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New Hampshire archives

September 29, 2006

Savings, at what cost? Small business insurance fix not such a great deal for many

Health insurance premiums for small business owner Michael Spero of Kingston dropped from $1,800 a month for his family of four last year to $500 a month this year.

That may sound like a rave review of the small business health insurance law that took effect in January, but there are a couple catches: Costs for office visits are a lot higher, and Spero, owner of C&M; Cleaning, pays the full cost of prescriptions under his new, less expensive plan.

In an effort to stay on top of the math, Spero is saving medical bills to see if the new plan is really such a good deal.

"I have two little kids and they get ear infections, so they're at the doctors' office," said Spero, whose coverage is for his family and one full-time employee for whom he pays half of the approximate $300 monthly premium.

"But saving $1,000 a month, I thought I could afford to pay a few of those," he said.

Senate Bill 125, the current law, took effect in January. It eliminates the use of health status and geographic location when setting insurance rates for small businesses, defined as those with 50 or fewer employees. It also creates a large reinsurance pool to cover high-risk people.

The previous law, Senate Bill 110, allowed companies to charge healthy people less and people with chronic conditions more.

Bill 125 repealed many of the provisions of the former law, with the goal of stabilizing rates that had doubled or tripled.

Spero is healthy, but his wife has fibromyalgia, a disease that causes severe pain in muscles, ligaments and tendons. She takes regular medication and is doing fine now, he says, but her prescriptions cost hundreds of dollars a month.

Spero was required to tell prospective health insurers about her condition under Bill 110, but not under the current law.

His family's premium went from $800 a month before Bill 110 to $1,800 afterwards.

While his premium has now dropped again, he is waiting to see if other costs add up. Last month, when one of his children got sick, he had to pay $85 for a prescription.

Unlike Spero, other small business owners already have made their minds up about the new law. They say it's not helping.

Nor Bimbatti, who owns Universal Flooring in Salem, could not afford health insurance premiums under the former law. He decided to test the waters under the new one.

He wanted to promote his three part-time employees to full time and entice them with health insurance. Three months ago he looked into that option and still found it unaffordable. Now those employees remain part time, and his family has private insurance.

"I'm always looking, but it's still not affordable," he said.

Thomas Harte of Landmark Benefits Inc. of Hampstead said Bill 125 has stabilized rates.

But, he said, "You will definitely find big winners and losers."

Harte's company is an insurance broker that covers 320 companies, ranging in size from one employee to large hospitals.

Pulling randomly from a stack of client files, he found one of the losers: a four-person group where the business owner's insurance for himself and his family went from $1,249 per month to $1,328 per month, a 6 percent increase.

In general, Harte said the winners have been companies with older-than-average demographics who lived in a part of the state where geographic location increased prices under Bill 110. He said the losers are generally those with younger demographics.

Gov. John Lynch pushed for small business health insurance reform during his 2004 campaign and has touted the success of Bill 125 in television ads in his run for re-election.

Spokeswoman Pamela Walsh said anecdotal evidence shows the bill is working. She added, however, Lynch knew all along there were factors outside the bill that could lead to increasing costs, such as rising prescription prices and aging population.

Lynch also created the New Hampshire's Citizen Health Initiative, a group of citizens, civic leaders, workers and health insurance experts examining ways to find longterm solutions to health care issue.

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