Oddly, the song that played in my head as I type the post title was Styx’ “Too Much Time on My Hands” and that does not fit at all! Too much time though has passed since I last posted here. Our other social media and day-to-day work has just taken all that time. *
I don’t know about you, but on/near my birthday I have a tendency to reflect. Not in a morbid or morose way, just in a “hmmm, where am I, where am I going, what are my current goals/dreams and where I am in meeting those I’ve held previously” way. Tomorrow is my birthday and though I’m not anywhere close to social security age, but the information below from Hawkins, Ash CPAs caught my eye and actually made me chuckle due to the timing.
Good Friday afternoon everyone! Hope this week has treated you well.
Today I bring you my promised post from last week’s De Pere at Dawn. Getting the video parsed down and uploaded was a process. *long process*. Unfortunately, we don’t have the full segment from Daren Allen, the final presenter because there was a video failure. We had part of it, but decided not to post only that segment since it was jarring.
I will post this with each presenter’s identifying information and a link to their PowerPoint presentation as well as the video link at YouTube (except for Daren). In a future post, I will link to an upcoming edition of Wisconsin Eye featuring a town hall with J.P. Wieski that will have the most current information.
Summary statement? Wow was it a great great panel. ”Best ever” in the words of one of our guests. With no further ado:
Introduction section (Cheryl Detrick, President/CEO De Pere Area Chamber)
Overview from the State perspective (J.P. Wieski, Legislative Liaison/Public Information Officer from the Office of the Commissioner of Insurance, State of Wisconsin)
Overview from business organization perspective (Lori Compas, Executive Director of the Wisconsin Business Alliance)
More details, yet still overview from insurer in Health Insurance Marketplace (David Grunke, Manager Strategic Accounts, WPS Health Insurance/Arise Health Plan)
And, MORE details, overview from insurer, Common Ground Healthcare Cooperative (Daren Allen, Vice President of Sales & Business Development for the Common Ground Healthcare Cooperative)
Long story short … on October 1st, go look. It will cost you nothing but a bit of time, may save you money and will satisfy your curiousity!
October 1st in 3 weeks away.
If you are furrowing your brow and wondering why you should care … well, if you provide, have or need health insurance, it is an important date.
First of all, the “exchanges” will be open for enrollment and we will have the rate information. For individuals, families, business owners and employers of all sizes shopping “apples to apples” (should) be available. If you want more information, *lots* more information, we still have some room at tomorrow’s De Pere At Dawn event. This panel is going to be epic. Our panels always are, but wow. The brain power & knowledge of J.P. Wieski (OCI, Wisconsin), Lori Compas (Wisconsin Business Alliance, David Grunke (WPS Health Insurance/Arise Health Plan) and Daren Allen (Common Ground Healthcare Cooperative) will be more than worth the 90 minutes. LINK HERE
Second, since the Health Insurance Marketplace (a.k.a. “the exchanges”) will begin offering health insurance on January 1st, on October 1st employers must give notice to their employees about coverage options available through the marketplace with a separate notice sent to dependents and others on their health insurance.
- The notice must information employees of the existence of the Marketplace in each state, what the services are to be provided by the Marketplace and how to contact the Marketplace
- The employer must also provided information on their sponsored/provided health insurance, if any, and state the intent of the employer to meet the Employer Mandates requirements (if more than 50 FTE employees).
- Also, the notice must explain that employees may lose the employer contributed amount toward health insurance (if that is what the employer chooses to do and if the employer does contribute toward health insurance).
- Finally, the notice must inform the employee of the employee’s potential eligibility for a premium tax credit if the employee purchases insurance through the Marketplace.
There is some dispute as to whether this requirement is limited to only those employers with 500k or more in annual revenue. To be safe? I’d say send it out. To be certain for *your* business? Contact your broker, your tax guy and/or your lawyer.
Yes, I said it. It is still Summer and I’m thinking Christmas. *shrug* I love the holidays, what can I say!
I was reading Hawkins, Ash CPAs current E-newsletter “Tax Update” and was reminded of Christmas. (You are really scratching your head now, aren’t you?) Gifts! Which (for some folks) can lead to the gift tax. The good people there shared:
So, if you are thinking of your gifting and are wanting to make plans, there you go!
OH! Speaking of Hawkins Ash CPAs – on September 20th we will be losing our “back fence” neighbor as they move to their new (very nice) digs at 2360 Dousman Street in Green Bay. (Right next to the intersection of Highways 41 and 29). They have been growing so much they have outgrown their space. Most recently they merged with Rochester, MN based firm Wolter-Raak and on September 1st, Anderson Tackman will officially merge in. Who says business isn’t good?! Congratulations and best of luck in the new home.
We will be celebrating with them for their Grand Opening at our special De Pere at Dusk on October 29th.
Have you driven down (or is that up?) Broadway in De Pere lately? If so, you probably noticed a house in the sky. As soon as I saw it, I knew I had to have the story behind what was happening, so I called DeLeers Construction.
Due to poor soil conditions, the house at 519 N Broadway was sinking. After doing soil testing, it was determined that helical piers needed to be driven down approximately 35 ft. to stabilize the new concrete footings and foundation walls. In order to perform the work, DeLeers Construction needed to raise the house roughly 2 ft. above grade and remove the old footings and walls. Raising the house was quite the feat; the house weighed approximately 121 tons.
Drive by a take a look!
I first wrote this post 2 years ago and I feel compelled to repost it today … for tomorrow and for all the tomorrows. We can ask God to bless America, but it is our job, our responsibility and our duty to protect what She stands for – “We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.”
Tomorrow is the celebration of America’s Declaration of Independence (let’s not quibble about the official date since there were some details!!), but today, rather than waxing about patriotism etc., I want to pay tribute to those 56 men who risked so very much for their families, their countrymen and, ultimately, for 300 million people they’d never ever know – us.
When was the last time you read and really thought about the words in the Declaration? College? High school? Middle school? Elementary school? Ever?
I challenge you to do so. Right now. Before you go buy more fireworks, or start the BBQ, or put your flag out. Read the following words. Slowly. Carefully. And with all the thought and consideration of those who wrote them.. Happy Birthday America!
The unanimous Declaration of the thirteen United States of America,
When in the Course of human events, it becomes necessary for one people to dissolve the political bands which have connected them with another, and to assume among the powers of the earth, the separate and equal station to which the Laws of Nature and of Nature’s God entitle them, a decent respect to the opinions of mankind requires that they should declare the causes which impel them to the separation.
We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness. — That to secure these rights, Governments are instituted among Men, deriving their just powers from the consent of the governed, –That whenever any Form of Government becomes destructive of these ends, it is the Right of the People to alter or to abolish it, and to institute new Government, laying its foundation on such principles and organizing its powers in such form, as to them shall seem most likely to effect their Safety and Happiness. Prudence, indeed, will dictate that Governments long established should not be changed for light and transient causes; and accordingly all experience hath shewn, that mankind are more disposed to suffer, while evils are sufferable, than to right themselves by abolishing the forms to which they are accustomed.
But when a long train of abuses and usurpations, pursuing invariably the same Object evinces a design to reduce them under absolute Despotism, it is their right, it is their duty, to throw off such Government, and to provide new Guards for their future security. –Such has been the patient sufferance of these Colonies; and such is now the necessity which constrains them to alter their former Systems of Government. The history of the present King of Great Britain is a history of repeated injuries and usurpations, all having in direct object the establishment of an absolute Tyranny over these States. To prove this, let Facts be submitted to a candid world.
He has refused his Assent to Laws, the most wholesome and necessary for the public good.
He has forbidden his Governors to pass Laws of immediate and pressing importance, unless suspended in their operation till his Assent should be obtained; and when so suspended, he has utterly neglected to attend to them.
He has refused to pass other Laws for the accommodation of large districts of people, unless those people would relinquish the right of Representation in the Legislature, a right inestimable to them and formidable to tyrants only.
He has called together legislative bodies at places unusual, uncomfortable, and distant from the depository of their public Records, for the sole purpose of fatiguing them into compliance with his measures.
He has dissolved Representative Houses repeatedly, for opposing with manly firmness his invasions on the rights of the people.
He has refused for a long time, after such dissolutions, to cause others to be elected; whereby the Legislative powers, incapable of Annihilation, have returned to the People at large for their exercise; the State remaining in the mean time exposed to all the dangers of invasion from without, and convulsions within.
He has endeavoured to prevent the population of these States; for that purpose obstructing the Laws for Naturalization of Foreigners; refusing to pass others to encourage their migrations hither, and raising the conditions of new Appropriations of Lands.
He has obstructed the Administration of Justice, by refusing his Assent to Laws for establishing Judiciary powers.
He has made Judges dependent on his Will alone, for the tenure of their offices, and the amount and payment of their salaries.
He has erected a multitude of New Offices, and sent hither swarms of Officers to harrass our people, and eat out their substance.
He has kept among us, in times of peace, Standing Armies without the Consent of our legislatures.
He has affected to render the Military independent of and superior to the Civil power.
He has combined with others to subject us to a jurisdiction foreign to our constitution, and unacknowledged by our laws; giving his Assent to their Acts of pretended Legislation:
For Quartering large bodies of armed troops among us:
For protecting them, by a mock Trial, from punishment for any Murders which they should commit on the Inhabitants of these States:
For cutting off our Trade with all parts of the world:
For imposing Taxes on us without our Consent:
For depriving us in many cases, of the benefits of Trial by Jury:
For transporting us beyond Seas to be tried for pretended offences
For abolishing the free System of English Laws in a neighbouring Province, establishing therein an Arbitrary government, and enlarging its Boundaries so as to render it at once an example and fit instrument for introducing the same absolute rule into these Colonies:
For taking away our Charters, abolishing our most valuable Laws, and altering fundamentally the Forms of our Governments:
For suspending our own Legislatures, and declaring themselves invested with power to legislate for us in all cases whatsoever.
He has abdicated Government here, by declaring us out of his Protection and waging War against us.
He has plundered our seas, ravaged our Coasts, burnt our towns, and destroyed the lives of our people.
He is at this time transporting large Armies of foreign Mercenaries to compleat the works of death, desolation and tyranny, already begun with circumstances of Cruelty & perfidy scarcely paralleled in the most barbarous ages, and totally unworthy the Head of a civilized nation.
He has constrained our fellow Citizens taken Captive on the high Seas to bear Arms against their Country, to become the executioners of their friends and Brethren, or to fall themselves by their Hands.
He has excited domestic insurrections amongst us, and has endeavoured to bring on the inhabitants of our frontiers, the merciless Indian Savages, whose known rule of warfare, is an undistinguished destruction of all ages, sexes and conditions.
In every stage of these Oppressions We have Petitioned for Redress in the most humble terms: Our repeated Petitions have been answered only by repeated injury. A Prince whose character is thus marked by every act which may define a Tyrant, is unfit to be the ruler of a free people.
Nor have We been wanting in attentions to our Brittish brethren. We have warned them from time to time of attempts by their legislature to extend an unwarrantable jurisdiction over us. We have reminded them of the circumstances of our emigration and settlement here. We have appealed to their native justice and magnanimity, and we have conjured them by the ties of our common kindred to disavow these usurpations, which, would inevitably interrupt our connections and correspondence. They too have been deaf to the voice of justice and of consanguinity.
We must, therefore, acquiesce in the necessity, which denounces our Separation, and hold them, as we hold the rest of mankind, Enemies in War, in Peace Friends.
We, therefore, the Representatives of the united States of America, in General Congress, Assembled, appealing to the Supreme Judge of the world for the rectitude of our intentions, do, in the Name, and by Authority of the good People of these Colonies, solemnly publish and declare, That these United Colonies are, and of Right ought to be Free and Independent States; that they are Absolved from all Allegiance to the British Crown, and that all political connection between them and the State of Great Britain, is and ought to be totally dissolved; and that as Free and Independent States, they have full Power to levy War, conclude Peace, contract Alliances, establish Commerce, and to do all other Acts and Things which Independent States may of right do. And for the support of this Declaration, with a firm reliance on the protection of divine Providence, we mutually pledge to each other our Lives, our Fortunes and our sacred Honor.
Samuel Huntingtonv William Williams
Charles Carroll of Carrollton
Robert Treat Paine
Thomas Heyward, Jr.
Thomas Lynch, Jr.
Richard Henry Lee
Thomas Nelson, Jr.
Francis Lightfoot Lee
Not quite as quick as a NASCAR pit stop but hopefully a quick one! I went to the meeting yesterday regarding the Common Ground Healthcare Cooperative and I will post about that but first, my pit stop.
One of the programs that we conduct here at the De Pere Chamber is called Live Healthy Brown County, a community and worksite-based wellness program. Most of our members have less than 70 employees so having these types of resources available to them is important, since they probably don’t have a dedicated staff person for this type of initiative themselves. This is the third year and we just motor along letting people know what we’re doing, inviting them to join in as well as providing information. Occasionally though, we get reminded that not all of us are on the same page as far as what and why we are doing things as a Chamber. This morning was one of those times.
Each Tuesday, we publish an e-newsletter for the Live Healthy Brown County program. The newsletter features a healthy tip from our sponsor Aurora BayCare Medical Center, a healthy recipe, information on activities going on in the community for fun and activity, and links to articles we found interesting. Today, in reply to this weeks edition, a long time valued member and friend replied with, “Interesting reading. But I still don’t see what this has to do with Chamber of Commerce Business.”
My initial response was a bit of furrowed brow and then I realized that while I would of course respond to him; this is an opportunity for me to make sure that we are engaging with our other members and community members as well.
This is how I replied:
This is the third year that the Chamber has been managed the Live Healthy Brown County program. As the workforce gets older and smaller, the Chamber recognized that we need to encourage members of our workforce and our community to live healthier lives so that they can be more productive workers. Many studies regarding “quality-of-life” have also shown that communities place an emphasis on community health and worksite wellness have a better return on their workforce expansion/retention efforts.
Additionally, beginning January 1st with the full implementation of the Affordable Care Act, the shift to “community rating” will link the wellness/illness of our community members to our health insurance costs giving all of us a stake in promoting wellness. Finally, also beginning January 1st, companies that offer wellness programs can hit workers who don’t meet certain health targets — such as lowering cholesterol, blood pressure, or body-mass index — with premiums that are as much as 30 percent higher than other employees’. Smokers who don’t quit face even bigger expenses: companies can charge them up to 50 percent more than other workers. Since business pushed very hard for those components to be included, we feel it is very much the business of the chamber of commerce, as a business organization charged with community and economic development, to be a leader in information, education and resources in this area.
I hope that helps!
He answered back, “Well done…. Thank you.”
I truly do welcome these opportunities. Not only does it allow me to clarify questions and respond to member concerns, but also allows me to talk about what we’re doing and why. Everyone who knows me for longer than three minutes knows that I’m very enthusiastic and passionate about what we’re doing here and why we’re doing it.
During yesterday’s Path to Leadership session, Wendy Franklin asked the question, “why is mission important?” And I answered with something along the lines of, “If it’s not mission-critical we stop doing it. Mission is not only what drives the organization, it’s what drives me personally.”
Emails like the one I got this morning remind me about our mission and remind me why we need to tell our story of what we’re doing. We can’t tell it just once or twice and think that’s enough we have to continue to do it. We have to continue to show our relevance and we have to continue to sell the value.
There, pit stop done! Thanks for the reminder, thanks for the mission, thanks for the time!
It’s Friday! *and the crowd goes wild*
Quick update for this end of week for our blog readers. We want to make sure you are getting all of our updates for goings on here at the Chamber, with our members and in our community. We can’t have you missing out! Down at the bottom of each post are “share” buttons for you to be able to spread the words of the Chamber, but we haven’t made it easy for you to follow us via our other social media venues. Time to fix that!!
Friend, follow, etc etc… we do the same.
Have a great weekend everyone, hope it is enjoyable and you get some time to unplug and unwind!
No! Wait!! Don’t leave…
Well, I’m recording this on my way back from Madison after attending Wisconsin Manufacturers and Commerce’s healthcare event that I mentioned earlier this week. My plan is to get this transcribed to have it post yet this week as I promised. With tomorrow being a half day and starting the day with our Maximizing Your Chamber Membership session and then a meeting with the Green Bay CVB regarding Restaurant Week (news soon!!) after that … it is tonight or late. So, tonight it is! Next week I will post about consumer driven healthcare and then the healthcare cooperative. Are you excited?
First thing I learned today: there are still a lot of questions for which we don’t have answers. That seems to be a consistent theme of the discussion. Next thing I learned is that if you are one of the millions of employers in the US and one of the hundreds of employers in our area who have less than 50 employees – the affordable care act will not penalize you in any way at all.
Not that you don’t need to pay attention and not that you don’t need to understand the affordable care act and its ramifications; but, you will not be penalized so you don’t have to worry about that. Feel better? Good. I have heard from so many of you in that bucket of folks who are very concerned, so I want to ease your mind.
If you have close to 50 employees, even if a good number of them are part-time, you need to pay closer attention. Yes, I’ll get to more about that in a little bit. Next, if you do have 50 employees and already offer decent health insurance at a reasonable cost, you probably don’t have much to worry about either. Let me asterisk that by saying one of the big takeaways from today is you need to talk to your insurance broker. Let me say that again – you need to talk to your insurance broker - if you are at the 50 employees threshold, it just makes good sense to know what you’re looking at for next year and beyond.
For the purposes of health care reform, you are a large employer if you have 50 or more employees. I have to say that is the smallest number I have ever heard referred to as a “large employer” by a governmental entity – but it is important to know the definition. Having said that, I’m going to try to explain the calculation in as simple a way as I possibly can. If you are even close or think you might be close to the 50 employee threshold, again, please talk to your insurance broker. Don’t wait, get on their calendar soon.
Here’s a calculation: let’s say you have 30 full-time employees. By that I mean they work consistently week-in and week-out full-time. They may be salaried, they may be hourly, but as long as they work more than 30 hours every week (or at least most weeks) they are a full-time employee. To that number you need to add full-time equivalent employees. How do you calculate that number? Well, this is a different calculation than I have heard before, so I want to make sure you hear it as well. Total all of your part-time employees’ hours for a month and divide that by 120. The answer to the equation is your full-time equivalent number. If you add your full-time employees plus your FTE number together and find your number is more than 50 you need to talk to your insurance broker because you are likely subject to the provisions of the healthcare act as a large employer and could be subject to penalties.
By the way, that “50″ number of full-time employees including your full-time equivalent employees is an average. So, if in one month you had 75 employees and the rest of the year you only had 20 employees you would not have 50 employees and would not fall subject to the rules. There are lots of details regarding measurement periods, administrative periods and stability periods. Talk-to-your-insurance-broker. One more point: nothing in this law says that you have to offer health insurance to your part-time employees. You only have to consider your part-time employees when it comes to calculating if you are subject to the 50 employee rule or not. You will no more be required to offer your part-time employees health coverage after January 1, 2014, than you do today.
The next important component, if you are over the 50 employees level, is the insurance package you offer must be “affordable.” Affordable is defined as costing no more than 9.5% of your employee’s income. The short version is this: if you have an expensive health plan and a number of employees who make minimum wage, or near minimum wage, you need to be concerned about the affordability component – otherwise it probably won’t apply. Having said that talk to your insurance broker.
Something else repeated today is regarding the rates that will be charged both through the exchanges as well as premiums for private insurance. The general consensus is that the rates will go down for companies who have a high number of older or less “well” employees and will go up for those companies have a higher number of younger or healthier employees. The fear is the exchanges will be “dumping grounds” for those who can’t get insurance elsewhere. No one knows what those rates will be here in the state of Wisconsin. As I mentioned earlier this week, only the states doing exchanges themselves have a sense of what their premiums will be, and at this point we’ve only heard details from California (and to some extent Washington and Oregon). The news from California regarding premiums on their exchange have been positive. We have our fingers crossed that we will hear similar news when our rates are announced here in Wisconsin.
A couple of other important notes that stood out to me:
First, the only people who will be eligible to buy insurance on the exchanges and receive subsidies from the federal government are those individuals who either have no insurance option at all through their employer or those who don’t have an “affordable” insurance option that also meets the “minimum essential coverage” requirements through their employer and make between 100% and 400% of the federal poverty level. (Yes … yet another item to talk to your insurance broker about!)
Second, if you are one of the employers I mentioned who have more than 50 employees and do not offer an “affordable” option for your employees, you will be subject to what is called a “Pay or Play” penalty that will cost $2000–3000 per employee. Please refer to my ongoing theme: if you have 50 or near 50 employees, you need to talk to your insurance broker.
The exchanges/cooperatives are to begin taking enrollments October 1 and then begin operation on January 1, 2014. There was also conversation today on whether all of this will happen on the schedule as outlined. Here is the long and short answer: probably. The general consensus is that a delay will only happen if an “operable” exchange is not in place in the state of Wisconsin. ”Operable” was defined as 71 of 72 counties in the state having coverage under an exchange available. From what we heard today that will happen.
As I mentioned earlier this week, Common Ground Healthcare Cooperative will offer products in the counties that we serve. We also learned that there were at least two health insurance companies that submitted rates at the end of April that will also serve our area for the exchange. On the insurance panel today were representatives from both Humana and United Healthcare. Humana indicated they have submitted rates for the individual exchange but not the small employer exchange. United Healthcare was not able to answer if they would be in the exchanges in Wisconsin at all. It is a big decision for an insurance company to decide given the number of unknowns. However, given United Healthcare is not involved in the California exchange, it is a likely scenario United will not be involved in the exchange for Wisconsin either, at least not initially.
So that’s it from today. You would think from a four hour meeting I would have more information! However, the reality is we just don’t know all of the answers yet. Next Wednesday I will be going down to Milwaukee for an informational meeting of the Common Ground Healthcare Cooperative. When I return from there I will have more information regarding what that may mean for you and your family as well as potentially for your employees. At the very least, it will be another option.
Finally – no one took me up on my offer of car-pooling to Madison. Trust me, I didn’t take it personally! I know it’s hard to take a half day out at a busy schedule especially when you don’t know if you will hear anything that you can actually use. It is still pretty early in the process. The second Wednesday of October we will be holding a session that will give a lot more information. We will have detailed information by that time as the exchanges will be taking applications. We plan to have a representative from the office of the Commissioner of Insurance, someone from WPS Health Insurance/Arise Health Plan as well as the Common Ground Healthcare Cooperative on hand to give information and answer questions. A lot more detail on the event to come, I promise.
I filled a good portion of the drive by listening to Olympia Snowe’s new book, “Fighting for Common Ground: How We Can Fix the Stalemate in Congress” on Audible via my iPhone. In my post last week I was talking about Cassie Schuh’s reading list from our leadership session in May, I mentioned that I was planning to listen to some of those books. So far, I would really add this book to that list. I would say it is for anyone interested in the way our Congress is working (or not working as the case really is), anyone who has a political interest or just interested in the way things are happening (or not happening) in Washington. If any of you have read it or plan on reading I’d love to hear your thoughts on it as well.
Yes, I hear the groaning. While the last several years have been punctuated by the “health care debate,” the rubber begins to hit the road over the next 7 months. Many of the components of the Affordable Care Act are already in place (timeline here) but in 2014 is the 800 pound gorilla – the arrival of the health care (insurance) exchanges for individuals. They will technically begin operation on October 1st of this year, according to www.healthaffairs.org: Starting in October 2013, people without access to coverage through an employer, Medicaid, or the Children’s Health Insurance Program will be able to purchase health plans through health insurance exchanges for coverage taking effect in 2014. These new marketplaces are one of the Affordable Care Act’s key mechanisms for expanding affordable coverage.
This Thursday, June 6th, I will be attending an educational session sponsored by Wisconsin Manufacturers and Commerce, “Preparing for the New Normal Part 2: Implementing the Affordable Care Act in Madison. If anyone would like to attend and carpool, please let me know. There is a $50 fee per attendee (link is the title), the ride will cost you nothing except 5 hours in the car with me!
However, according to an article in USA Today on May 30th, “Seventeen states and the District of Columbia have received HHS approval to create their own exchanges, and 15 states will work with HHS to run a marketplace, while the 19 remaining states will operate exchanges created for them by the federal government. Many states, particularly those with Republican legislatures and governors opposed to President Obama’s health care law, did not create exchanges.” (Wisconsin was one of the states to not create an exchange.) ”Beginning in October, individuals will be able to do a side-by-side comparison of plans either through online state or federal exchanges. Insurers will not be able to charge more for or exclude those who have pre-existing conditions.
Insurers have submitted proposed pricing and plans, and, in the states that have released that data, there is a large variety of pricing. California’s premiums came in 50% lower than what had been projected, and in Washington and Oregon, people will pay less for premiums on the individual market than they did before the law, also called the Affordable Care Act.”
While we don’t know what the exchange will look like in Wisconsin, there was an additional option in the legislation: healthcare cooperatives. The new cooperatives are an option that came out of the debate for “a public option” during the national discussion on this topic.
More from Healthaffairs.org: “The provision created what was originally a $6 billion federal fund–reduced by law in 2011 to $3.4 billion, and reduced again in January 2013 as described below–that would enable sponsoring organizations to apply for loans to create new health insurance cooperatives.
These nonprofit, consumer-driven organizations would offer health coverage–and possibly also care networks–through the exchanges under the same regulatory requirements imposed on private insurance companies at the state and federal level. The provision was incorporated into health reform legislation in the Senate, and became law when the Affordable Care Act was signed by President Barack Obama in March 2010. Under Section 1322 of the Affordable Care Act, CO-OPs will offer coverage through the exchanges primarily in the small-group market, which generally serves companies or organizations with fewer than 100 full-time employees, and in the individual market. Like other plans offered through the exchanges, CO-OPs must be ready for open enrollment beginning October 1, 2013. The law required the Department of Health and Human Services (HHS) to distribute funds to at least one CO-OP in each state. But because of the most recent funding cuts, no more new CO-OPs will be established beyond the 24 that have already been created, at least for now (Exhibit 1).”
Wisconsin got one of the loans. The Common Ground Healthcare Cooperative, based in Milwaukee, will serve individuals and small employers in Brown, Calumet, Door, Fond du Lac, Kenosha, Kewaunee, Manitowoc, Marinette, Milwaukee, Oconto, Outagamie, Ozaukee, Racine, Shawano, Sheboygan, Walworth, Washington, Waukesha, and Winnebago counties and any individual, non-profit or small business will become a member when they purchase health insurance through Common Ground Healthcare Cooperative.. There are, in fact, health care cooperatives already in Wisconsin, but this is not a purchasing cooperative, but rather an actual insurance company. In answer to the question, “why will this work when similar concepts have failed?” According to their website, “Unlike other initiatives for small employers and individuals, Common Ground Healthcare Cooperative will not be contracting with an existing for-profit health insurance company to buy insurance and create a purchasing pool. Common Ground Healthcare Cooperative will be the insurance carrier and with its non-profit, member governed structure, Common Ground Healthcare Cooperative will provide quality plans that are affordable, coordinated, and responsive. Common Ground Healthcare Cooperative leaders have a strong vision for improving the health of members and for controlling the health care costs of its members which are the key factors to control premiums.” Open enrollment will begin October 1, 2013 and coverage will become effective January 1, 2014. Enrollment will be continuous throughout the year so prospective members can enroll on January 1, 2014 or after. The cooperative has been and will be holding education seminars. The seminars are designed for individuals (under 65) without insurance, self-employed individuals, small business owners and nonprofit leaders. Topics for discussion include the new insurance marketplace (exchange), subsidies for purchasing insurance, the individual mandate and other important issues. Each seminar is identical.
I will be attending the June 12th session in Milwaukee and extend the same carpool offer as above. I can’t find a fee for the session and the ride with me would be no cost (other than 4 hours in the car with me!).
I will report back here on what I learn and my thoughts if you can’t attend yourself (or just can’t bear to!). Whether you plan to attend one of these sessions, or the one we will hold in the fall, I hope you will get yourself educated. This is vital to you individually, your family and your employees. Stay tuned…