Hartford Business Journal

HartfordBusiness.com | March 8, 2021 | Hartford Business Journal 15 Keep day-to-day operations running smoothly with simplified cash management solutions from PeoplesBank. bankatpeoples.com/businessteam Take the work out of managing cash flow. Works for me. Member FDIC/Member DIF in Connecticut either on or off the state's insurance exchange, but they collectively only cover about 108,200 lives in a state with more than 3.5 million people. Oxford Health Insurance, which offers an off-exchange product, has the biggest small group market share, covering more than 40,000 lives. Jeffrey Hogan, the northeast regional manager in Farmington for employee benefit consultant Rogers Benefit Group, said other insurers — including Anthem, Aetna and UnitedHealthcare — are introducing new tech-enabled, consumer- focused health plans for small businesses that offer apps to access care and patient data, virtual care and other tools that aim to better coordinate care, improve outcomes and reduce costs. Plans are also increasingly introducing value-based care that begins to move providers away from a fee-for-service model, which Hogan said is a major cost driver in the healthcare system that makes insurance unaffordable for many small businesses. Kenneth Comeau, president of CBIA Service Corp., a subsidiary of the Connecticut Business & Industry Association that houses the organization's health exchange, said having another competitor in the state's small group market "just makes everybody better." Called Health Connections, CBIA's exchange offers insurance through ConnectiCare ranging from traditional, fully-insured health plans to "level-funded" policies, an emerging self-insurance hybrid plan targeted at small employers. "There's a lot of innovation that goes on" in Connecticut's insurance marketplace, Comeau said. "There's plenty of opportunity out there." Recent innovations include the rise of level-funded plans, in which employers still contract with insurance companies but take on more of the financial risk. "There has been more and more movement to try to create options for employers in the private sector," Comeau said. Some innovations within the market that are likely to outlast the COVID-19 pandemic are telehealth and "voluntary products," which allow for more customizable benefits paid for by employees entirely through payroll deductions. "The private sector will continue to work to innovate to create options within the framework that the regulatory environment allows," Comeau said. Kenneth Comeau Patricia Rivera A s Bloomfield health insurer Cigna prepares to re-enter the state's small group market with a new plan for employers with 50 or fewer workers, Connecticut's health insurance landscape remains somewhat uncertain. Gov. Ned Lamont, progressive Democrats and Republicans have all recently unveiled plans that would reform the healthcare industry. While the plans differ, there seems to be bipartisan agreement that the cost of health care for small businesses and individuals is too high and unsustainable long term. The most notable and controversial proposal is one put forward by Democratic state lawmakers that would set up a state-run health insurance plan for small business and nonprofit workers to be implemented and run by the office of the state's comptroller, Kevin Lembo. Essentially it would allow those groups, and potentially others, to buy into the state employee health plan. Business groups including the Connecticut Business & Industry Association and Connecticut Association of Health Plans, which represents the state's health plans, are lobbying strongly against it, arguing it could potentially add significant costs to state government, directly compete with one of the state's most important industries, and lead to a single payer system. Health insurers employ well over 10,000 people in the state. Lembo, a main proponent of the public option, has argued that insurers have had years to bring to market new and more affordable plans for businesses and individuals, but haven't done so, forcing the state to step in. Meanwhile, Lamont has proposed creating additional subsidies for people who buy insurance on the state's health insurance exchange. The subsidies would be paid for by a new tax on health insurers that would raise an estimated $50 million annually. Lamont also wants to limit annual increases on prescription-drug costs, creating opposition from the state's pharmaceutical industry. Democrats in the General Assembly also support the new tax on health insurers. Finally, Republicans want to establish a reinsurance program that would shield insurers from exorbitant claims, and therefore help mitigate major premium hikes on small businesses and individuals. The GOP also wants to establish healthcare cost growth benchmarks and import cheaper prescription drugs from Canada. Policymakers will spend the next few months debating the issue. The legislative session ends in early June. Health insurance reforms on the way? By Greg Borodonaro gbordonaro@hartfordbusiness.com

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