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  • Emma Wilson

Navigating Healthcare Reform as an Employer

Updated: Mar 9, 2022

What is your best bet in a highly regulated but ever changing Healthcare Marketplace?




As an employer you're already dealing with so many day to day decisions that trying to keep up with the latest healthcare reform proposals and what that means for you as a business owner can almost be an impossible task. Health insurance alone can be difficult to understand, and when regulations around health insurance are in a constant debate as they have been over the last decade, it is all the more difficult. To ignore the latest regulations and proposed changes however is not an investment in your business since many of these regulations are linked to tax breaks that employers rely on to continue offering benefits to their employees. Do you know the shelf life of the coverage you have benefited to your employees? By now you understand the importance of offering these benefits to your employees, but have you forecasted if you can continue to do so if regulations change? I will break down the most significant proposals to our current health care reform as it relates to employers and how Jeremy Carter, as a broker, will be your best ally no matter what changes may come down the aisle.


There is a large push for a one payer system in the US and it has already started on the state level in CA and NY where bills have been proposed to move to a one payer system but were rejected in recent votes. As much as I'd like to think they were rejected due to the nature of a one payer system, unfortunately I believe a major factor in their rejection is the lack of articulated funding practices --- this part of a bill can always be amended and resubmitted, so if we stay on this political path, those bills will eventually be financially critiqued and then passed. On the opposite end of the spectrum, those who advocate for small businesses have found that the biggest hurdle for small businesses in the healthcare market is not their inability to offer these benefits, but in the time and expense it requires to maintain the logistics of a compliant employer based on today's healthcare regulations. Thus, they are also (indirectly) moving towards a one payer system in an effort to alleviate employer burdens, but we all know this comes at the risk of losing top talent due to no benefits. Unfortunately, employers are finding themselves having to spend a lot of time advocating their compliance or paying an attorney to do so, if an employee chooses to go to the Marketplace in lieu of enrolling in coverage with their employer. The repercussions on an individual forgoing an employer plan to enroll in the Marketplace are minimal in comparison to what is imposed on the employer if found to have not offered coverage. Keep in mind that 98% of the time, the employee chose to go to the Marketplace however the burden of proof (and expense) falls on the employer. Even if all fines are waived, the time and effort it requires to prove compliance is increasingly proving to be more of a burden than many employers are willing to carry if healthcare reform continues down this road.


While we are not political experts here at Carter Health Insurance, we are helpers, and advisors and truly go to battle for each of our clients to ensure they have the best coverage available to them. We cannot tell you what the next 3 years of healthcare reform have in store for us only that there will always be hurdles to jump through and we're here to help get you over those hurdles.


The reality is, Employer Based Health Coverage was created in an effort to allow business owners to increase an employee's wage whilst not being taxed on the increase. This has for decades allotted for responsible business owners to attract better talent and ensure success of their business for years to come. Successful small businesses create successful communities and that is what we advocate for here at Carter Health Insurance.


So if we don't have the winning bet for the next healthcare reform bill to be passed, how can we help you navigate this uncertain territory? There in lies the beauty of being a broker. We have access to all private and marketplace plans and we work directly with individuals to find the plan that best meets their needs and their lifestyle. What does that mean for you and your healthcare compliance? That means that we will work with every member of your team to find them individual coverage, whether that is a private plan or marketplace plan and we document everything along the way so there's no gap should the compliance come into question. We help your team members that choose to go with the Marketplace to complete their paperwork appropriately so your business is protected. There is no guess work from you, the employer, and after we meet with your team members, all documentation is provided to you. We offer all types of plans, including Marketplace and we document each policy as we go for your records. It's as simple as that.


No, we can't predict the next hurdle lawmakers may throw at small business owners, Carter Health Insurance can help you get the best individual coverage possible for your employees. By continuing to offer employee health coverage, you will stand out to you industry's top talent, against other businesses that may choose to fold on offering benefits in light of compliance fatigue, We also ensure that your compliance is documented appropriately along the way since we handle each policy on an individual basis, so you never have to worry about losing time and money in the future to prove you're in compliance.


So while we wait to see what is next in US Healthcare Reform, feel free to reach out to us directly with any questions you may have regarding our services. We also offer free consultations and review of your current coverage. No obligation, reach out anytime. We look forward to hearing from you!

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