Insurance pros are agents of change on the front lines of health care reform.
by Laurie Wink
Leading health insurance professionals in our region describe the Affordable Care Act as “overwhelming,” “complex,” “high stakes,” and “time consuming.” But they also say the health care reform legislation has been a boon to their business.
The Affordable Care Act (ACA)–referred to as Obamacare by its critics–was enacted in 2010 and is intended to decrease the number of Americans who don’t have health insurance. The ACA is the largest government expansion of health care coverage since the creation of Medicare and Medicaid. A series of legal battles have been mounted to do away with or weaken the legislation. But after the U.S. Supreme Court rejected a lawsuit against the ACA in June, its future seems secure until the 2016 elections.
Whether or not it’s here to stay, the ACA began phasing in a series of mandates in January 2014 that have impacted employers of all sizes. And employers have turned to health insurance professionals for advice on strategies to avoid costly penalties.
Matt Glaros, chief strategy officer–benefits producer at Meyers Glaros Group in Schererville–notes, “In the past, there was a lot of discussion about insurance rates. Now our value is helping employers handle the requirements and risks, making sure they’re compliant. The old theory of the insurance guy who golfs all the time and entertains people is not true. I don’t think we’ve picked up a golf club for a while.”
The “we” in this case includes his father, Will Glaros, the company’s co-founder and managing partner of employee benefits. Will works with employers who have more than 200 employees and Matt handles those with fewer employees.
Will Glaros has specialized in employee benefits for most of his 40-year career in insurance and says the challenges of the ACA are similar to those he experienced during implementation of the federal COBRA and ERISA laws. “These challenges are when opportunities arise to educate the public.”
Business at Meyers Glaros Group has grown about 40 percent in the past few years as more employers seek help with the ACA. The firm has hired three new employees who stay up-to-date on ACA legislation. When specialized expertise is needed, the agents collaborate with accountants and attorneys.
The company provides clients with helpful tools, such as a 16-point checklist of notices and communications that must be completed during the year. “For clients, it’s very time consuming and if they don’t do the right thing, it could be financially devastating,” says Will Glaros. “You hear so many people talk about how great health care reform is, and it has provided insurance to a whole lot of people. But to cover those people, the cost has to go up.”
This year marked the beginning of the so-called “Pay or Play–Shared Responsibility” ACA provisions with potential penalties for employers with 100 or more full time employees. In 2016, employers with 50 or more full time employees will also be affected.
Matt Glaros says health care reform has resulted in expanded opportunities for employee benefits experts to demonstrate their value.
“In the past, if you said you worked in insurance, people shied away because they didn’t want you to sell them something,” he says. “All of a sudden, if they hear you’re in health insurance, there are questions galore. Now people want to talk to us.”
Ryan Colvin is a principal and an employee benefits consultant for Gibson, an employee-owned business founded in 1933 with offices in South Bend, Plymouth, Indianapolis and Fort Wayne. Colvin has been with Gibson for 12 years and works with area companies employing from 100 to more than 8,000 workers.
“The ACA has all kinds of tax penalties,” Colvin says. “The biggest challenge for employers is understanding the law and figuring out administratively how to track and manage it.”
Colvin’s job has evolved into an educator and facilitator. Heading into the last quarter of 2015, he’s working with client insurance renewals and factoring in strategies for employers to avoid financial penalties that take effect in 2016. In the process, he collaborates more frequently with benefits attorneys, CPAs and other professionals.
“As the level of complexity has gone up, we’ve been working more outside of the scope of a traditional benefits broker,” he says. “We help build strategies aimed at managing the growing complexity of offering benefits to employees. We provide tools and resources to help employers engage their employees, lessen their administrative burden and control costs.”
Colvin says employers are generally frustrated by the new changes surrounding health care benefits but realize that, in today’s competitive marketplace, benefits packages are valuable tools that can be used to attract and retain top employees.
Craig Menne says employers are looking to insurance professionals to help them come up with employee benefits packages that give them an edge in hiring top people. “Many employers are fighting for talent,” he says, “and want to know how the benefits process can assist with that. Many of our clients would state that one of their biggest challenges is finding, attracting and retaining talent. Benefit packages are integral to their ability to do that.”
Menne is president and life and health agent for General Insurance Services (GIS), with offices in Michigan City, La Porte and Valparaiso. He leads a team of six employee benefits specialists who work with Northwest Indiana companies having anywhere from two to more than 1000 employees.
Menne says the ACA has had both positive and negative effects on the insurance business. For example, today’s health insurance application forms don’t require as much information, so agents can process paperwork more efficiently and handle more clients. On the other hand, they spend more time advising business owners and human resources professionals on implications of health care reform laws.
And they partner more frequently with attorneys and CPAs, Menne says. “They rely on us for some things and vice versa. It’s been beneficial because things aren’t cut and dried. I have a law degree and it’s tough at times to keep up with this specific law. It’s literally a full-time job.”
GIS employee benefits specialists have risen to the challenge, according to Menne. “There’s a fair number of insurance agents who’ve had the response, ‘Oh wow, this is too much.’ We’ve taken the opposite view. We need to embrace the opportunity. It has opened doors that were more difficult to open in the past.”
Klaus Knuth says the ACA has expanded the client base for Mishawaka-based Keystone Insurers Group, a division of Pinnacle Insurance Group of Indiana. Knuth is vice president of the Indiana benefits division and is responsible for creating opportunities for agency owners to grow their businesses among employers with from two to several thousand employees.
“The larger the employer, the more exposure they have to ACA fines and penalties,” Knuth says. “Employers don’t want to be hit with massive fines and need quality advice. There’s so much uncertainty about what needs to be done, and a lot of mixed messages. Our ability to combine competitively priced benefit plans with ACA expertise has benefitted us.”
Knuth, who has been an employee benefits insurance specialist for 12 years, says, “The ACA definitely impacts what we do. We focus on making sure employers remain compliant with all aspects. It’s necessary for us to not only understand the law but also to communicate it to employers.”
Keystone Insurers Group has two health care reform compliance experts who stay up-to-date on legislative changes and try to forecast what’s ahead. Knuth says, “There are a series of provisions that are coming into effect over the next several years.”
Christopher Rowland, owner and manager of the benefits division of Healy Group in South Bend, has specialized in employee benefits insurance since 1985 and joined the company in 1999 to expand the employee benefits division. He echoes other insurance professionals’ comments about health care reform.
“It has certainly changed our lives with respect to working with clients,” he says. “We spend a lot of time informing them on what’s happening with the ACA. It’s a continuing education process with our existing clients.”
As a member of the National Association of Health Underwriters, Healy Group professionals go through continuous training to stay abreast of changes in the implementation of the ACA. Benefits staff members meet weekly to discuss experiences and plan strategies for assisting clients, Rowland says. The company holds seminars and other educational events to keep clients updated on the ACA.
Labor law attorneys and other experts are contacted when specific questions arise. “We’re treading very carefully because we can’t give legal advice, but we can find sources for the answers,” Rowland says. “We will say that this is our understanding of what the ACA is saying but we may need to ask a labor law attorney if we get into grey areas of the law where it’s not real clear.”
Rowland predicts businesses with 10 or fewer employees will be getting out of the health benefits business and turning over responsibility to individual employees. The Healy Group is positioning itself to meet the changing needs by working directly with employees.
In spite of the complexities inherent in health care reform legislation, Rowland says, “It isn’t that scary monster that we all saw it as in the beginning. We’re working our way through it. There’s reason to be optimistic.”