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2014 In Review
The world of healthcare is ever changing, especially across Utah. From the governor’s proposed Healthy Utah plan to new ideas on population health management, industry experts have a lot to keep an eye on in the coming months and years. Our panel also discusses the pros and cons of the Affordable Care Act, consumer engagement when it comes to insurance, and how technology is changing healthcare.
We’d like to give a special thank you to Dave Gessel, executive vice president at the Utah Hospital Association, for moderating the event.
We are in the throes of the second year of open enrollment for health insurance under the Affordable Care Act and the federal/state exchanges. What trends do you see in this new world?
HUTCHINGS: The only concern I have with private exchanges and the whole push toward choice is that are we ignoring cost again. When rates go up and when you have multiple options, those carriers don’t have any idea what risk they are going to get. If an employer has a defined contribution, then what happens when the rate goes up? Who gets the cost? The employees? As we are looking two and three years down the road with the exchanges, those increases are much higher than our individual companies are experiencing. That’s something we have to balance. If we are all about choice, sometimes we do that at the sacrifice of cost.
CONNER: We were all surprised last year when healthcare.gov had such a failure when they launched in October, and it took a long time to recover from that. What we are hearing from Health and Human Services and CMS is it’s going to be better this year, but it’s not going to be significantly better. They are saying they have fixed some of the technology problems, but they aren’t promising the world, and hoping that people will be patient when they go through the process of doing their insurance.
We are still seeing a lot of businesses, large and small, trying to figure out what their role is. What is it they have to report on as far as the mandate goes? Do they have the right plan designs and the affordability of those plans for the employees? I bet all the consultants in the room can say they are still doing a lot of conversation with their clients on how to direct them to 2015 and how to handle the reporting.
BENNETT: What we are seeing, especially for mid-size employers, is they have consciously made the decision that benefits are here to stay and that’s part of our culture. They are looking for more decision tools, whether that is software, private exchanges, resources or education tools. They want to start involving their employees in the decision process rather than the employer pushing things to the employees—to have the employees be stakeholders through education tools.
BRAUN: Large employers don’t know what they are supposed to report. There’s four or five different ways to count employees. Depending on what piece you are reporting on, you count them differently. That’s got to be fixed. As far as where we sit, clearly the public exchange and Avenue H are all options for us, as is the traditional large employer/small employer insurance. Even that definition gets blurred in a year. People that were large employers now become small employers. There’s so much uncertainty still.
CONNER: Most of the businesses that decided to continue to do group benefits are the higher income, more professional-type businesses. Their employees really wouldn’t get an advantage of the tax subsidies through the healthcare.gov site. They are also the ones competing for talent, and they want to do what they can to attract and retain that talent.
BENNETT: Because of healthcare.gov’s failure, more employees fear going out to the marketplace. They are now putting a higher value on their benefits. You hear people for the first time saying, “I love my insurance company.” Because of that, a tech company that’s got a low employment pool will absolutely have a top-tier benefits package, and they’ll use that from a recruiting standpoint. Somebody in the service industry may be saying, “The economics just don’t make sense for us to continue to offer benefits.” You are really getting a division among employers—those that value benefits and are going to continue to beef those up, and those that are going to look to the federal marketplace to offer their employees benefits.