KAYSVILLE -- Amid the confusion and issues affecting sign-ups for the Affordable Care Act, Utah is still going strong with Avenue H, its health insurance marketplace for small businesses.
As one of the leading states in number of small businesses, according to Patty Conner, director for the Office of Consumer Health Services, the state implemented its own program four years ago. With the recent federal requirement to have insurance by January 2014 or pay a penalty, the number of Avenue H enrollees has soared.
The Northfront Business Resource Center at the Davis Applied Technology Center in Kaysville recently held a conference for many small-business owners wondering how to proceed with healthcare coverage. Businesses with one to 50 employees can apply through Avenue H, which gives small businesses more flexibility than if they were to obtain the coverage directly from the insurance company, according to Conner. Avenue H is not tied to the federal government plan.
"We have heard a lot about the Affordable Care Act in the last four years, but now it is here, and we have to figure out what's going on," said Conner during the conference.
Everyone is required to have a quality health care plan, which now includes 10 essential health benefits: ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, prescription drugs, rehabilitative and habilitated services and devices, lab services, preventive and wellness services and chronic disease management, and pediatric services, including oral and vision care.
One concern that several attendees asked Conner about was the rising cost of premiums. Conner pointed out that prior to the Affordable Care Act, pre-existing conditions were rampant and too often people purchased skinny plans that had a lot of out-of-pocket costs, causing many to go bankrupt from unplanned medical expenses. "That is why the law changed so everybody has to have the same type of health plan moving forward," said Conner.
However, because some of the essential health benefits were not typically covered in health plans previously such as maternity leave, mental health and substance use disorder services, and rehabilitative and habilitated services, prices for coverage are being driven up to include them in the new health insurance plans.
"Did you pick yourselves off the floor after seeing the rise in cost for health coverage?" Conner asked conference attendees. "In general, everyone is seeing an increase because everybody has to have the same coverage, and no one can be turned down. That's the good part of the law since you can't be charged more for health issues."
No longer can they say someone who has cancer will cost more, according to Conner. Two neighbors the same age will have rates that are exactly the same, whether it be individually through the Affordable Care Act or through Avenue H. However, if those two neighbors have families, their costs will vary depending on the number and age of their dependents.
Kristine Tate, wife of a sole proprietor, said before attending the conference, she and her husband were very confused about the new health insurance options. "Now we are less confused, and it's nice to see that the state of Utah has been on board before they even needed to be," said Tate. "We aren't young anymore, so it's nice to see some health insurance options available to us, which will give us peace of mind, something we haven't had for the last ten years."
Once small businesses enroll through Avenue H, most of the work will be done for them. "We help narrow down the options and then do the work for small businesses so they can get out of doing human resources and focus on their real business," said Conner.
Small businesses have until Dec. 16 to register through Avenue H, and their employees with have until Dec. 23 to enroll for coverage by the first of the year. For more information visit www.AvenueH.com.