Significantly Reduce Your Healthcare Cost: An Update
MCAA Association Health Plan
By John Storto
We understand the challenges that many of our members face in providing cost-effective health insurance to employees. To help our members navigate these struggles, the MCAA has partnered with Assurance, one of the premier insurance brokerages in the country, to develop an Association Health Plan (AHP). This plan provides a solution to the high costs of healthcare for small to mid-sized businesses and is exclusive to MCAA members.
Association Health PlansOver the past several years many employers have struggled with the cost of providing health insurance for both their employees and themselves. Recent healthcare reform held the promise of reduced costs as well as expanded access.
Ironically, the final result for employers with 2 – 50 employees was actually the opposite: costs went up exponentially and the plan design options became more limited. While it’s true that insurance companies could no longer set their premiums based on employee’s answers to medical questions, the average cost of premiums increased so much that many employers struggled to provide coverage at an affordable cost to their employees. In addition to the restrictions on underwriting based on the health of the group, there were additional requirements in the 2-50 life market segment that added cost to the plans (requirements that are not in the 50 plus market segment). As a result of these restrictions and requirements, it is believed that costs in the 2-50 size market can be as much as 15%-20% more expensive than a similar plan in the 50+ market segment.
The current administration’s answer to this dilemma was to introduce new competition into the health insurance space by allowing (in limited circumstances) the development of Association Health Plans (AHPs). In one sense, AHPs are not new – business associations have been able to offer common health insurance benefits to their members for decades. However, under the previous rules there were significant restrictions and, unfortunately, substantial opportunity for fraud on behalf of the association. This new rule addressed many of those issues to strengthen AHPs. It also allows insurance carriers to treat a 2-50 employee group that joins the association to be treated like a group that has 50 or more employees (and benefit from lower rates).
Association Health Plans have many benefits for groups of people with a common interest in addition to financial savings. By banding together in a national plan, small employers can use their combined membership to negotiate better terms with insurance carriers. AHPs also allow small employers to gain access to large group plan designs and doctor networks while avoiding pitfalls that add costs to small group medical plans.
Medical Coverage with UnitedHealthcareWe are excited to announce that the MCAA Association Health Plan will be live starting January 1, 2019. This is the first national association being rolled out by UHC since the Trump administration issued the new Association Health Plan regulations. Because MCAA has been in existence since the 1950s, we qualified under the “old” rules and are able to price each employer group independently from each other. This has enabled most of our members to obtain competitive plans and rates regardless of where they are geographically in the country and the make-up of their population. We also believe this will enable us to maintain competitively priced plans well into the future.
The program allows employers to choose the plan design that is the right fit for their employees, with 40 plan design offerings available. All plans utilize United Healthcare’s (UHC’s) largest network, Choice Plus, which gives members access to a one of the largest national networks available, as well as the choice of out-of-network coverage. Employees can save money by using in-network doctors and facilities where they will pay less for services, while also having the freedom and flexibility to use out-of-network providers at a higher cost if they need to see a specific doctor or visit a certain facility. Employers are able to visit www.uhc.com to view the list of providers in the Choice Plus network, Employers are able to search within a proximity of an address, or by providers name (both Drs and hospitals are included in the searchable database).
Employers have the option to choose up to 5 out of the 40 plans to offer their organization, and there are multiple Health Savings Account compatible plans. These options will allow you to ensure the right level of benefits at the right cost for your employees. With the proposals we have already started to process for January 1, 2019, most of our members are receiving substantial savings compared to their current plans, many in excess of 10% savings from their current plans.
The MCAA association plan also includes a full range of supplemental benefit offerings including life, disability, dental, and vision. These voluntary benefits help employees cope with out-of-pocket costs associated with accidents or illnesses – costs that major medical insurance is not designed to cover. Participating in these supplemental benefit offerings can be a cost-efficient way to provide additional coverage to employees who can purchase these plans through their employer at a lower, group rate.
Life and Disability with One AmericaFor employers that are providing a minimum of $10,000 of life insurance to their full-time employees, we have a voluntary (employee-paid) disability policy that includes the following:
- Guaranteed issue (no medical questions)
- Pays up to $1,000/week in benefit for the first 13 weeks
- Pays up to $5,000/month from 13 weeks to 2 years after disability (for companies with at least 5 participants)
Dental and Vision with UnitedHealthcareThere are 4 levels of dental plans and 4 levels of vision benefit plans to choose from through UHC. Plans are available on both an employee pay all (Voluntary) and also with employer participation (Contributory) basis.
How to Obtain a QuoteThis new program allows brokers throughout the country to obtain quotes for January 1, 2019 as well as for later effective dates. Members have the option to partner with Assurance or choose a broker of your choice. Brokers will be able to access a Quote Request Form on the MCAA website. There are two different processes – one for employers with 2 to 4 employees and a second option for employers with 5 or more employees. The quote process takes 2 to 4 days for preliminary rates and another 2 to 4 days for the final underwritten rates. Each account is underwritten on its own merits and will have different rates depending on the account details. So far, we have found significant savings for groups with 2 to 50 participants.
To be eligible, a company must be a mason contractor (SIC Code 1741) and an active member of the MCAA. New companies can also participate in the AHP, if they become MCAA members by the effective date of the plan. UHC requires that the employer contribute at least 50% of the employee only premium and that at least 50% of all eligible employees participate in the plan.
Employers may join the plan at any time during the year and their plan will renew on their anniversary date. The plan is insured by UHC and is available in 43 states today. The remaining 7 states have yet to rule on whether association plans will be permitted in their states.
Get in TouchJohn Storto, Principal of Employee Benefits at Assurance, will be attending the MCAA Booth at World of Concrete on January 20-25, 2019 to discuss the new Association Health Plan with members and potential members. Assurance is among the largest and most awarded independent insurance brokerages in the United States. A “Top 50” broker and repeated national “Best Place to Work” winner, Assurance creates value by minimizing risk and maximizing health for 6,000 businesses and individuals across the country. John will be able to discuss the entire portfolio of plans and how to obtain proposals.
About the Author
John P. Storto is a Principal at Assurance Agency, Ltd.