Three Ways ACA is affecting Business

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More often than not, when healthcare reform is brought up, the impact and the interests of businesses are lumped together, as if each faces with the same challenges as the next. The reality is that as healthcare-related requirements for businesses have evolved since the passing of the 2010 Affordable Care Act (ACA), the interests and priorities of different sized businesses are changing as well.

Some provisions in the ACA for example, only impact employers with a certain number of full-time employees. One such rule going into effect in 2015 is the Employer Shared Responsibility Provision. It states that if 50 or more full-time equivalent employees work for a business, that employer is obligated to provide a minimum level of healthcare coverage for those workers, or face a penalty of $2,000 or more per employee. Obviously, if you’re a business owner with only 30 employees and have never provided insurance previously, this rule does not apply to you.


That potential fine is causing many employers with more than 50 full-time workers to re-evaluate their situations and determine the value that health insurance may bring to their business operations while simultaneously striving to keep both their budgets in check and their legal obligations in good standing.

Here’s a brief overview of the trends among different sized businesses that are becoming more pronounced as health reform advances:

  1. Small businesses with fewer than 50 employees may now weigh new coverage options which would allow them to move their employees to the health insurance marketplace, also known as health insurance exchanges. However, if they already offer healthcare coverage, they face potential loss of talent recruitment as they scale back on health insurance benefits in the effort to save money. To curb this dilemma, many smaller employers are investigating defined contribution or defined benefit options, while others are considering simply dropping coverage or not offering it at all regardless of the implications.
  2. Mid-size businesses have distinctly different interests when it comes to health care coverage. These employers with 150 to 2,000 employees are typically interested most in health and wellness programs to help their workforce maintain and grow productivity and help manage health insurance costs. Options such as tobacco cessation and fitness programs, along with health screenings, are particularly interesting to these employers.
  3. Large businesses with more than 2,000 employees are typically interested in enabling their employees to become more consumer-driven in their individual health insurance decisions. Tools, like online transparency applications, that help employees learn which doctors or hospitals are in their networks, along with quality and cost data, are popular. They offer employees incentives to adopt healthy lifestyle changes that can yield healthcare savings for the company down the road.

They also show high interest in incorporating more financial incentives for employee healthcare behaviors, such as smoking cessation, participating in annual health screenings, and more.

For example, OfficeMax, a large employer, is helping its employees make good health a priority with a tobacco cessation program that provides lifestyle health coaching, coverage for prescription drugs and tobacco-free buildings. OfficeMax also implemented an awareness campaign which increased the annual physical exam rate for its associates and their families by more than 33 percent.

“We recognize that these successful wellness programs help keep our associates and their families focused on being healthy, enabling us to keep the overall costs of their employee benefits competitive, which is important in today’s business environment,” says Jill Marie Chapman, senior director of benefits with OfficeMax, which recently merged with Office Depot.

Approaches like those of OfficeMax don’t have to be limited to large companies, but frequently are. One small business example is Alper Services, LLC, in Chicago, a financial services, risk management and property and casualty consultancy with about 50 employees. Alper has developed a company-wide wellness program that is successfully encouraging a healthy culture that extends beyond the workplace. Since the implementation of the program, the company has seen the following improvements: Lower healthcare costs due to a healthier workforce, reduced absenteeism, higher employee morale, lower employee turnover and enhanced recruitment and retention of their employees.

Whatever size employer you may work for, or the type of business you operate as a business owner, what’s clear is that the mandates that accompany healthcare reform are causing employers and employees alike to take on new responsibilities and re-think how both view health insurance coverage.

Kevin Cassidy is the divisional senior vice president for Illinois markets for Blue Cross and Blue Shield of Illinois. BCBSIL is committed to promoting the health and wellness of its members and its communities, fostering greater access to care, and working to lower the overall cost of care while improving the health care quality and patient outcomes. This commentary is sponsored by BCBSIL.

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