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What Business Owners Need to Know about Healthcare Reform


For anyone who has been following the news (and most people who haven’t been following the news as well), it shouldn’t be much of a surprise to hear that healthcare is a hot button issue. Love it or hate it, the Affordable Care Act (ACA) has been around for a while. Though it significantly differs from what it was originally, it hasn’t gone away, and it doesn’t look like it’s going to be going away anytime soon. Business owners should especially take note of this, considering that large portions of the ACA are devoted to dictating who gets health insurance and what employers have to do about it.

It seems like every couple of years around election time, whether it’s the Presidency, the Senate, or the House, one of the key talking points is what’s happening with healthcare. Either the ACA is going to “stay forever” or “be repealed and replaced” or simply “be repealed.” It always comes up and it’s never quite clear exactly what might happen.

Recently, for example, the individual mandate has been repealed as part of a tax plan put forth by Republicans. What does this mean? Well, for employers, it doesn’t mean a whole lot. However, it is a large step forward in terms of what could affect employers in the future. After all, the individual mandate isn’t the only mandate in the ACA. The other one is the employer mandate, which is an issue that comes up time and time again. As it currently stands, if an employer doesn’t offer a health plan that provides a minimum amount of coverage for its full-time employees, it is subject to a large penalty per employee, over a minimum number of thirty employees. While Democrats are currently opposed to a change, Republicans are pushing for it.

Now come the questions. You are a business owner, so consider some of the following:

  • Without an adequate view of the ROI of your healthcare plans, how can you make a good decision regarding which plans to go with?

  • Do you know enough about the current regulations to understand what plans your employees need to have in order to avoid fines or other regulatory penalties?

  • What kind of plan do you need to have in order to satisfy your employees needs, the current regulations, and attract new talent in a competitive marketplace?

  • Have you ever considered a self-funded plan? Do you even know what a self-funded plan is?

  • What are your current costs and how much are they increasing each year?

For many employers, the answers to some (or all) of these questions are difficult to arrive at due to the simple fact that it’s next to impossible for the average person to figure this out themselves. Worse, since everything is continuously in flux, it can be a full-time job simply keeping up with what regulations and requirements may be changing. Business owners can be sure of one thing, however; not understanding quite what is expected of them in terms of providing healthcare won’t be a valid excuse should the government come knocking at their door asking why they aren’t following regulations properly. Here are a few things every business owner should know right now: The Small Business Health Options Program (SHOP) has been established for employers with fifty full-time equivalent employees or fewer who also wish to provide health coverage.  For the most part, SHOP programs are the only way for small businesses to qualify for tax credits in order to lower the costs of their premiums.  Regardless of whether they provide health insurance, employers have to provide information about the healthcare marketplace to their employees.  If you are going to offer health insurance, it has to be done within ninety days of an employee’s start date.  Employers have to provide employees with a Summary of Benefits and Coverage form which outlines what their health plan costs and what it covers. There are incentives built into the ACA to establish wellness programs for the workplace. This list is by no means exhaustive. In fact, the things on the list may change by the time of publication. If there is one constant in the healthcare landscape, it is change. Unfortunately for business owners, that can be frustrating and leave them confused as to their options.  So that is the story that brings us to today. What does it all mean? Where do you go from here as a business owner with all of this information? Good questions. Not only are they good questions, but unfortunately they are questions which don’t have solid or concrete answers right now. Healthcare has become a hot button issue, politically speaking, and until it cools down some, the entire idea of a stable system is something of a pipe dream. Understanding the changes to healthcare requires more time and commitment than you, as a business owner, probably have to devote to it. That’s why seeking out professional help to navigate your options in the current climate is the best course of action.

To begin reviewing your company healthcare options and start saving money, contact Steve Strege at 952-746-4365 or sstrege@nesbitagencies.com.

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© 2020 by Ross Nesbit Agencies