Small employers are increasingly dropping health insurance. Premiums are prohibitively expensive and dire economic times are forcing owners to cut costs.
In an effort to control costs, some are resorting to what can only be characterized as fraud.
I recently returned from a trip to the Sunshine State, where I had the opportunity to meet with two prominent brokers. During the course of conversation one gentleman related the following.
An employer had contacted their cpa firm asking some questions about employee benefit payroll deduction requirements. To date they had paid 100% of premium but wanted to begin to have the employees contribute. This, in part, was the response the client received. Subsequent conversations between my colleague and the CPA firm indicated the broker that had taken the cpa firm down this path was doing it for others. In a separate conversation a my. Olleague had with a representative of another carrier, that person confirmed that this type of stuff was not uncommon. And we wonder why the cost of group is higher and is increasing at a faster rate ……..
Here’s the email the CPA firm received from the fraudulent broker.
“The cost of health insurance is a problem that we all are trying to grasp. We as employers are attempting to take care of our employees but control the ever rising costs. You have the ability to change your health insurance policy to either method the most common is a percentage of the single premium however, some employers use the flat dollar method as well.
I would recommend that you consider the change to HSA plans with the use of individual policies. The company can pay the premium or portion and contribute to or not to the HSA plan. The cost of individually underwritten plans are about half the cost of group plans. You can maintain group policy if you have employees that can not be underwritten as long as you have at least two.
We changed to this method this year including the full funding of the single person HSA and saved $10k. This savings does include the full family premium and HSA deductibles paid for two (XXX and me).
The negatives that you will have is the potential of uninsurable and the initial fear that the employees may have. The employee will have to pay the cost of benefits from the HSA account until the full deductible is meet then thereafter no out of pocket costs. The typical deductibles range from $1250 single to $2500 family. Even if you have not reached your deductible you will only pay the insurance companies costs.
The other negative is maternity benefits for individual plans are very weak (after one year on plan only pays $1500) so if you have any potential mothers this is something that needs to be considered.
I do have a contact if you need that assisted us with United Health Care in the transition. I personally believe that the HSA plans are the way to go.”
This is fraud.
Insight, analysis & opinion from Joe Paduda
Some attorney’s where holding seminars in FL teaching this. I had brokers come back up to Ohio and ask me about this. Picked up a couple good brokers who were working with another guy that had his carrier contracts cancelled. All the major carriers found out he was doing this and cancelled him. Problem is no one ever gets prosecuted for this type of stuff.