Health Care Broker Says “Send Your Employees Out On Their Own”

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With over 50 full-time equivalent employees, Trish Appleby, the owner of Donatelli’s restaurant in White Bear Lake, Minnesota, knew she wouldn’t be able to use the Small Business Health Options Program to offer health insurance to them.

And she knew many of the provisions of the ACA might not necessarily benefit her workers.

Still, she said, she was told by her health care benefits broker he was sure there would be some positive impact for her and her employees when all was said and done.

“We currently pay 75% of our employee’s premiums and 50% of their family premiums and we’ve done this for years,” Appleby told Minnesota Public Radio. “It’s a big part of our culture. It’s who Donatelli’s is. It’s very disheartening to be told ‘don’t do that any more. Send ‘em out on their own.’”

Appleby said she understands that she has some older employees with health problems, and that as a group, they probably rate as “pretty unhealthy.”

Still, she was dismayed when their health care renewal rate came in with premiums well over 10% higher, yet accompanied by 10% less coverage.

“We are being encouraged to stop our group health coverage and send our employees out to the market themselves.”

One expert who was also on the program I listened to, said the hike in premiums, combined with a reduction in coverage, would have happened with or without the ACA. That the ACA is really having no impact on her business at all right now. It’s just the way health care coverage is going.

But he also conceded he recognized for employers like Donatelli’s there is “a point of principle,” and health care is getting in the way of what the company stands for.“I asked the benefits broker if I could simply give my employees money for them to go out on their own, but that’s really a gray area right now,” continued Appleby. “Pre-tax, post-tax, trying to avoid discrimination. No one is giving me the answers that I need.”

Appleby told the radio program host she hadn’t yet spoken with any of her employees about her conundrum. She doesn’t quite know how to broach the subject after learning under her current employee health care plan their annual out of pocket exposure would max out at $12,700 for a family.

“That is astronomical. They can’t afford that. Why even have health coverage?”


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