MANDATORY HEALTH CARE IN 30 STATES!
Mandatory health care is changing the health care benefits world!

Going where no state has gone before, Massachusetts explores new frontiers in health care.  Mandatory healthcare will change the dynamics of our business.  Everything from plan design to product offerings to how you buy coverage.  And speaking about buying coverage…

Group Insurance for $295/Month…NO WAY!  THE COSTS WILL BE MUCH, MUCH MORE!         

This is the price at which Massachusetts has capped the cost an employer will be charged or fined for each employee unless they provide health insurance. 

The more you read the law, the more complicated the details are.  First of all, where does the $295 come from?  It comes from some maximum expected cost to provide this “coverage.”  So far Massachusetts hasn’t determined what this coverage is or how much it will cost. 

Here’s the important point.  It’s not a maximum of $295.  Get this…an employer can be charged up to $295 if their employees have claims under $50,000.  If the employees’ claims at that employer exceed $50,000, the employer can be charged between 10-100% (also not decided) of these claims!  Wow!  Wow!  Wow!

When I say the details of the plan are detailed and complicated, we don’t actually mean this in a bad way.  Like all legislation, it takes a great deal of effort to understand the intended and unintended results as they try to cover loopholes, and provide benefits on an equitable basis.  The cost for the benefits will depend upon on what percentage of the poverty level you are at as well as many, many other factors.

Other questions that still need to be answered for employers:

• I'm an employee with coverage, what now do I do with my family?  Is this the next step where employers are charge for the family expenses as well?
• Can I find coverages that match their minimum requirements for under $295/month?  Corporate Synergies believes you can!
•  What kind of reporting will you be required to give to the state?
•  When you have employees in MA and even though you don’t have a location there, your employees fall under this mandate and, therefore, you do as well!
• How are you going to administer all this on every state that comes up with this program has different regulations and details?  Corporate Synergies is there to help.  We’re developing programs to quantify and administer all these new compliance and finance-related obligations.
• Self-funded/Erisa plans generally avoid this type of state stuff?  Do self-funded plans escape this obligation?  Absolutely not.  These are employee residence mandates not employer insurance regulations.

Here’s the new Million Dollar Question: 

Do you know what the CONNECTOR is?  No, it’s not a Super Hero from the Justice League. 

It is the Commonwealth Health Insurance Connector, a newly-created government agency in the Commonwealth of Massachusetts as a key element in their new mandatory health insurance program.  This organization is mandated, at its discretion, to find, develop and restrict products for all size employers and employees to purchase individual and new group insurance programs. 

Essentially it makes it easy for an employer to allow employees to get a wide variety of choices of health insurance products.  The employer doesn’t have to go out and find 50 different individual and group insurance products.  The employer doesn’t have to administer the billing for 50 different products and to allow employers to offer this as a new assortment of benefit coverages to their employees. 

There are precedents to this in New York and in California.  In New York they were set up by the State for small groups and in California by private coalitions.  The idea is to allow individuals who can’t or don’t participate in employer plans to get access on a tax deductible basis and payroll deduction basis for their employer. 

Interestingly, in Massachusetts Section 125 plans are mandatory for all employers with over 10 employees!  The commendable goal of this program is to create a better market so that individuals can purchase individual coverages using the free market system versus state-created and managed plans. 

Actuaries expect this program to increase the individual market by 25%.  Will it work?  Not for 3-5 years.  Is 25% good enough?  Absolutely not!  The goal really needs to be 200-300% more competition in the individual market.  Will the consolidator be the solution?  Maybe, eventually.  It’s probably an impractical but great idea.  What it does do is it lays the foundations to fail, to learn from and to be improved upon for a system that might actually work some day to provide affordable, private sector, universal health.

Corporate Synergies.  1-866-CSG-1719