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New Laws Create More Health Insurance Options for Virginia Small Businesses, Realtors – Daily Press

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

One allows associations to set up a consortium of benefits that would help small businesses gain the same buying power as large employers for employee health insurance.

“It’s about access to health care, something I’ve worked on my entire career, and affordability,” said State Sen. 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 workers by providing health coverage to workers and their families,

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

“It’s a way to make health insurance more affordable,” Del said. Keith Hodges, R-Urbanna, who sponsored the Realtors Group Insurance Bill.

The two proposals have been battlegrounds for years, fought over fears they would pull enough people out of the Affordable Care Act health insurance market to raise premiums for everyone else.

The idea of ​​the Benefits Consortium Bill, as presented to the General Assembly, is that it would allow groups like the Virginia Chamber of Commerce to set up a mechanism for small businesses to access the relatively low premiums that larger employers can charge.

Mason said the idea was that the consortium would bring together tens of thousands of small business employees; by spreading the risk over so many, the cost per person is lower. The consortium would be led by a board of directors. Any excess income over claims and reserve requirements would be used to retain future premiums.

Mason said he started working on the proposal – his first effort came in 2020 – shortly after giving a talk to a House panel saying he thought the idea was bad.

“They asked 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 wear it,'” said mason.

“We intend to form a benefits consortium,” said Laura Ramthun, director of communications and marketing for the chamber.

The chamber is waiting for the state Bureau of Insurance to write regulations, she said.

Basically, the law says associations could set up something like the self-insured pool that many large employers use and make its coverage available to small businesses. With self-insurance, instead of buying a policy and relying on the financial resources of an insurer to cover claims, an employer sets up their own funds, usually hiring a company to administer the program.

Consortium coverage should include all health benefits required in the Affordable Care Act, as well as the cost-sharing and value of 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 companies’ actual claims experience was zero, their specific premiums would be set at percentages defined above, at, or below base rates, while trends for the entire pool would determine future base rates.

The estate agent’s bill takes a different approach, offering individual members a way to purchase insurance policies with rates like those groups are quoted, rather than individual market premiums, Martin said. Johnson, the association’s senior vice president for government relations.

For some, their incomes are high enough to not qualify for Affordable Care Act grants. For others who may not be doing as well or are just starting a career, even with the grants, the bonuses may seem hard to pay.

“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 make the case for the bill: one, that about 20% of real estate agents don’t have insurance, so his bill would reduce the number of Thousands of uninsured Virginians.

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

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This mattered because past efforts for alternative health coverage, such as extending short-term coverage periods, failed when health plans and other opponents said their narrower set of benefits would drive too far away. of healthy people from the pools of the ACA plans. The result would be a spiral of premium increases.

What the bill allows is for the association to be able to buy a group insurance policy for them – essentially the same kind of group coverage that big companies buy now if they don’t opt ​​into a group insurance program. self-insurance, Johnson said.

The association is discussing with insurers and the Insurance Office to see how this could work; whether it goes ahead will depend on what kind of rate it is quoted, Johnson said.

For real estate agents who get their insurance through the ACA Individual Marketplace, but are trying to stretch their money by not buying as much coverage as they might need, his bill would provide an option to remedy their insufficient coverage, Hodges said.

After the intense debates before General Assembly committees over the past few years, “there isn’t much controversy left about its negative impact,” said Doug Gray, executive director of the Virginia Association of Health Plans.

The final version of the benefits consortia bill passed the state Senate 40-0 and the House 63-35. The Realtors Bill passed the House 95-2 and the Senate 40-0.

Dave Ress, 757-247-4535, dress@dailypress.com

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