IBJNews

Q&A

Back to TopCommentsE-mailPrint

The U.S. Supreme Court’s ruling to uphold the Patient Protection & Affordable Care Act cleared a big cloud of uncertainty for employers, but with just 18 months before the most significant provisions of the law kick in, many questions remain. Three benefits consultants from Indianapolis-based Gregory & Appel Insurance—Bob Miller, Mike Miles and Karl Ahlrichs—sat down to discuss what the future looks like for employer health benefits.


IBJ: Now that the health insurance reforms that were part of the health reform law have been upheld, how do you expect employers to react?

Miller: Employers said that, regardless of what happened [at the Supreme Court], they were not going to cut benefits. I think there’s going to be a number of the small ones—and I’ve got a couple of clients like this—that said they’re going to use the exchanges. But I think we’re going to see it as the exception rather than the rule.

Miles: I don’t think employers are going to be able to make a decision. Until we see exactly what that exchange plan is going to look like, I think people are going on the assumption that the exchange plans are going to be priced attractively. And we just don’t know that. It’s still going to be kind of tough for them to make decisions until we figure out all the puzzle pieces on the table.


IBJ: The health reform law is more than two years old now, yet there are still so many questions about how it will work. Do you expect that to continue because of the law's complexity?

Miller: That’s typical. This is something that’s going to go on for years. The federal government, they’re creating more questions than they’ve got answers. That’s going to frustrate employers because they want answers.

Ahlrichs: This confirms that they need to have a strategic plan for their benefits that aligns with their business plan. They have to have it now because of this complexity. People who normally just float through year-to-year decisions and pass on the increase and think that’s good enough, that ends now. They need to draw up a strategic business plan that includes the total rewards side and the wellness side.

Miles: We think this is really going to be a call to action on the part of employers to really get serious about strategic planning and population health management. The only way you can really, truly control your costs is not going to be through plan design any more. What they’re really going to have to do is create incentives to really get employees to get control of their chronic diseases.


IBJ: The health reform law calls for states to create online exchanges in which individuals and small employers can shop for and purchase health insurance—and do so with a government subsidy, if their incomes are low enough. Do you expect Indiana to be ready to launch an exchange in 2014 or will it have to send Hoosiers to the insurance exchange being created by the federal government?

Miles: If the state was going to have an exchange program, they basically were going to have to have all that defined and priced by early 2013. I don’t know how long it’s going to take them to pull the trigger and jump in.

Miller: Even if Indiana started today, they won’t have it finished by 2014, and the feds are going to come in, anyway. So we could see the feds come in, at least initially.


IBJ: The big question for employers is, of course, will health insurance premiums go up faster or slower under the health care law? How will the presence of the exchanges and the government subsidies affect health insurance costs for employer-based health plans?

Miller: I think it’s going to be an underwriter’s nightmare. How do I price your plan for Jan. 1, 2014, when we don’t know who’s going to stay [in the employer plan] and who’s going to go [buy insurance in an exchange]?

Miles: Are they at risk for having a number of employees that come off the group plan and go into the exchanges? That’s going to have a tremendous impact on the pricing of the group plan for the employees that remain. There is going to have to be some very sophisticated modeling done for employers. If [the exchanges are] going to take all of their younger, healthy people, and that’s going to cause the rest of their health plan to go into a death spiral, what do employers do? Depending on how this all plays out for a particular employer, this could really end up changing the dynamic for how the spreading of risk works.


IBJ: Could the Supreme Court’s ruling that failing to obtain health coverage is not an infraction of the law, but is merely a choice that can be taxed, lead to more people than initially expected choosing to the pay the tax and remain uninsured? If so, could that lead to higher insurance premiums in commercial health plans?

Miller: About 44 percent of U.S. citizens don’t file federal income taxes, because they don’t need to. So if you’ve got that many people not filing taxes, how are you going to make them pay this? I think they totally underestimated what the cost impact is going to be.

Miles: If you have an opportunity to anti-select, that’s a recipe for disaster. ... It’s going to be challenging times ahead, but it’s almost kind of exciting.

ADVERTISEMENT

  • Obamacare
    My CPA suggests to defer most of my comp to the next year and next year and take just enough to put me under the cap so I can get a subsidy from the exchange. Think of that, a conservative, college educated, businessowners that can reduce his income and get a tax break. Dang...I should have become a liberal a long time ago. If I work it right, I may not have to pay any taxes, drive my expensive car, take vacations and live on a lake. DANG!!! I'm going on the lecture circuit!!!

Post a comment to this story

COMMENTS POLICY
We reserve the right to remove any post that we feel is obscene, profane, vulgar, racist, sexually explicit, abusive, or hateful.
 
You are legally responsible for what you post and your anonymity is not guaranteed.
 
Posts that insult, defame, threaten, harass or abuse other readers or people mentioned in IBJ editorial content are also subject to removal. Please respect the privacy of individuals and refrain from posting personal information.
 
No solicitations, spamming or advertisements are allowed. Readers may post links to other informational websites that are relevant to the topic at hand, but please do not link to objectionable material.
 
We may remove messages that are unrelated to the topic, encourage illegal activity, use all capital letters or are unreadable.
 

Messages that are flagged by readers as objectionable will be reviewed and may or may not be removed. Please do not flag a post simply because you disagree with it.

Sponsored by
ADVERTISEMENT

facebook - twitter on Facebook & Twitter

Follow on TwitterFollow IBJ on Facebook:
Follow on TwitterFollow IBJ's Tweets on these topics:
 
Subscribe to IBJ
  1. liek the rest of America

  2. These quaint,obsessed musings by the stalkers are certainly entertaining, but I'm trying to figure out what, if anything, all the yelping below has to do with Zak Brown.

  3. It's evident that Moffett was pushing the right buttons and corporate America is now trying to squash him. He just wanted to withdraw the free pilot services provided to the company by the pilots to try and put some pressure on a company that has not been interested in negotiating a contract in over 5 years. The company does not provide a contract because not having one has saved them a bundle of money. Shame on any Republic pilots not standing behind their union leader just because things are getting tough, can you not see such strategic moves by the company as putting the last union president in a corporate position and into THEIR pocket. Do you really believe the last union president is so appalled at the attempts by Moffett, do you not remember his oppositions to the company? We stood behind him. It has been proven over and over again for thousands of years without fail, a man cannot serve two masters. Anyone that believes people vote contrary to their paycheck and livelihood deserve to be taken advantage of, the recent statements by the former union president are laughable as he denounces the current union president from his new corporate position. Have you ever seen a drafted sports player score points for his previous team, it cannot be done, he is not on the pilots side anymore, he gets his money a different way now than you and I do, and he should not be allowed to remain on the seniority list. A drafted player brings strength, credibility, tactical knowledge, and a strategic advantage to his NEW team, he would not be drafted or paid were it otherwise. We are all forced to choose only one side to play for and support, not doing so has many references in life such as insider trading and shaving points, all illegal for good reason. This basic fact is why corporate moguls, scientist, and engineers all sign non-discloser agreements and non-compete clauses, as protection in case they are lured into switching sides as our former union president has done. No NFL coach ever drafted a player so that both teams could benefit and better understand each other, they are recruited to win the game against that former team, period. Likewise the company does not recruit the former union president by accident or mutual understanding, its strategy. Don't confuse playing the game with good sportsman-like conduct in support of common business and prosperity goals, with the requirement to only play for one side. Good men we all love and favor fall subject to this manipulation, often without their knowledge, and it is not a betrayal of their friendship to oppose them when they switch sides. If we did not love and trust them, they would not have been chosen and lured to the other side in the first place. The deception by the drafted player is not made at a conscious level, it's just human nature and it's all about money and power which corrupts our ability to be objective and loyal to two masters. This is why our court system created the defense attorney, and why our military created counter intelligence. Its strategy and its propaganda, and it works, and that's why the "powers to be" manipulate the chess pieces by sometimes changing their colors. Some players know they are being manipulated when their color is changed, but it brings them more money and power so they do not care. The rest have good intentions but do not even realize they are being manipulated. This tactic is also known by another name, Divide and Conquer. In battle sending an imperfect message with an imperfect team is obviously not ideal, but it's still being sent by YOUR team, your union leader, a leader that has common goals and common rewards with you, they are the best, because we have elected them to do a job for us. If you are not backing Moffett but believing the spin by those that have recently switched sides, you are taking food out of your own mouth. Showing unity and backing an imperfect situation still results in taking just as much ground, it's about unity and bargaining power. It's not necessary to wait around for that perfect attack because it will never come, the company will spin and attempt to destroy anyone that gets in their way. Ultimately it's not about any specific attack anyway, ASAP or whatever it makes no difference, it is and always has been only about power. If this company cared about safety it would not build pairings with 8 hour overnights, come on, are you that naive? Besides, do you really think Hoffa cares, no, he got a call from corporate America and was squeezed into denouncing Moffett. If he didn't they would spin the safety card against him and the Teamsters National with implication for truckers, future contracts, insurance rates etc...saying something like the Teamsters use safety as a bargaining chip, blah blah blah... Do you really think any pilot is going to do something unsafe for the contract, absolutely not, the only ones threatening safety here is the company with reduced rest, fatigue, and poverty. Do you not find it odd that Hoffa and the Teamsters are opposing a Teamster president publicly? Would the Teamsters National not normally support and work with one of their own? Why did they not sit down and help him strategize, correct any mistakes, and charge ahead? Would the Teamsters National not normally support and leverage a contract for all those pilots that have been paying Teamster dues, isn't that why we have all been paying Teamster dues in the first place? I sure haven't been paying dues so that the Teamsters National could come along and write this kind of an article undercutting our union leader and our unity. Whose side is the Teamsters National really on, it's obviously not the Republic pilots side.

  4. No matter what Moffatt does the company is going to spin it like he is the terrorist and brainwash people like you into believing it, wake up, back your players that are trying to change things for you and your livelihood. Where has Hoffa been for the last 6 years, except collecting our dues. Seriously, do you really think an FO going for upgrade, signed off by a checkairman ready for the upgrade, who then fails, is not even capable of returning as a First Officer.

  5. whoa!

ADVERTISEMENT