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Salaried-based insurance offers hope for some companies

Oklahoma City-based Buy For Less found relief from soaring health insurance costs by custom designing a program that, among other things, introduces salary-based premiums. Workers who earn less, pay less. And those paid $10 or less an hour are provided free health insurance.
by Paula Burkes Published: December 9, 2012

/articleid/3735728/1/pictures/1902895">Photo - Buy For Less employee Linda Pelletier pulls shopping list items for a customer's Internet order at Uptown Grocery in Edmond, By Paul Hellstern, The Oklahoman <strong>PAUL HELLSTERN</strong>
Buy For Less employee Linda Pelletier pulls shopping list items for a customer's Internet order at Uptown Grocery in Edmond, By Paul Hellstern, The Oklahoman PAUL HELLSTERN

Beginning Jan. 1, 2014, employers with 50 or more full-time equivalent workers must offer employees who work 30 hours or more a week affordable coverage or face penalties of up to $3,000 per employee.

Coverage is considered unaffordable if employee premium contributions exceed 9.5 percent of household income, Bumps said. And varying employee premium contributions by salary can keep lower-wage workers' costs under that 9.5 percent threshold, she said.

Cori Loomis, a director with Crowe & Dunlevy law firm, also looks for more salary-based models. “As we see premiums rise and rise, affordability will become more of an issue for lower-paid employees,” Loomis said.

But salary banding likely won't work for employers with mostly lower-paid workers, Loomis said. “If only 10 percent of your workforce has a higher salary, you can't shift the whole cost to them,” Loomis said.

Oklahoma City independent insurance broker Michael Shaw of Andreini & Co. believes many employers simply will charge workers 9.5 percent of their gross salaries, with a cap of say $350 a month.

“The irony will be low-wage earners will be protected by the 9.5 percent of wages and the high earners will be protected by a cap, but middle income earners will have no relief,” said Shaw, who expects employers, based on current tiers in the fully-insured market, to charge an additional $200 to $400 for spousal coverage; $100 to $300 for a child or children; and $300 to $700 for family coverage.

To meet the mandated limit of 9.5 percent of family income, employers would have to request tax returns or W2s from workers, which Shaw, a former human resources director, doesn't anticipate.

“Not only would it be an administrative nightmare, there'd be huge privacy issues,” he said.

“Workers,” he said, “wouldn't want their employers knowing, for example, if they moonlighted as a trainer or what their spouse makes. In their minds, it might affect what, if any, raises they get.”

“The 9.5 percent (limit) is really just conditioning people for another tax that they have got to pay,” Shaw said.

For her part, Buy For Less hourly employee Linda Pelletier, of Edmond, chose to pay for the grocer's highest plan, the gold option, which carriers a $40-a-week premium.

“I don't get sick very often, but I took it just in case,” said Pelletier, 62. “Just the fact that I'm getting older, I figure some time or another, I'll need to rely on health benefits.”

Dubroff said since more employees now are covered under the company's health plan, more are getting checkups.

“They're catching problems earlier,” he said, “so they save money and we save, too.”

by Paula Burkes
A 1981 journalism graduate of Oklahoma State University, Paula Burkes has more than 30 years experience writing and editing award-winning material for newspapers and healthcare, educational and telecommunications institutions in Tulsa, Oklahoma...
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The cost of health insurance

Average annual premiums this year are $5,615 for single coverage and $15,745 for family coverage.

SOURCE: The Kaiser Family Foundation


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