The MCAA’s Association Healthcare Plan

The last several years have been a wild ride in terms of healthcare and health reform. From changing policies to emerging markets, finding affordable healthcare coverage has become a struggle for many business owners and individuals.

Many of our members have also been struggling with the cost of providing health insurance for both their employees and themselves. Recent healthcare reform held the promise of reduced costs as well as expanded access.

Ironically, the final result for employers with 2 – 50 employees was actually the opposite: costs went up exponentially and the plan design options became more limited. While it’s true that insurance companies could no longer set their premiums based on employee’s answers to medical questions, the average cost of premiums increased so much that many employers struggle to provide coverage at an affordable cost to their employees.

Association Health Plans

The current administration’s answer to this dilemma is to introduce new competition into the health insurance space by allowing (in limited circumstances) the development of Association Health Plans (AHPs). By banding together in a national plan, small employers can use their combined membership to negotiate better terms with insurance carriers. Employers in one part of the country are not limited to their local insurance carriers, but can negotiate with carriers across the country, and potentially use that competitive pressure to drive down costs locally.

Lastly, by banding together and forming a large group, small employers can have access to large group plan designs and doctor networks while avoiding some of the pitfalls that add costs to the small group medical plans.

This summer, the Trump Administration issued new AHP regulations identifying who can set up an association and how that plan should operate. However, there were still a number of hurdles.

In one sense, AHPs are not new – business associations have been able to offer common health insurance benefits to their members for decades, but under the previous rules, there were significant restrictions and, unfortunately, substantial opportunity for fraud on behalf of the association. This new rule addresses many of those issues to strengthen AHPs.

This includes incorporating the HIPAA non-discrimination rules – preventing AHPs from using any sort of medical history to rate individuals or single employers within the association – and taking a strong stance that states still have the authority to set the rules with regards to the solvency of AHPs in their jurisdiction.

For example, New York and Kansas will not allow Association plans within their borders. Additionally, while the government has given the green light, insurance carriers are typically very selective on who they are willing to offer a program.

MCAA’s Medical Coverage with UHC

We are excited to tell you that we are in the final stages of discussions with UHC to build an MCAA Association Health Plan for our membership for businesses with 2 or more employees. MCAA is one of only two Association plans in development with UHC in the Midwest. While new Association Health Plan rules were released by the Trump Administration, the Department of Insurance in the State of Illinois did not release their guidance until September 21st.

We are now working through the pricing of the UHC medical program for our members. Based on the actuarial reports we have seen, we expect that there will be considerable savings for our members within the plan – especially for those members that have between 2 and 50 employees.

We will have 4 medical plans to choose from so you will be able to ensure the right level of benefits at the right cost for your employees. The MCAA Association Plan will also have a full range of supplemental benefits to offer our members including life, disability, dental, vision, and retirement.

Life and Disability with One America

For employers that are providing a minimum of $10,000 of life insurance to all of their full-time employees, we have a voluntary (employee-paid) disability policy that includes the following:

  • Guaranteed issue (no medical questions)
  • Pays up to $1,000/week in benefit for the first 13 weeks
  • Pays up to $5,000/month from 13 weeks to 2 years after disability (for companies with at least 5 participants)

Disability coverage is one of the most difficult coverages to obtain in our industry without providing medical history, so we are really excited about this offering.

Dental and Vision with Ameritas

There will be 3 levels of dental plans and 6 vision levels of vision benefit plans to choose from.

How to Obtain Proposals

MCAA is developing this plan with the assistance of Assurance Agency, one of the premier insurance brokerages in the country. We welcome our members to obtain proposals directly from us or through an insurance broker of their choice. We are in the process of rolling out the program with coverage beginning on January 1, 2019. New members to MCAA will also be able to join the new MCAA Association Health plan and ancillary programs (life, disability, dental and vision) throughout the year.

Words: John P. Storto, Principal, Assurance Agency, Ltd.
Photos: DefenseEngineer, gerenme, sturti, Warchi