Health insurance can be complicated. What type of coverage do you need? How will it be used? What deductible is right for you? How much will it all cost? What if something catastrophic happens?
Tough questions.
But now consider those questions and their answers for the 25 employees working in your thriving but still growing business? It gets tougher.
With the advent of the Affordable Care Act, it is required by law that business owners who employ more than 50 people must provide group health insurance coverage to their employees. In fact, employer sponsored health coverage is the most common health insurance in the U.S., covering an estimated 151 million people under age 65. Health care coverage through work is a common employee benefit and for many businesses is a key tool in recruiting top talent.
But what about the smaller, growing business? That’s where the cost-benefit analysis becomes even more crucial. And despite the benefits of offering health care to your employees, including recruitment, retention, and increased wellness leading to increased productivity, employee sponsored health care for the small business owner remains a challenge.
In fact, according to a recent study by the Kaiser Family Foundation, while 96% of businesses with 100 plus workers offering health benefits, only 50% of companies with 3-49 employees offered coverage this past year. That’s down from 59% in 2012 and 66% over a decade ago.
But here in Gainesville, that may be a different story.
“We are finding an increase in small businesses looking to offer employee health benefits due to the strong competitiveness for hiring and retaining talent in Gainesville,” says Dawn Moore, health insurance agent with local agency, Darr Schackow Insurance. But that certainly comes at a cost, both in time and bottom line.
“The health care industry is changing constantly, daily, in fact,” says Moore, “and keeping on top of that for a small business owner can just be overwhelming and costly.” That’s where working with an experienced agent is crucial, according to Moore.
“Many times, businesses offer costly insurance to their employees, that doesn’t even meet the needs of their workers.”
Agencies like Darr-Schackow work with businesses to poll employee usage of insurance and their needs as a whole.
“By getting employees involved in the process and understanding how individuals plan to use their health care benefits, we can more accurately and cost effectively meet the needs of both the employee and the employer,” adds Moore.
For example, Darr Schackow has seen an increase lately in the use of the Primary Care model for health care. According to Moore, it allows for unlimited access to primary care services which keeps the employee healthy, while offering a dramatic reduction in premium costs to the employer.
Gainesville-based Celebrate Primary Care has offered members a direct relationship with their personal health care provider since March 2015. The membership-based group eliminates the insurance process completely, meaning no more copays.
According to Celebrate co-owner Lisa Magary, DNP, ARNP, “Eighty percent of insurance claims in health care happen in primary care. By removing insurance, we are able to reduce costs while retaining excellent care.”
And reduced cost is not the only benefit of direct primary care, says Magary, “Through direct contact with a medical provider, patients no longer have to wait for an appointment and more time can be spent on care.”
With a maximum of 600 patients per practitioner, Celebrate Primary Care offers members access to care via phone, text, email and video conferencing even when the patient is traveling. In-person appointments are set within a day of their request.
Membership also allows access to generic medications at a discounted price, an onsite pharmacy and many common lab services as additional conveniences.
“The Primary Care model is not an alternative to traditional health insurance but an enhancement,” says Moore, “and still offers an overall savings to the business owner.”
And Magary agrees, “We work with 77 small businesses in the Gainesville area and many pair our services with a higher deductible insurance plan or health care sharing should the need for a specialist, surgery or hospitalization be required.”
Options certainly exist for the small business owner who wants to care for his or her employees. However, understanding the needs of employees now and anticipating their future needs is crucial in providing high quality yet cost-effective health care benefits for the growing business.
By Kathryn Pizzurro
