At present, the conventional wisdom appears to be that many employees will simply be dumped into the exchanges and employers will wash their hands of the health care issue. But even if advisers have clients who make this choice, they should consider offering exchange advocacy services to this group. Employees are going to need an advocate to answer questions and assist with navigating exchanges. Without help, it’s a potential nightmare that could lead to a very dissatisfied workforce.
As it currently stands, 28 states will have federally-approved, more-or-less uniform exchanges. The other 22? An unpredictable grab bag that could see some states have one, single-payer option, while others (think California) could have nearly 50 choices from which to pick. The crux is, there have to be people in place who know the ins and outs of all of them.
So many questions jump to mind when pondering a post-Jan. 1, 2014 America: Are employers properly staffed? Who do the employees and their family members call when they have a problem? Do they call the state? The insurance company? You as an adviser? Are brokers or HR departments even authorized to talk to the insurance company? As an adviser, you’re not the plan’s sponsor and you’re not the enrollee. But HR departments will need support in order to answer questions on not just one plan, but potentially 50 options.
A partial answer to the issue, of course, is the role of the broker/adviser. An employer should expect a broker to fill gaps and find solutions. Running financial analyses to decide whether or not the business should “pay or play” is paramount, as is taking a look at the retention implications if your competition offers traditional employer-based coverage and you’re handing out $5,000 a year and sending employees to the exchanges. But helping employees in exchanges is a whole new territory worth exploring. It certainly won’t be easy to learn the intricacies state exchanges, but there will be a market demand for support.
Overall, being present and competent is the order of the day once the Affordable Care Act becomes a reality. Brokers need to act as a conduit, or contract with a conduit, to help employees navigate through. A lot of these issues fall on the shoulders of the human resources department, but a broker or adviser needs to offer comprehensive care.
Mangan is an EBA Advisory Board member and CEO of United Benefit Advisors, an independent employee benefits advisory organization with more than 270 offices throughout the U.S., Canada and the U.K.
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