Though supporters and opponents of the Patient Protection and Affordable Care Act have a lot to disagree on, during a hearing Wednesday they agreed on one thing: That small business owners who are shopping for health plans should have some help from brokers and agents.
The headaches awaiting owners who head to HealthCare.gov or a state-based exchange website and try to sign up for Small Business Health Options plans on their own came up often during the Senate Small Business and Entrepreneurship Committee hearing on the SHOP exchange program rollout.
Some witnesses talked about successful efforts to offer SHOP programs.
Witnesses reported that Kentucky's kynect exchange has received 343 complete SHOP applications, and that employers in New Mexico have started 1,143 SHOP applications.
Mila Kofman, executive director of the District of Columbia's D.C. Health Benefit Exchange Authority, said users of the district's DC Health Link exchange have set up about 700 employer accounts. About 1,350 of the employers' employers are seeking full-price coverage, and about 2,000 are likely to qualify for subsidies, Kofman said.
But Kofman said buying small-group coverage can be complicated and time-consuming, even under the best of circumstances.
"If you're not working with a broker, you really need to take your time," Kofman said.
Gary Cohen, the director of the Center for Consumer Information & Insurance Oversight, said CCIIO has tried to work closely with agents and brokers, with the understanding that most small businesses buy coverage through them.
"We need to work really hard to make sure we're working with the agent-broker community," Cohen said.
Business owners also discussed problems with trying to get coverage through the SHOP enrollment system.
Drew Greenblatt, a Maryland steel wire company owner who represented the National Association of Manufacturers, said he initially thought his premiums were going to increase 49 percent.
To get good coverage with an increase of just 10 percent, he had to get coverage with a plan year that starts Dec. 1.
"I want to provide health coverage for employers and their families, and I have, but, because of the law, the coverage I wanted is no longer available to me because it is unaffordable," Greenblatt said.
Maryland has a state-based exchange, but Greenblatt said it has had such a weak SHOP communications effort that he just recently learned that the SHOP program won't start until April. Greenblatt said he has no idea what products will be available from the exchange when SHOP enrollment starts.
David Allen, the head of a medical billing company in Colorado, said he spent hours coping with bugs in the enrollment system for Colorado's state-based exchange. He had trouble setting up an account, and more trouble uploading employee data.
When the system finally let him shop for coverage, he saw that the richest plans available had annual deductibles of $1,500.
The deductible for his current plan is $750.
"I could do this on my own, without the assistance of the exchange," Allen said.