A look at Utah's health care options for employers and employees

Published: Monday, Sept. 30 2013 6:35 p.m. MDT

Patty Conner, director of Avenue H, in Salt Lake City on Wednesday, Sept. 25, 2013.

Laura Seitz, Deseret News

SALT LAKE CITY — Cindy Deverall manages health insurance benefits for local Prescott Muir Architects. With all the changes taking place in health care this year, she was not looking forward to it.

And she's not alone.

A recent Salt Lake Chamber of Commerce survey reveals that 81 percent of small businesses in Utah are unclear about what's required by the Affordable Care Act, a major part of which goes into effect Jan. 1.

"This is the first year they've had to pay out of their own pocket for health care, so we wanted to make it as easy on them as we could," Deverall, office manager and accountant for the small business, said.

To steer clear of confusion, an insurance broker pointed Deverall to Utah's small-business health insurance marketplace — Avenue H — which has been operational for more than three years.

The marketplace, which offers consumers a choice between 70 health care plans, proved a perfect solution for Prescott's budget. The business could designate a specific amount toward each employee's health care, and yet each employee could decide how that benefited them.

"We had one employee select a plan vision coverage because that was really important to them, and another chose a plan that covered chiropractic care, which was really essential for their family, so they got to tailor it to what works for their family," Deverall said. "One even chose a plan that cost less than we alloted for her because it included a Gold's Gym policy and that was something she really wanted."

While small businesses — those with fewer than 50 employees — aren't required under the Affordable Care Act to provide health insurance coverage to their employees, the law states that beginning in 2014, every American must carry a policy or pay a fee with their taxes.

The law also requires all businesses, large and small, to inform employees of their options to buy health insurance by Tuesday.

Getting health coverage

The chamber survey found that 90 percent of businesses want to offer health care options to their employees, as good benefits are an important part of recruitment and retention. Statistics show that healthy employees are also key to productivity.

Understanding what's available and how to obtain it, however, is a different story.

Prescott, which has fewer than 20 employees, decided it would offer a similar amount to what was paid for each employee's benefits in the past and let the employees decide what to do with that allotment in the marketplace.

Under the auspices of Avenue H, group rates are already negotiated, and for an extra small administrative fee, billing and processing can be fulfilled each month in one streamlined transaction.

"It's an opportunity to come in and shop for health insurance policies and make comparisons between the companies that offer them," said Patty Conner, director of the state's Office of Consumer Health Services, which runs Avenue H.

Conner is an expert on the ACA and specifically knows the ins and outs of the law for businesses. She was hired to run Utah's already functioning marketplace in 2010 and is working on plans to extend it to the state's large employers when lawmakers give the go-ahead and provide funding for potential expansion.

Avenue H, Conner said, offers a number of tools to help navigate what is available online, as well as access to brokers who understand the rules and regulations that small businesses face. She expects it all to get more familiar to people as time moves on.

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