The Affordable Care Act 2015... & your agents thoughts on it

So, I met with our Covered California representative today. First, I will say that I am SOOO happy that I have been assigned a representative who will actually be available when I need him and HELPFUL! I really enjoyed him & I think he can make this whole open enrollment a better experience for us all. I think I might just hog him all to myself!

What I learned: On January 1, the SHOP portion for Small Business will be functional (currently it isnt, so I am saying in good faith only that it will be). Here are a couple reasons why a small business might consider setting up a small group plan instead of a private plan like many opted to do for 2014:

  • You will be able to legally double dip! You can claim your health insurance premiums as a write off AND you can also take the tax deduction that is offered ONLY if your agent goes through Covered California to build your health plan. If your agent bypasses Covered CA and works directly with Blue Cross or another insurer, you cannot even get the tax credit so there is no double dipping to even contemplate.

  • You will be able to exclude employees dependents ONLY by going through Covered California. Right. If your agent wants to keep you in the traditional channel, you will still have to offer insurance to your employees dependents. The reason this isnt ideal is that if you dont want to pay for any of the premium for those dependents, its most likely that the employee wont be able to afford to insure their dependents on your plan. But because you OFFER the coverage, they would not be eligible for the subsidy. This puts you in an uncomfortable position as an employer, because you are now a burden to your employees. They need that subsidy because just going uninsured is no longer an option.

  • You wont have to buy pediatric dental if you dont need it i.e. if you dont have any kids or if you're going to insure them on a different plan than base plan that is forced upon you in the private channels. Yeah, if you dont buy from Covered Ca, you are actually, in a sense penalized for it. You are forced to buy something you dont need & cannot use. Ever. Unless you're Benjamin Button.

So, as an agent, I have vowed to be as honest and open about the ACA as I can possibly be. I go with the flow, but not blind to the consequences. We watch them unfold & we hope that we can live with them. We call it progress right?

What I see that concerns me is that the government backed Covered Ca has many carrots to wave that say, "buy from us, buy from us". WHY do they want you to SO BAD? SO bad that you can double dip at tax time? So bad that they criple their competition in such an obvious manner?

Because going through Covered Ca connects to the IRS. Open flow of communication there. They can see what you report for payroll so you dont have to tell them who makes what. Then, when your employees go to sign up their family members for Covered Ca subsidies, they report income and of course it all gets compared with what you reported their income as, and if there are descrepancies they can be caught quickly. Just in case anyone wanted to fudge what they make, I guess? That's just a start, a great conspiracy theorist can come up with all kinds of dirt as to why they want your business so bad, and I am not a conspiracy theorist, so, I've got next to nothing.

But, as for how I feel about their fierce way of competing with private businesses... I am so glad I am not the CEO of a health insurance company. Blue Cross has been going around and around with Covered Ca, they even pulled their agreement with them, told them to take a hike, all the harsh words were spoken. At the end of the day though, can they really afford to hold out? I dont think so, and Blue Cross has always come through for the policyholder in the end and done what they have to do, but they go down fighting, which is more than I can say for the others (though they have their strengths too).

When the government can come in and outsell you, out carrot you, and steal ALL your customers... what will they think of next? Stay tuned, America. This is what we wanted, right? Are we headed in the right direction?

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