Don't Panic Says Insurance Rep To Employers

WATERTOWN - Todd A. Muscatello's advice to employers about complex federal health-insurance reform is not to panic.

Mr. Muscatello, vice president of sales for Excellus BlueCross BlueShield, spent Thursday morning trying to help north country employers understand how health-insurance reform will affect them.

"We've been getting responses from a lot of our members about confusion about health-care reform," said Peter J. Whitmore, chamber president and chief executive officer. "We want to help navigate this."

The event was hosted by the Greater Watertown-North Country Chamber of Commerce in Watertown on Thursday. At the meeting, Mr. Muscatello went over the timeline of implementation of the health-insurance reform legislation. Some of the smaller provisions were effective immediately when the legislation passed in March, but most of the major changes will take effect in 2014.

Mr. Muscatello opened his talk with a caveat: "You've got questions, and we've got more."

Mr. Muscatello said:

* The system largely maintains the employer-based system with changes and financial implications.

* The legislation affects Medicare, Medicaid and employer group insurance providers.

* The changes begin this year and continue through 2019.

In 2014, people will be required to enroll in a health-insurance plan, and so-called health benefit exchanges will be established. Those exchanges must comply with four coverage tiers - ranging from covering 60 percent of health-care costs to 90 percent of health-care costs.

One of the changes is that employers with more than 200 employees that offer coverage must automatically enroll full-time employees in a health plan. If the employee doesn't want health care coverage the company provides, they must then opt out rather than just not opting in to begin with.

And while it may not seem like a major change, it could create a lot of extra work for employers and how they deal with their payroll companies, Mr. Muscatello said.

Another big change is that states must create two types of health-benefit exchanges where insurance buyers will be able to select from a variety of plans that are administered by private insurance companies. The two types of exchanges are for individuals and small businesses.

As for many of the legislation's other provisions, there are many opportunities for change between now and 2014.

"This legislation has been politicized to death. It's confusing and it was written in a rush," Mr. Muscatello said. "And a lot is going to change before this is implemented, because we have another presidential election between now and then."

But when employers wanted to know what kind of specific cost increases they would see in 2014 if they continue to offer the same type of coverage as they do now, Mr. Muscatello didn't have a specific answer.

Too many factors come into play, he said, including new regulations and differing explanations of certain provisions. Those inconsistencies must be worked out before employers will know how much their health-care costs will change in the next four years, Mr. Muscatello said.

"Stay on top of this the best you can and use your broker - you don't need to be an expert," he said. "Stay educated, but keep doing what you're doing: Continue to manage the best benefit program with the best cost."