I have spent more than two decades in the healthcare and health insurance industry. I’ve seen a lot of changes. My years of experience tell me the health insurance industry has forever changed. Of recent, I find myself passionate about the topic of alternative benefits.
For many in 2020, the value of alternative benefits became the only solution I could offer for many small employers, individuals and families that lacked adequate Health Insurance Coverage opportunities.
Why? The marketplace dynamics have progressed where choice, access and affordability are at risk for many Americans!
In 2019, the Kaiser Family Foundation found that 35% of covered workers in small firms are in a plan where they must contribute more than one-half of the premium for family coverage, compared to 6% of covered workers in large firms. Reference: https://www.kff.org/report-section/ehbs-2019-summary-of-findings/
Additionally, Kaiser Family Foundation found the average annual premiums are $7,188 for single coverage and $20,576 for family coverage.
These were staggering numbers when I first read them, but the issues became palpable within the industry as renewals rolled out this year.
Choice. There are increasingly less Insurance products offered on the Healthcare.gov website for many States. There are some States that are now down to one ACA option.
Access. For small business, their employees and many gig workers, there is no other option offered, as any other non-ACA qualified plan has either Group restrictions or pre-existing condition limitations.
Affordability. If Choice and Access can be successfully navigated, the last and possibly most difficult reality is both the ACA and small group plans have become increasingly unaffordable for the average American household.
Those in large firms are fortunate as their employer still have negotiating power, even if more limited and costs increases that were dramatic. For some, the market has left them with very few options or a broker to help them sort out what few options are available.
As an advocate for improved solutions, I have joined organizations such as the Mid-America Coalition on Health Care in order to advocate specifically for small business owners and self-employed individuals.