Small Business Owners and Coverage in Massachusetts

Small business owners near Boston provide health coverage to their employees. The state is proud that only three percent of its population is uninsured compared to nine percent across the county. But business bears the burden of coverage being linked to employment in one of the most expensive health care markets in the U.S.

Why is the uninsured rate so low? Legislation. The Commonwealth required residents to be covered starting in 2007, as well as companies with more than 10 employees to provide coverage. While the legislation has changed over the years, the intent has remained the same.

What role does employer-sponsored coverage play? Significant. In Massachusetts, 55 percent of the population is covered through their employers. Across the country, only 49 percent of Americans have employer-based health insurance.

What size is the business? Less than 10 employees. So, the small business owners aren’t required by law to provide coverage, nor is it easy to do so. They provide their employees with health insurance because “it’s the right thing to do.”  

What help do they get? None. They’ve found online resources and insurance brokers frustrating to use. The company is too small to have a benefits manager or HR generalist, so the owners work directly with the health insurance company to purchase coverage.

What type of plan do they offer? PPO. The plan has a low annual deductible and low annual maximum; therefore, employees have minimal out-of-pocket expenses. But the plan’s network doesn’t include some of Boston’s premier—and expensive—medical centers.

How much do employees pay? Nothing. The business owners want to attract and maintain high-quality talent. A health plan that has no employee and family contribution and rich benefits differentiates their company in a competitive job market.

Have they been satisfied with the health plan? Sometimes. While premium is expensive, the insurance carrier’s customer service has been excellent. But employees whose children attend out-of-state colleges have had difficulty accessing care.

What else? Children. For their own family, the Affordable Care Act has meant that the small business owners could cover their kids to the age of 26. The young adults are now (thankfully!) covered through their employers or Obamacare.

These small business owners don’t think much of “Medicare for All,” nor do they expect it to happen. They also believe that America’s health insurance system is in need of transformation. But they have a company to run, work to do, and bills to pay. In the meantime, they’re Mastering Health Insurance.

Source: Kaiser Family Foundation. “Health Insurance Coverage of the Total Population” (2017 data)