The struggles of a business trying to survive.
A couple of years ago I wrote
the following: “I would like to be able to go to my insurer’s Web site,
and go to a page that generates an instant rate adjustment based on a
brief description of a possible new hire. Let’s say I get to enter the
age and sex (and maybe whether they smoke) of the prospective employee
and any others in their family. Then I get a number right then and there
that tells me what this will do to my insurance rates.”
Well, that day has arrived. The
exchange
established by the Affordable Care Act is intended to allow for
one-stop shopping, with uniform underwriting standards based on age,
location of residence, family structure and tobacco use. My insurance
company used to jerk my rates up and down without explanation, although
the clear implication was that it cost more to have older and sicker
workers.
Under that system, it was very difficult to shop for competing quotes. I have been getting insurance from
Independence Blue Cross for years, but on two occasions, I asked a sales representative from
Aetna
for a quote. Both times, the representative promised savings of 15 to
20 percent but then also demanded a complete roster of my employees and
their dependents.
Not surprisingly, when the underwriters were done, the rates we were
quoted were almost identical to what we were already paying. So I have
stuck with Independence Blue Cross for the last 13 years, mostly to
avoid the hassle of dealing with a different company.
Share Your Experience
You’re the Boss would like to hear from small-business owners who are adjusting to the Affordable Care Act.
After
receiving a shocking quote
from my health insurance agent, I decided to go to HealthCare.gov to
see whether I could price alternative policies. I was able to connect
without difficulty, and my first impression was: Looks nice! I do a lot
of government business and, in my experience, most federal sites that
link to large databases have a certain naïve aesthetic — this
invoicing site from the Defense Department being a good example. The insurance exchange site is considerably nicer. I would rate its overall look and feel as excellent.
This was not the first time I had been on the exchange. I had taken a
quick look shortly after it opened, in early October, when I was
curious to see whether specific plans with pricing were shown. Even in
the first week of the exchange’s existence, I was able to navigate
(starting
here)
to a pricing tool that lets you plug in your state and county and get
generic sample quotes. The first page asks whether you are buying as an
individual or a small-business owner. I tried both and found both
options worked well. Either way, you are taken through a sequence of
pages that explain how the plans work and how the individual subsidies
work. And then you go on to pricing.
All of the information is clearly presented. When I tried the pricing
tool, the prices I saw were for a single person and a family, but it
was not entirely clear how old all of these theoretical people were, so
the numbers were not all that useful because they varied widely with
age.
After seeing the generic quotes in early October, I let the project
sit for a while, having been assured by the media that the site was a
disaster. It was not until after I got my renewal package, on Oct. 29,
that I went back. This time I tried to get a specific quote — first
going to the page to create an individual account, which did not work.
There was no response after I clicked the link to start the application.
Thwarted, I went to the Independence Blue Cross site to see what it
would be like if I tried to buy directly. It was not hard to find
the page to start an application,
but the actual shopping window would not load. Instead, I got a
server-disconnected notice while using both Safari and Chrome browsers.
Hmmm. The public and private sectors: tied in a race to the bottom.
I tried the Blue Cross site again the next morning and was able to
get through. I answered a bunch of questions about the members of my
family, and eventually got a tailored quote for Keystone Gold HMO:
$1,379.65 per month. Interesting. My agent had quoted me $1,437.27 per
month for Keystone Premier Gold, but I could not figure out what the
differences were between the two plans.
I also tried the Aetna site, where I answered the same questions
about the age of my family members, but here I was shown only plans in
the silver and bronze categories. I could not figure out how to generate
gold level quotes. I wanted to see what pricing was like for comparable
coverage, and the Obamacare metal labels indicated that what I was
being shown was not the same as what I had seen from my agent, so that
did not help me.
I searched “health insurance” on Google and ended up at another site,
United Healthcare’s,
with an easy-to-use calculator. And then I noticed, after submitting my
information, some very small print that briefly flashed, “Please note:
Plans with requested effective dates of Jan. 1, 2014, or after have
significantly different pricing and benefits.” Apparently the numbers
shown on the next page were not for plans compliant with the Affordable
Care Act. Utterly useless.
Late in the evening last Monday, I returned to HealthCare.gov and
tried to create an account. This time I succeeded without difficulty.
Logging in was straightforward — create a user name and submit personal
information: name, address, Social Security number. I was tired,
however, so I did not start the application immediately.
The next morning, I logged in, again without difficulty, and spent 30
minutes on an application for myself and my family, applying as
self-employed buyers. I wanted to see if the costs offered to
individuals differed from the costs I was quoted as part of a group buy.
The first part of the application was a verification of my identity,
very similar to what happens when I get a credit report online. I was
asked some questions about former addresses and phone numbers that
presumably only I would know. It worked flawlessly. Then I went through
the usual questions about the ages and sex of my family members and our
tobacco use. There were a few optional questions about our race and
ethnicity, and then I got the quote.
I was shown pricing for 24 plans: two platinum, six gold, nine silver
and seven bronze. In the mix was my old pal, Keystone Gold HMO, at
$1,379.65 a month — same as on the Independence Blue Cross website and
lower than the quote from my agent. (I have not spoken to her yet about
this. I’m waiting for her to come back with the pricing she promised
from Aetna.)
The next afternoon, while I was at work, I decided to look into
getting pricing for my employees, using the SHOP part of the exchange,
as HealthCare.gov is designed to service both individuals and
small-business bosses. One of the first choices you make, on the home
page, is whether to go through the site as an individual or as an
employer. Having tried the individual quotes, I wanted to see what
happened when I tried to get a quote for all of my workers, like the one
we had received from my agent.
There is a different set of pages to navigate, with
plenty of FAQs
(easy to read and navigate), but in the end you do not get to see
pricing online. Instead, you fill out a PDF, which is basically your
business’s name and address, and a list of employees, and put it in the
mail. Very 20th century. I presume that the paperwork is required
because this part of the site is not functioning yet, but I do not know
that for certain.
I did learn one detail about the paper application, and the
individual application, that is important. The site does not emphasize
this, but you must have the
current version of Adobe Reader
installed on your computer or you will not be able to read the PDFs. I
had an older version, and when I first opened the document, it was nine
pages of question marks. I installed Reader 11.04, and it was all good.
When I started shopping for my business, I set up another account at
HealthCare.gov, this time using my business address. I try, in all of my
financial dealings, to keep some distance between my personal life and
my business life, so it seemed logical to set up another account. The
application page does not distinguish between an account established for
a business and an account established for an individual. You still
enter your own name and Social Security number. Again, I went through
the questions to verify my identity, and everything checked out. So I
ended up with two accounts, with two user names: one a variation on my
own name, the other a variation on my business name.
Having done that, I started on the mail-in business application. The
first question asked for my “Marketplace User ID.” I was confused as to
what this might be. When I completed my application as an individual, I
was given a nine-digit application number. Was that what the program
wanted? When I entered that number on my computer, a notice popped up
saying it was incorrect. What to do? I called for help.
The application lists a phone number for a help center: 800-706-7893.
I called at about 3:30 on Thursday afternoon. I pressed 1 for English
and 0 for a representative, and to my surprise, the phone was answered
on the first ring by Amy, who was pleasant and helpful. She told me that
the Marketplace User ID was my login user name, not my application
number.
I asked her what would happen after I mailed in the application, and
she told me that I would be contacted by someone from HealthCare.gov to
complete the process. How long would it be before I was contacted? She
didn’t know. She said the representatives had not been given an answer
to that question. I should mail in the application and hope for the
best. I told her that I needed to renew by Jan. 1, and she assured me
that it would be taken care of in time for that deadline.
That went so well — immediate service by a pleasant person who
answered the questions she could — that I decided to do it again, just
to see if the first time was a fluke. First, I worked on the application
for a few more minutes. It asks for name, Social Security number, hire
date and birth date for each eligible employee, which took a while. Then
I called the help line again: same easy procedure, same instant pickup
(this time from a different person), and same answers.
So I completed the application and put it in the mail on Thursday.
And now I wait: both for HealthCare.gov to get back to me and for a
quote from Aetna to be delivered by my agent, Maggie.
One more thing: I tried to log in to my personal account last night,
and it was taking a long time to load. It could not pull up my
application. Hmmm. Then this morning, I logged into my business account
and found that the information from my personal application had appeared
under the business login. Double hmmmm.
So here’s my conclusion. If you are using HealthCare.gov, do not make
multiple accounts using the same name and Social Security number. You
can apply both on the personal side (online) and business side (using
the paper application) with the same login. That issue aside, the site
seems to be working, and I found it to be well-designed and helpful.
As for the conclusion to my search for affordable health insurance, I
cannot predict when I will be able to write it. I need to hear what my
pricing will be for business plans, both from my agent and from the
government. Then I will try to come up with a game plan in consultation
with my employees. We will make a decision about what to do, and you
will be able to read all about it here.
Paul Downs founded Paul Downs Cabinetmakers in 1986. It is based outside Philadelphia.