Many employers with less than 100 employees provide insurance, too. But, the smaller employers are not happy about the "requirement" to provide medical insurance. Any supposed benefit to an employer that might be derived from medical insurance as leverage is not apparent to me or to any of the other small employers I have talked to about this.
In general, some form of medical coverage is needed in order to attract and retain competent employees. So, I don't really have a choice about whether or not to have a plan; I just have a choice about the type of plan. But, even then, there is a certain minimal expectation of what the plan covers and how it is structured.
As a small employer, I can watch my annual increases (there are never decreases) range from about 8% to over 20%. There are legal limits to the maximum increase, but the increase is always based on the insurance companies "experience" with my pool of workers.
Therefore, I am interested in the health of my employees, but not in a healthy way. As much as I hate my reaction, I can't help but cringe when a medical treatment is needed by the people who work for my company. I know that their treatment for an illness will change my experience rating and will move my rate increase upward in the following year. I hate this feeling, and so do the other employers I talk to about this problem.
I don't want to be selfishly concerned if an employee has a health problem -- I would much rather just be sympathetic and helpful.
But, the reality of small business medical insurance as an employee benefit forces us small employers to confront our situations. I have seen a range of reactions by employers to the effect that employees' medical treatments have on our medical insurance costs. Some move their entire company to plans with ever-decreasing benefits in an attempt to offset rising costs. Some require the employees to absorb all or most of the cost increases. Some just soldier on, trying to pass the increases onto clients and customers or failing that, reduce margins or reduce other expenses. Tragically, some employers think that they need to shame, cajole or otherwise influence their employees to forego medical care, especially chemical dependence or mental health treatments, just to minimize the insurance company's experience assessment.
I want this situation to change and so do many other small business owners and managers. We want to get out of the medical insurance business.
Me? I want single payer health care -- regional or national, I don't care. I want to pay for it through general taxes.
I am not alone.
Keith Nybakke