The Ottawa County Health Department and the County Health Plan Advisory Task Force have released the results of a survey of 816 small businesses in the county that may indicate the feasibility of a county health care plan in which the state, the business and the employee share in the cost.
Two important statistics were uncovered by the survey, according to the Health Department: 68 percent of Ottawa County small businesses do not now offer health care coverage to some or all employees; and 45 percent of employers said they could afford a monthly premium of up to $89 per employee.
The task force began a year ago to research the potential for a county health plan in Ottawa County. The task force, after investigating other county health plans — particularly Muskegon County’s Access Health — then undertook the Ottawa County Small Business Health Coverage Landscape survey to reveal what is happening in regard to:
- The proportion of uninsured in the small businesses in the county’s small business community, and the factors that influence a company’s decision to purchase and offer health benefits.
- How existing coverage varies by company demographics.
- How receptive small businesses would be to the multi-share plan, or MSP, model.
Small businesses were defined as having 50 or fewer total employees. Thirty-two percent of the surveys were completed by companies that offer all employees health coverage, 37 percent by companies offering “some” employees health coverage, and 31 percent that offer no health coverage.
The survey, completed by the Hope College Carl Frost Center for Social Science Research, was also designed to assess potential participation in an MSP form of health coverage among small businesses in Ottawa County.
The MSP health coverage model, already in operation in Muskegon and Kent counties but not Ottawa or Allegan, is designed to provide an affordable alternative for insuring employees for medical care, not including dental or optical coverage. The models also link health and wellness resources already available in a community with collaboration among area nonprofits, health care providers and businesses to provide and finance health services. Multi-share coverage plans typically split the cost of covering uninsured part- or full-time workers between the employer, the employee and the community. The community share is funded in a variety ways unique to each community.
Marcia Knol, Ottawa County health planner, said the Muskegon County Access Health plan, which she described as “innovative,” was established about 10 years ago. The Access Health model has since “spread around the country now,” according to Knol.
She said that for a total cost of about $150 to $160 per person, Access Health provides “pretty comprehensive medical benefits” (except for dental/vision), with the cost shared evenly by the employer, the employee and the state of Michigan.
Two years ago, the state was reportedly planning to bring the MSP model to the remaining 11 non-participating counties, but the onset of the recession killed that idea, said Knol. However, Ottawa County officials are still interested in it, which is why the survey was done.
The long-term goal of a county plan in Ottawa is to improve the health of chronically uninsured working individuals by facilitating timely and appropriate health care as well as improving personal health literacy and health behaviors, according to a press release from the Ottawa County Health Department.
The Ottawa County Small Business Health Coverage Landscape survey “substantiated the need for an alternative form of health coverage for small businesses,” according to the OCHD. The survey went out to some businesses only about a week after the enactment in March of the federal Patient Protection and Affordable Care Act, which some critics refer to as “Obamacare.” The timing in relation to the federal legislation was coincidental, according to Knol, but many of the survey respondents took the opportunity to volunteer negative comments about the legislation.
One survey respondent was “very concerned about Obamacare and what impact it’s going to have on my business and my health. It’s going to have a very negative impact on my business because it’s going to go through the roof. I’m seeing already companies backing off on hiring …”
Along with the negative comments on the health care legislation, the survey notes that “it is evident people are unclear about what to expect from the passage of the new bill.”
An overwhelming majority of those surveyed, who were read a brief description of the typical model of a county multi-share plan for employee health coverage, indicated they would be interested if one were available.
Other significant findings, according to the OCHD press release, include:
The primary barrier to small companies offering health coverage is the insurance cost to the employer.
The primary factor that leads small companies to discontinue employee health coverage is the same: insurance costs to the employer.
Forty-five percent of employers reported they could afford a monthly premium ranging from $50 to $89 per employee. Presumably, that implies a total cost per employee (split three ways) of $150 to $267. The coverage does not include anyone other than the specific employee and does not require deductibles although co-pays can typically range from $10 to $30, according to Knol.
In some MSPs, the employer and employee each pay for about 30 percent of the cost of a plan (which only covers the employee, not family members) and the remaining 40 percent is covered by government or some other entity, such as a community foundation.
According to survey results, companies most in need of an affordable alternative are: the smallest (1-4 employees), have some or only part-time employees, pay the lowest wages, have been in business the fewest years (1-10), and operate in the northern half of the Ottawa County. The survey indicates that those employers do not see the lack of health coverage as a barrier to hiring or retaining employees.
The full report on the survey is available at www.miottawa.org/health. Under the Hot Topics heading at the top, select Ottawa County Small Business Health Coverage Landscape.