New laws create more health insurance options for small Virginia businesses, real estate agents – Daily Press

Two new Virginia laws will create health insurance options for two groups of companies that have felt excluded from cheaper coverage.

One allows associations to create a benefit consortium that would help small businesses gain the same purchasing power that large employers have for employee health insurance.

“It’s about access to health care, something I’ve been working on my entire career, and affordability,” said state Senator Monty Mason, D-Williamsburg, who sponsored the measure.

He said the law would help small businesses – those with between 2 and 50 employees – attract and retain the workforce by offering health coverage to workers and their families.

The other new law allows the Virginia Association of Realtors to organize group insurance for its members.

“It’s a way to make health insurance more affordable,” Del said. Keith Hodges, R-Urbanna, who sponsored the estate agents group insurance account.

Both proposals have been battlefields for years, contrary to concerns that they would get enough people out of the Affordable Care Act health insurance market to raise premiums for everyone else.

The idea with the benefits consortium bill, as presented to the General Assembly, is that it would allow groups such as the Virginia Chamber of Commerce to establish a mechanism that would allow small businesses to access the relatively low premiums that large employers can command.

Mason said the idea was that the consortium would bring together tens of thousands of small business employees; by spreading the risks over such a large number, the cost per person is lower. The consortium would be managed by a board of directors. Any surplus revenue over the claims and mandatory reserves would be used to withhold future premiums.

Mason said he began work on the proposal – his first effort came in 2020 – not long after giving a speech to a House panel saying he thought the idea was bad.

“They asked us if we could talk about it and after explaining what it could do, I said ‘if you decide to go ahead, let me know and I’ll take it,'” Mason said.

“We intend to form a benefit consortium,” said Laura Ramthun, the House’s director of communications and marketing.

The chamber is waiting for the State Insurance Bureau to write the regulations, he said.

Basically, the law states that associations would be able to create something like the self-insurance pool used by many of the major employers and make its coverage available to small businesses. With self-insurance, instead of buying a policy and relying on an insurer’s financial resources to cover claims, an employer puts their own funds, usually by hiring a company to run the program.

Consortium coverage should include all health benefits required by the Affordable Care Act, as well as the cost sharing and value of the coverage standards in that act. It would be prohibited to deny coverage for pre-existing conditions.

Like workers ‘compensation insurance, it would set a base rate for participating companies and, once the companies’ actual experience with claims is nil, their specific premiums would be set at predetermined percentages above, at the same level or below base rates, while trends for the entire pool would determine future base rates.

The Realtor’s Bill takes a different approach, providing individual members with a way to purchase insurance policies at similar rates to those quoted by the groups, rather than individual market premiums, said Martin Johnson, the association’s senior vice president for relations with the government.

For some, their income is high enough that they are not eligible for Affordable Care Act benefits. For others who may not be doing as well or are just starting a career, even with benefits, the premiums may seem hard to afford. .

“Real estate agents are not like other professionals – they are mostly independent contractors. So they can only get insurance in the individual market, ”Hodges said.

He said two key points helped him support the bill: First, that about 20% of real estate agents don’t have insurance, so his account would reduce the number of uninsured Virginians by several thousand.

The second key point was that the bill states that any plans eventually made by real estate agents should include at least all the essential benefits required in the Affordable Care Act plans.

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This was important because past efforts for alternative health coverage, such as extending periods for short-term coverage, faltered as health plans and other naysayers claimed their narrower set of benefits would lure too many healthy people away from them. ACA plan pool. The result would be a spiral of premium increases.

What the bill allows is for the association to purchase a group insurance policy for them, basically for the same type of group coverage that larger companies buy now if they don’t opt ​​for a self-insurance program, Johnson said.

The association is talking to insurers and the Bureau of Insurance to see how it might work; Whether it continues will depend on the type of tariffs quoted, Johnson said.

For real estate agents who get their insurance through the ACA Individual Market, but who are looking to stretch their dollars by not purchasing all the coverage they might need, his account would provide an option to address their under-coverage, he said. Hodges.

After intense debates in front of General Assembly committees in recent years, “there isn’t much controversy left over whether it has a negative impact,” said Doug Gray, executive director of the Virginia Association of Health Plans.

The final version of the charitable consortium bill passed the State Senate 40-0 and the House 63-35. The Real Estate Agents Bill passed House 95-2 and Senate 40-0.

Dave Ress, 757-247-4535, [email protected]

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