ACA Profile: Aida Visakay spends two hours a day on ACA issues
Editor's Note: See our main story: Obamacare's early impact in Morris
Aida Visakay, 57
of Parsippany
Job: Vice president of employee benefits, AxisPointe Employee Benefit Advisors
Location: Cranford
"Everyone is affected by the Affordable Care Act, whether you're an individual or a large business with more than 50 employees, because we all have to pay for it. I just renewed one of my groups, with 300 employees. Four percent of the renewal costs went toward taxes to pay for health care reform.
"The ACA could have been a lot easier and it could have been that everybody would still get coverage. They dealt with accessibility, but they never dealt with cost. The general public thought, We're all getting health insurance. Wonderful! That's great. It's not free, though. The cost is just spread across the board. Nothing is free in health insurance."
Current scenario:
• Starting in 2015, companies with more than 100 employees are faced with a pay-or-play option: offer coverage or incur penalties that are not tax-deductible to the company. Starting in 2016, the same applies to companies with 50 to 100 employees. Which is best? Aida Visakay helps businesses decide. If they opt to offer coverage, she helps them structure a plan that they can afford and that meets all the requirements imposed by the Affordable Care Act.
"In one of my groups with 420 people, I'm in the process of analyzing whether it'd be less expensive for them to not offer coverage and pay the penalty," Visakay said. "If the employees are making minimum wage, it's better for them not to have the employer offer coverage and they can go on the Health Insurance Exchange and get subsidized.
"On the other hand, employers offer benefits for many reasons," she added. "They want to attract and retain good employees. They believe they should take care of their employees. They want a healthier work force. So the question becomes, Why offer benefits?"
• Visakay spends two hours of every day working on issues related to the Affordable Care Act.While she helps her clients plan ahead, she and they are hampered by the postponement of various provisions. Plus, she spends a lot of time educating employers and speaking publicly on the topic to employer groups.
• Employers have less flexibility in the plans they offer their employees, including caps on maximum out-of-pocket expenses. So they're looking at cutting their full-time staffs. Some school districts have made their paraprofessionals part-timers so they're working under 30 hours and get no benefits.
• On the plus side, self-funding and level-funding plans are now available to businesses with as few as five enrolled employees. Visakay calls these hybrid plans "a win-win" because businesses get refunds of money if claims cost less than anticipated and the insurance company takes on all the risk if they cost more.
A look ahead:
One of the ways to bring down health insurance costs, according to Visakay, is transparency in pricing. "If we were able to shop for services in the medical field like we do for a car," she said, "we would end up saving money."
Ultimately, preventative tests that are free to the insured cost an extra 2 percent overall in the cost of a health plan. Still, Visakay believes prevention is key. Catching an illness before it becomes chronic, she said, is a way to create a healthier country and, in so doing, control health costs.