By Wayne Hansen, Wayne’s Heating & Cooling & Appliance, Moberly, MO
As a second-generation small business owner, I can attest that things aren’t the way they used to be. Our family-owned company faces greater challenges today than at any time in the more than 50 years we have been in operation.
The good news is that in America, when challenges arise, the market often responds with viable solutions.
That’s exactly what’s happening right now with the U.S. health insurance market. This year, small businesses and families had more health care plan options to choose from than ever before.
But if Missourians aren’t careful, government regulators may soon do away with some of the most affordable and flexible options currently available.
The issue at hand is the provider network – a critical consideration for small businesses that provide health benefits for their employees.
More than half of Americans with health insurance have some type of managed care. Most people are familiar with the concept: patients pay a small co-pay for medical services, such as a doctor’s appointment, prescription refill, or emergency room visit. The caveat is that patients must use providers inside their health plan network if they want the lowest out-of-pocket cost.
Health plan networks vary in size and the providers that participate. Generally speaking, larger networks that cover more providers come with more expensive premiums. High-value provider networks, on the other hand, are smaller, more targeted, and often carry premiums 20% lower.
When network, cost, and coverage align, these high-value provider networks can be a great choice for small businesses. These plans include all the specialties patients might need. But by honing network participation and negotiating prices, these health plans deliver significant savings.
The selection of a health plan often falls to employers. Although not every employer is required to provide health insurance, most business owners strive to do so – and for good reason: to keep their workers happy and healthy.
For small businesses like ours, the issue is often even more personal. We know every one of our employees. We know their families. We know when they have a new baby on the way, or if their spouse has been diagnosed with cancer. We want our workers to have the coverage they need to get the care they need, no matter what comes up.
But we also have to do what it takes to keep our doors open, including managing the costs of our benefits. It’s a delicate balancing act, which is why having flexibility is so important.
In today’s market, small business owners can evaluate a wide range of health plans to find the best fit. Some will go with the lowest cost plan, regardless of network, because a modest premium makes it possible to offer health insurance at all. Other companies may search for networks that offer a greater selection of local doctors or other criteria.
We also have good checks and balances in place. Given our day-to-day involvement with employees, small business owners hear about it when a health plan isn’t living up to expectations. When that happens, we can change policies the next time around.
Unfortunately, some lawmakers want to remove choices from the market. They want to outlaw plans with high-value networks and make us all purchase health insurance that is more or less the same. But this would eliminate the most affordable health plans.
We all know that a one-size-fits-all marketplace is likely to fit no one well. Let’s keep real people and their unique needs front and center. Let’s continue to allow Missourians to choose the health plans that are best for our families and ourselves.