presentation by terry gardiner small business majority national academy for state health policy
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Exchanges – Attracting Small Businesses. Presentation by Terry Gardiner Small Business Majority National Academy for State Health Policy February 16, 2011. About Small Business Majority. Public policy advocacy organization – founded and run by small business owners - PowerPoint PPT PresentationTRANSCRIPT
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Presentation by Terry Gardiner
Small Business Majority
National Academy for State Health Policy
February 16, 2011
Exchanges – Attracting Small
Businesses
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• 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
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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
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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
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• 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
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• 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?
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• 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
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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
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• 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
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• 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
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• 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
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• 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
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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]