse and dependents. 4. If your employer does not offer coverage, you can go to the exchange and get coverage if you meet Income requirements. SO make sure you do not get a raise or take any incentives that might kick you out of the exchange subsidy.Finally, Good Luck
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Posted by: David W | February 4, 2013 2:26 PM
Sarah Dash is sadly mistaken with her 96% statement. Most small employers will see changes of one sort or another. Rate increases for employers with "good claims" will be significant. Those small employers with HSA plans with deductibles in excess of $2000 will see cost increases because of the buy up in coverage. As a matter of fact this provision makes embedded deductibles illegal. Those that are receiving tax credits for offering coverage in the private market will be required to buy in an exchange. Essential benefit sets will cause additional cost increases along with significant additional taxes. I could go on for days on this subject but I think I have made my point. When writing an article make sure you speak to someone who knows the market and the unintended consequences.
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Posted by: Jason M | February 4, 2013 2:17 PM
Great, so the employees will have more questions about PPACA and the exchanges. I would be glad to help them, oh yeah I forgot, no one has told us what we will get paid. If the government plans to compensate us like they did for PCIP plan than they can find some uninformed non-profit with no liability coverage to tell them which plans to choose. Now we know how terrible the subsidy will be and what a 70% actuarial value Silver plan is, those eligible for the subsidy will not be able to afford their contribution, let alone pay that much premium for a terrible plan. This so-called health reform is going to go down in flames.
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