The Patient Protection and Affordable Care Act, often called the Affordable Care Act or just Obamacare, represents one of the most far-reaching government overhauls of the U.S. healthcare system since 1965 when Medicare and Medicaid came into being. It will be phased in over time, with the majority of the changes taking effect in 2014.
The act focuses on increasing the rate of health insurance coverage for Americans and reducing health care costs. Here’s what some area businesses have on their minds about health care reform as the time nears for the full impact of the ACA:
- Steve Brubaker, chief of staff, InfoCision Management Corp.
- Craig Shular, chairman and CEO, GrafTech International
- Alan P. Jacubenta, president and CEO, Mango Bay Internet
- Rick Hull, president and CEO, Premier Bank & Trust
- Chuck Abraham, executive vice president/CFO, Hitchcock Fleming & Associates Inc.
- Rick Solon, president and CEO, Clark Reliance Corp.
- Andy Zynga, CEO, NineSigma Inc.
- Jodi Berg, president and CEO, Vita-Mix Corp.
1) How is your company preparing for changes associated with health care reform?
Brubaker
- With more than 4,000 employees, education is key and our priority is to make sure we provide everyone with the knowledge they need to make informed decisions. There are a lot of changes on the horizon and it’s important we communicate these changes in a timely manner. We are doing this though our internal communication channels such as our employee newsletter, employee intranet and face-to-face meetings.
Shular
- GrafTech has always provided an excellent health care plan to its team members. We are well-positioned to comply with the PPACA. Our plan is affordable for our employees; therefore, no one will be eligible for government subsidies and GrafTech will not be assessed a penalty.
Jacubenta
- We are in constant contact with our benefits agent whom we have worked with for a number of years and have been very pleased with his knowledge and service. He attends all the latest classes and seminars available to keep us apprised of the latest laws. He will let us know what’s changing with the different carriers and how it might have an impact on our current and future coverage.
Hull
- Most importantly, we are making sure we stay educated on the changes. It is important that we are able to answer our employees’ questions and also be supportive of their needs. Our budgeting process is robust, and we spend a lot of time in this area making sure we are making the right choices for our employees and our company.
Abraham
- For more than three years, we have been learning about the requirements since the ACA was passed in March 2010. We will review our current plan design with our benefits consultants this summer. At that time, we will assess any changes that may be required for our 2014 renewal, including the possibility of adding a high-deductible option to our current plan.
Solon
- Our preparation for health care reform has consisted of our human resources staff reviewing the law with our health care providers and consultants. In addition, our legal counsel has reviewed our existing health insurance programs to insure compliance.
Zynga
- We are working closely with our brokers, Oswald Cos., for frequent and regular updates regarding health care reform and the related steps of adoption. Oswald advises us of both milestones and compliance requirements so we can plan for and execute on each. Staying informed is most of the battle for us right now as we ramp up toward 2014.
Berg
- We have been educating ourselves regarding the elements of the law through articles, seminars and benefits affiliations. We offer a fairly comprehensive health plan to our employees today and are constantly monitoring the progress, changes and evolution of what is available in the insurance marketplace. So far we do not believe that the changes will have a large financial impact on Vitamix.
2) What are you doing specifically to contain health care costs for your employees?
Brubaker
- As a self-insured employer, we’ve always placed a high value on providing our employees with comprehensive health and wellness programs. Reducing our claims is a priority by ensuring our employees have convenient tools like on-site wellness clinics and fitness facilities to promote healthy decisions, and decrease employer out-of-pocket expenses. Where many companies are cutting back on amenities, we embrace the concept as a driver of employee engagement.
Shular
- GraFit is a company-sponsored wellness program that includes free biometric screenings and incentives to make healthy lifestyle choices.
We offer employees the opportunity to purchase fresh produce from a local vendor who delivers to our site every week.
Our leadership team helps shoulder the burden of health care costs too. Mid-level managers each pay an additional $150 per month for health insurance; senior-level executives pay an additional $200 per month.
Jacubenta
- Every year, we go through a process to get health care quotes from different providers. We compare their offerings in order to get the best coverage for the best price. If a change is warranted and it is cost effective, we do it with the least amount of coverage change as possible. The current provider usually matches what we were able to find through quotes, decreasing the overall increase in price.
Hull
We have opted to continue to pay a larger portion of the overall cost rather than pass that on to the employees. In addition, we shop our benefits annually to make sure we are receiving the best possible coverage at the lowest cost possible. We continue to search for new tools to add to our offering that will allow the employees to have all the benefits they need. We also have a wellness program that is aimed at preventive care.
Abraham
- Even though not required to at the time, our plan implemented coverage for Essential Health Benefits (basic preventive/wellness services), elimination of pre-existing condition exclusions, and an expanded definition of dependent. Additionally, we have tried to raise “wellness” awareness through a number of efforts: encouraging participation in the Heart Walk and other types of exercise, administering “weight-loss challenge” initiatives and sponsoring yoga and meditation classes at the agency. We also discuss regularly with our associates the importance of wellness, use of network providers, requesting generic drugs when available and proper use of urgent care facilities — in short, being wise consumers of health care.
Solon
- We started several years ago to educate our employees on the types of activities and choices that drive health care costs. We utilize our health care providers and consultants to propose innovative programs to help us control costs, and we have gone to a wellness program to promote individual health care improvement.
Zynga
- We have a high-deductible HRA plan in place. We have taken the deductibles up to $5,000/$10,000 for premium reduction. We cost-share the premium with employees — the company pays 75 percent and the employees pay 25 percent of the premium. Further, within the high-deductible plan, we set a sub-deductible of $500/$1,000 for each employee, after which the company reimburses 80 percent of claims until the plan deductibles are met. It may sound complicated, but it’s kept us in the top quartile when compared to our peers for affordability of our plan to employees. We are also in the early phases of a wellness program, which we expect over time will help control/reduce cost increases. The biggest motivation for us to have such a plan is simply to provide resources that keep our employees feeling as healthy and energetic as they can, which we hope translates into more fulfillment while at work.
Berg
- We take a Total Wellness Approach to our employee benefit plans. We were early adopters of an outcome-based medical benefits coverage that encouraged positive healthy behavioral changes among our employees. Through a combination of biometrics, education, fitness programs, and financial incentives driven by wellness promotion, we will experience the benefit in overall reduced health care costs for the long term. We started a tobacco-free campus in 2012, and do not hire tobacco users. Vitamix still pays 100 percent of its employee medical premium; however, we have implemented a high deductible plan that employees can reduce to zero if they meet the criteria for modified NIH biometrics targets. For example, an employee who meets all target range biometrics for blood pressure, cholesterol, body mass index and smoking, along with participating in health education, training, or regular physical exercise, will incur no deductible for the year.
3) Do you foresee having employees pay a larger share of company-offered health care coverage?
Brubaker
- We’ve always taken a strategic approach to employee health and wellness. What that looks like right now is adapting our offerings to not only comply with the new requirements, but also to provide our employees with coverage that meets their family’s individual needs. We continue to monitor and will comply with all of the reform’s expanded coverage choices so we can provide our employees with effective and affordable options.
Shular
- That is not our current intention, but we will continue to monitor and evaluate if a change in the cost share model is required. Over the last 10 years, we have managed our program to an annual average inflation rate of 3.7 percent. This compares favorably to the national average of 6.3 percent over the same period. Our concern is that elements of PPACA do not lower insurance costs, but in fact cause the rates to go up.
Jacubenta
- Things are unpredictable other than we know that there is a good chance that prices will continue to skyrocket. If we had to, we would ask our employees to pay a share of the expense for health coverage. It depends on what happens in the beginning of 2014 with community rates and what they offer versus staying with private insurance and the cost to the company.
Hull
- Not at this time. Our goal is to allow our employees continued benefits while keeping them affordable to the employee.
Abraham
- Our goal would be to minimize having employees pay a larger share. Since we are in a service industry that relies heavily on high-caliber talent, our benefits plan is one of several tools used for recruitment and retention. Our goal would be to continue to make the health benefits as affordable and attractive as possible to our employees.
Solon
- We have always believed that paying a substantial portion of the health insurance premiums is helpful to recruiting the best people. We do not contemplate increasing the percentage that our employees pay.
Zynga
- We pride ourselves with trying to have a healthcare plan in place that is affordable yet quality coverage for our people. While I think it is too soon to draw a line in the sand about the cost sharing, I can say that philosophically we are opposed to increasing the burden on our employees.
Berg
- We do not foresee this happening in the future; however, until the full impact of the ACA is discovered, we will reserve our opinion on the matter. Some pundits say it will definitely increase overall costs, while others say more competition will reduce costs long term. We are unsure what our health care insurers will do; however, our focus will continue to be on what we can control, and for now that is our wellness offerings and employee incentives toward better health.
