New Rules On Health Insurance Help SC Small Business Owners, Employees

The success stories are growing:

* A small business owner had been paying $550 a month for a low-benefit, short-term, individual health insurance policy because a regular plan was too expensive. However, he knew he needed to address the health insurance needs of his employees, who were not otherwise covered. A group health plan would have cost the business $3,000 and his employees $150 each per month.

Instead, he and his employees enrolled in full-benefit individual plans in the federal Health Insurance Marketplace. Thanks to federal premium assistance, the owner's monthly premium is $400 and premiums for his employees range from $0-$76.

* A sole proprietor with no employees was paying $500 a month for a low-benefit, short-term health insurance plan. Again, the reason for having the "hospitalization only" plan was cost. Now, he and his daughter have a full-benefit Health Insurance Marketplace plan for $99 a month after the premium subsidy.

And here's an example of how saving on health insurance also saved jobs:

An employer had a decision to make because of reduced business revenue: Either drop a group health plan, which was about to go up 9%, making the monthly cost to the business more than $2,600 and for each of her four employees $160, or cut worker hours and/or positions.

Instead, she found a third way forward. She helped her workers enroll in individual Marketplace plans that offered better benefits. No positions or hours were cut, and employees saved on health insurance, with premiums between $0 and $115 per month.

A year ago, you would not have heard these success stories.

However, two federal rule changes on premium assistance for health insurance plans offered in the Affordable Care Act's federal Marketplace have been very beneficial for small business owners and employees.

For the past several years, the South Carolina Small Business Chamber of Commerce (SCSBCC) and others have complained that small business owners were being priced out of traditional health insurance by rising premiums.

We advocated for lifting the income cap on federal premium subsidies that had locked small business owners out of receiving the benefit.

The Biden Administration eliminated that income cap earlier this year.

The other rule change was a dramatic increase in the premium assistance, thanks to the American Rescue Plan passed in March.

The increased subsidies have driven down premium costs for the average worker.

According to national data, four out of five workers who enroll in a Marketplace plan can find a plan for $10 or less per month. Low-wage workers with incomes between 100% and 150% of poverty are now getting full coverage health plans that have no premium.

The SCSBCC is working with the state's Primary Health Care Association (SCPHCA) on a statewide campaign to educate the public about the new premiums in the federal Marketplace. The SCSBCC focus is on the opportunity now available for very affordable health insurance for small business owners and their employees.

With a federal grant to the SCPHCA, 16 "navigators," working out of community health centers across the state, are providing information about Marketplace policies being offered by four insurance carriers. These navigators can determine a policy's cost after premium assistance is applied. Enrollment is then immediately available.

There is no cost to the employer or worker for the navigator's services.

We encourage small business owners who do not offer group health insurance to move quickly on this opportunity. The open enrollment window ends Jan. 15. After that, there are only special conditions, including dropping group coverage, that would allow for enrollment in a Marketplace plan.

To get assistance, go to healthcare.gov and click on "find local help." Here you can search for an "assister" (navigator) from a community health center. There's also a list of local insurance "brokers" who can also help with Marketplace policies at no charge.

Alternatively, you can call the SCSBCC (803-252-5733) for assistance in getting help.

Frank Knapp is president and CEO of the South Carolina Small Business Chamber of Commerce.