UPPER TOWNSHIP — The federal Affordable Care Act’s publicly subsidized insurance plan has created numerous unintended consequences for business owners and their employees, a local insurance representative told the Cape May County Chamber of Commerce on Tuesday.

Business owners should pay close attention to developments as the plan is rolled out, even if they do not have to make any decisions about coverage for employees or themselves until 2015 or, in some cases, 2016, said Stephen Sanborne, senior sales executive for Thomas Heist Insurance Agency.

Sanborne said one of the biggest changes is the premium rating system, which is tailored around the ages of employees, with each age group charged a different insurance premium.

As a result, he said, larger families might find their premiums skyrocket based on the number of adult children covered.

The federal government subsidizes the premiums for most low-income and moderate-income applicants. The subsidies cover as much as 80 percent of the premium, depending on the income of the applicant.

Premiums for small-group plans cost significantly more than in previous years because the new insurance covers a wider range of conditions. This includes pediatric dental coverage, which is included in premiums for everyone, including single twenty-somethings without children.

And some companies, such as real-estate agencies that offered insurance to their agents, might see these contracted employees abandon the group plan to sign up with policies offered in the ACA individual marketplace. That could steer management to the individual marketplace as well, he said.

“The real-estate company owner might find they lose their coverage, too, because they no longer have a group health plan,” he said.

Sanborne urged businesses to talk to their insurance carriers now about what approach makes the most sense for them. That could mean restructuring their health plans or, in extreme cases, restructuring their employment bases.

Employers are not obligated to cover part-time workers. And employers for the sake of fairness might consider contributing a flat rate toward their employees’ insurance premiums instead of a percentage.

Sanborne, of Northfield, spoke to the Cape May County Chamber’s meeting at the Deauville Inn in the Strathmere section of Upper Township.

Chamber Chairman Scott Campbell, vice president at TD Bank in Middle Township, said the Affordable Care Act, popularly known as Obamacare, is one in a series of changes and challenges with which business owners must contend this year.

“It makes it a real challenge, especially with the seasonality of the economy ... in a county that makes money in a short amount of time,” Campbell said.

Apart from health care coverage, businesses are concerned about the likelihood of an abbreviated summer season for 2014.

“Schools are expected to get out later this year because of all the snow. Labor Day falls early. We’re looking at a shorter season this year,” he said.

Contact Michael Miller:


Been working with the Press for about 27 years.