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Health insurance: Small business owners seek answers but get few at Manchester forum

New Hampshire Union Leader

May 20. 2013 7:02PM

MANCHESTER — Small business owners got a primer on the Affordable Care Act, as Manchester’s annual celebration of Small Business Week got under way with a workshop on health insurance Monday morning at The Derrfyield Country Club.

If they were looking for definitive answers about what kinds of plans will become available on the new health insurance exchanges that are supposed to open on Oct. 1, they came away disappointed.

The online exchanges intended to help consumers and businesses shop for health insurance as they now do on sites like are behind schedule. Rules and regulations that define the plans are still being developed. And so far, only one company, Anthem Blue Cross and Blue Shield, is planning to offer products on the exchange.

The business owners peppered the presenters with questions, and while there were some answers, the big picture remains fuzzy even as the implementation date of Jan. 1, 2014, draws near.

The federal government did not expect so many states to opt for, or default into, a federally managed exchange, said Maria Proulx, senior legal counsel for Anthem and chief presenter at the event.

Washington has been overwhelmed by the fact that 26 states are relying entirely on the federal government to build their systems — one for consumers and one for employers.

Eighteen states have decided to build their own exchanges, while seven, including New Hampshire, have decided to develop the programs in cooperation with the federal government

“How can we possibly plan for 2014 when the government itself is admitting they don’t know what choices we have?” asked the owner of a recreational watercraft business who asked not to be identified. “We consistently hear that small businesses are being helped by the ACA. That’s a dubious claim, but perhaps it’s true. But we don’t know and our brokers can’t tell us.”

Proulx said the frustration was shared by insurance companies.

“We get asked on a daily basis what plans we’re going to offer,” she said, “and we have to say we’re not sure, even though we’re supposed to launch on Oct. 11 for open enrollment.”

Anthem still expects much of its business to be conducted outside of the exchange network, as do the three other major health insurers in the New Hampshire market — Cigna, MVP and Harvard-Pilgrim. Those last three are standing on the sidelines for now.

The idea that the exchanges would enable consumers to make comparisons across companies is certainly not going to be realized in New Hampshire, where only Anthem is likely to be active on the exchange, at least in the first year.

“We did expect that maybe some new carriers would be coming after the market,” said Denise McDonough, regional sales vice president for Anthem, “but that has not been the case.”

Lisa Kaplan Howe, policy director for New Hampshire Voices for Health, said her group expects to see greater interest in 2015, after the start-up issues are resolved.

“It is a disappointment,” she said. “We had hoped for some meaningful distinctions between a reasonable variety of plans. But it’s the first year, and hopefully things will evolve and change as time goes on. Come 2015, when (the employer site) is fully functional, we hope by then there are multiple carriers for employees to chose from.”

Small Business Week events in Manchester continue through Friday, with workshops on finances, human resources, sales, startups and many other topics. The Small Business Awards event Friday morning features the newly appointed commissioner of the Department of Resources and Economic Development, Jeffrey Rose.

For a full schedule, visit

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