We’ve heard plenty about the pain Obamacare is inflicting on companies big and small: the hassle of shopping for plans, the challenge of managing a flood of new paperwork requirements, the battle against rising premiums. But as every entrepreneur knows, where there’s pain, there’s profit for the person who can cure it. (Just ask your doctor.) Here are three young businesses tackling some of the big challenges brought on by Obamacare and helping ease the burden for other businesses.
Picking Plans
The pain:
It's tough to pick a health plan that fits your employees’ budgets--and their health problems.

The fix: Let them do it themselves. Through ConnectedHealth’s private online exchange, employees decide how to spend a given health care “allowance” that you set, choosing from multiple plans offered by more than 80 carriers nationwide, as well as plans sold through state and federally run insurance exchanges. Unlike the troubled Healthcare.gov site and many state exchanges, which have delayed online enrollment for small business plans until late 2014, ConnectedHealth provides a fully functional online shopping experience right now. It even offers tools to help employees estimate how much health care they will use--and therefore what kind of plan would best serve them--based on factors like age, gender, region, and family composition. The four-year-old Chicago company has clients nationwide, and lets users to shop for ancillary coverage, such as life, vision, and disability insurance, in addition to health plans.
The pain: New compliance and reporting requirements could mean untold additional man-hours for your HR department. To avoid running afoul of regulations taking effect over the next couple of years, employers must carefully track workers’ hours to determine eligibility for health benefits, check that the coverage they offer is affordable in relation to income, and report details of coverage to the government and workers in W-2s and other IRS filings. (For more information, see this article on important Obamacare deadlines.)

The fix: Zenefits is a free online platform that pulls together information from across all your benefits and payroll systems, making it easy to generate the reports you need and to update employee data system-wide with just a few clicks. Zenefits is also a licensed insurance broker that works with multiple carriers, and will, if you wish, help you select a group health plan. (Like other brokers, the company gets a commission from insurers, which allows it to offer its software services for free.) Already using a payroll service you like? No problem. Zenefits integrates with all major third-party payroll systems. Launched in San Francisco in April 2013, Zenefits has raised more than $17 million from investors and is already one of the top 100 insurance brokers in the state of California. As of January 2014, the service should be available nationwide to companies with two or more employees.
The pain: As of January 2014, small group premiums are subject to community rating--meaning, no matter what your company’s medical history, your rates are essentially the same as all the other small businesses in your region. However, large employers’ group health premiums are still subject to “experience rating” by insurers--that is, the more healthcare your company uses, the higher your premiums. Likewise, the cost of a self-funded health plan--an increasingly popular option for medium-size companies--is impacted directly by how much, or how little, employees use costly medical services. 

The fix: Get employees to go the doctor less. How? Sherpaa, a New York City-based startup, offers a sort of digital diversion service. For a monthly fee of $50 per employee, workers get 24/7 online or phone access to a team of on-call doctors. “By providing access to a doctor, we can resolve 60 to 70 percent of problems without sending you into the healthcare system,” says co-founder Jay Parkinson. “We can rule out scary stuff, make a decision on the best next step, prescribe medications, and follow up if necessary.” No office visit necessary. By helping keep health-care utilization low, Parkinson claims the service can save clients--who include Etsy and Tumblr--up to $4,000 per employee annually. Sherpaa also helps identify common billing errors, which can help reclaim money for employees; advocates on behalf of users with insurers; and provides clients with a yearly “bill of health” that can help when renewing or shopping for a new plan. Currently, Sherpaa is only available to companies in New York City, but the company aims to expand to other cities soon.

Published on: Jan 24, 2014