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By Alex Tolbert
If you’re a small to midsized business (SMB) owner, leading your team to a healthcare reform victory is not as hard as you think. 
Employers with fewer than 50 employees stand to win big under the Affordable Care Act (ACA) by dropping their group plan and transitioning employees onto individual health insurance plans. Industry insiders estimate that for 70 percent of all SMBs this game plan is a win-win for both employers and employees.
If you follow this game plan, you’re no longer subject to premium increases, which is a home run for controlling business costs year after year. Not only do you control costs, but you also give your teammates more flexibility to find the right healthcare plan to meet their specific needs.
Here are three plays you should have in your health reform playbook:

1. Run through the plays. Your employees don’t need to read the entire ACA. However, you should provide them with reading material and internal instruction on how they can sign up for their new plan and what’s important for their new plan, especially when it comes to the subsidies available for individual polices.

Americans have access to subsidies to help them pay for insurance purchased through new so-called “subsidy exchanges,” a place where health insurance is bought and sold. Subsidy exchanges are a really important topic you should make sure your employees understand.

The biggest difference between exchanges we had in the past and these new subsidy exchanges is that these will be the only place Americans can get a federal subsidy to help with the cost of the insurance premium.

2. Draft a broker or other insurance professional. Your time is valuable. You run a business, and you don’t have time to sort through the healthcare confusion. To fully evaluate and make sound healthcare choices for your employees, it’s a good idea to have a trusted advisor, like a broker or insurance professional, on your team.

The problem, however, is that commissions for individual health insurance policies have been cut so low that it’s difficult for a healthcare broker to make a living if he or she focuses on selling individual health insurance. Additionally, healthcare has gotten so complicated that it’s hard to stay current on how it all works without giving it your full attention. Many brokers are deciding it is not worth it, and are giving their attention to other types of insurance.

Luckily, there are other professionals entering the health insurance scene. Insurance companies like UnitedHealthcare have opened retail stores to help people sort through their options. One drawback to those stores is that they’re not independent and won’t be able to advise individuals on insurance company options outside of UnitedHealthcare.

To counter this effect, my company, Bernard Health, has opened healthcare retail stores staffed with licensed, independent and non-commissioned health insurance advisors.

Some compare our model to H&R Block or a CPA firm, and clients note that we’re not only able to make sense of the numerous options available through an online quote engine, but can also compare those to coverage that might be available to through a spouse’s plan or government program. On average, our clients save over $2,000 a year on healthcare expenses through our advising services. Moving forward, we expect more healthcare navigators to adapt our approach and join the consumer-centric healthcare movement.

3. Implement a defined contribution game plan. The traditional reasons for offering a group health plan—employees can’t be denied coverage, recruiting tool, tax deductions, etc.—are no longer relevant. New tax laws and healthcare reform changes have opened up a new way for employers to administer health insurance with individual plans.

In addition to implementing individual health plans, a defined contribution strategy can very successful for SMBs when implemented correctly.

How defined contribution works:

  • Employees work with an expert to choose a health plan strategy tailored to their unique circumstances. Expert advisors help your employees look at different plans across all carriers, and then compare all their options and answer questions.
  •  Each employee selects a different plan, catered to his or her unique health needs. If you have 15 employees, it is likely they will end up going with 15 different plans.

Why it’s good for SMBs:

  • You don’t have to deal with picking the plan for everyone.
  • You don’t overspend because of the needs of a few employees.
  • You are no longer in the middle between your employees and the insurance company. Because employees get to pick their own plan, annual complaints directed at you about health insurance are minimized.


Ultimately, each company’s situation is different, and requires a strategy that is specifically unique to its needs. As your team’s coach and playmaker, it’s important to make the right plays now that will put your team in the best position to win the health reform game.

Alex Tolbert is the founder of Bernard Health, a company that provides non-commissioned, expert advice on health, Medicare and COBRA insurance and medical bill consulting. To learn more about Bernard Health, visit