How Small Business Can Get the Best Health Coverage at Most Affordable Price

Frank Saltzburg, a partner with Healthcare Solutions Team, LLC ( outlines his strategies for businesses to lower their health care premiums while providing the most comprehensive health plans:
•  Always use a professional, state-licensed broker or agent who is certified as a health care reform specialist. They are trained and educated to be aware of the best plans in the ever-changing current market, both in the private and public exchanges. It does not cost you any more to use a broker since major medical rates are already approved by your State Insurance Commissioner.
•  Don’t use a public online quote engine as your final answer. It is only a starting point and is susceptible to data breaches leading to identity theft.
•  Be aware of the limitations of public exchange call center navigators who don’t hold a state-issued health insurance license. In many cases, navigators are not state-licensed to represent major medical coverage and are not even government-certified as health care reform specialists in the Affordable Care Act.
•  Use the bundle concept to give you better coverage at a more affordable price with less out-of-pocket financial exposure.

Saltzburg says there has been an influx of online insurance quote engines through the public insurance exchanges. “The problem here is these public exchange quote engines will list  ‘bargain health plans’ that typically have the smallest network of doctors and hospitals. Many people are shocked to learn their plan’s network is limited to one county within their state and their doctors are not part of these networks. A recent Associated Press survey found that most cancer hospitals don’t accept Obamacare,” he stated.

“One big, ongoing concern is that the average deductible is estimated at $5,000. However, what everyone should really be looking at is the out-of-pocket maximum per calendar year. This is the true financial exposure we all experience. We design our plans so that the deductible and the maximum out-of-pocket exposure are no longer a major issue…We bundle our plans to include accidental coverage to pay up to the deductible amount and cover out-of-pocket expenses. Plus, we offer critical illness coverage to also offset the deductible and any out-of-pocket expenses. The critical illness coverage offers the ability to have a lump sum payout allowing the insured to have an extra $5,000 to $200,000 of living expense money. While people are recuperating from their critical illness, they won’t worry about paying daily living bills. Bundling allows the insured to have a more comprehensive plan with true peace of mind,” he said. For more information, visit

How HSAs Beat HRAs

BusinessBoxingPeople with HSAs are more likely to engage in cost-conscious behavior compared to those in HRAs, according to a report by the Employee Benefit Research Institute (EBRI). HSA participants are more likely to ask for a generic drug instead of a brand name, check the price of a service before getting care, ask a doctor to recommend less costly precriptions, develop a budget to manage health care expenses, and use an online cost-tracking tool provided by the health plan. Paul Fronstin of EBRI said, “HRAs and HSAs may be similar, but there are some key differences that may produce different incentives …Those with an HSA are more likely to respond to health pricing.” An employee owns the HSA, which is completely portable. With HRAs, an employer is not required to provide the unused balance to a worker when they leave the company. For more information, visit

ACA Enrollment Extension Could Dent Insurance Industry

Extending the enrollment period for Americans seeking health coverage under the Affordable Care Act could mean pricing and logistical implications for health insurers, according to Fitch Ratings. According to the Fitch report, “We believe an extension would be a negative for health insurers. Pressure on insurers to extend existing policies is likely less problematic than extending the enrollment period. The current deadline for enrollment is March 31, 2014, although plans will take effect on Jan. 1 for those who sign up earlier.
An extension could increase the number of people who wait until they need healthcare to buy the insurance. The open enrollment period for health insurance plans offered in the insurance exchanges began on Oct. 1 and the process has been plagued with technical problems on websites

Allowing more time would also create logistical issues with pricing and state participation, which could raise short-term risk for insurers.

Under normal circumstances, insurers set premium rates before the enrollment period based on cost-of-care estimates. When the enrollment period is lengthened, these estimates may no longer be as accurate.

Some state regulators are encouraging insurers to extend existing policies for three months beyond their Jan. 1, 2014 expiration date due to technological problems with exchange websites. Fitch says that this would be less problematic for health insurers than extending the current enrollment period as long as benefits and premiums on the extended policies don’t change from current levels and the extension is effective for a relatively short period.

Nevertheless, such extensions could result in a short-term increase in risk levels of business sourced through the exchanges. Consumers whose policies are extended are likely to have better risk profiles compared to early users of exchange-sourced insurance. The extension could hurt the financial results of insurers whose enrollment is weighted disproportionally toward exchange business.

Fitch also says that an extension would delay the positive benefits that hospitals would see as a result of health reform including higher patient volumes and lower bad debt expenses for treating the uninsured. For more information, visit

Last Updated 01/19/2022

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