Submitted by TAC Benefits Group
As the Affordable Care Act moves into the 9th year of existence, there remains uncertainty in the health insurance world where premiums and deductibles continue to skyrocket. *Since 2010 health insurance premiums have increased by 54%, and deductibles have increased by 111%.
One of the key components of the Affordable Care Act was the expansion of Medicaid in many states (including NJ) for individuals and families earning 138% of the U.S. Poverty Level. This expanded health care to many low-income individuals and families. However, as is typical of many government programs, the middle class (between 138% and 400% of poverty) and employers are left with the burden of increased deductibles and premiums.
Percentage of the poverty level and associated income
There is hope! There is a little-known requirement for non-profit hospitals to provide free or discounted care to maintain their non-profit status. By utilizing a benefit strategy incorporating this requirement, you as an employer, CAN provide affordable health care to your low to middle income employees at a very affordable price.
This benefit design provides a comprehensive healthcare plan which is complemented by Direct Primary Care, Prescription Medications, an Advocacy Program with Community programs. This enables your employees to enroll in a program for less than $100 per month with no or very little out of pocket expense. The out of pocket expense varies based on income and assets. Individuals who participate are provided an advocate. The advocacy program helps the individuals navigate the community programs to get the care they need at the lowest cost, whether it be an office visit, an emergency room visit, or a scheduled hospital procedure.
There are 5,724 hospitals in the U.S., according to the American Hospital Association. Of these, 2,903 hospitals are nonprofit and 1025 are for-profit. Additionally, 1045 hospitals are owned by state or local (county, hospital district) government entities.
The chart below illustrates the number and percentage of hospitals by state run, non-profit, and for-profit hospitals New Jersey, New York, and Pennsylvania.
To learn more details specific to your group and other states in which you have employees, please have your broker or benefit manager submit an inquiry to email@example.com or reach me directly at firstname.lastname@example.org.