A New Option for Small Business Health Insurance

Shawn Turner |

We are excited to announce the creation of a new option for small business owners to access health benefits for themselves, their employees and their families—The COSE Health and Wellness Trust—a self-insured, multiple employer welfare arrangement (MEWA) designed for companies with up to 50 employees participating in health benefits.

In anticipation of the next wave of transition required by the Affordable Care Act, the COSE Health and Wellness Trust gives small business owners another option to meet the health benefit needs of their companies.

This self-insurance option is a lot like the option that unions and large companies have in the market today. Similarly, the COSE Health and Wellness Trust leverages the combined size of many small employers working together and balances the risk across the pool of companies.

Unlike community-rated ACA plans, the plans available through the COSE Health and Wellness Trust recognize the unique preferred health risk of most small businesses.  The plans that will be offered have far fewer restrictions on the benefit structures that are available under the ACA. Many of the plan structures reflect the kind of benefit options that were common to small businesses before the ACA and that exist in their current grandfathered and transitional plans. Those transitional plans must be ended by January 1, 2018.

And for the smallest of businesses, the COSE Health and Wellness Trust provides an option for group coverage for small businesses with no employees. Today, new small business owners with no employees can only access insurance through the individual market. Only grandfathered plans and transitional plans (that are slated to go away by January 1, 2018) exist as additional options here. The COSE Health and Wellness Trust will be a new option with plans available to these small business owners without employees to provide coverage for themselves and their families.

The COSE Health and Wellness Trust will be an additional renewal option available to members of COSE and the Greater Cleveland Partnership with less than 50 eligible employees and we are currently providing quotes for coverage as soon as September 1st.  Getting a quote is easy for those enrolled in our insurance program. You can request rates for this option effective immediately. Those members not enrolled or small business owners that are not yet a member can also get a quote for coverage and then determine if the plans and membership make sense for them.

A Little Background About How We Got Here…

When the ACA became law in 2010 and was implemented in 2014, our focus was on finding the best option for each small business under the new law. For some of our members, ACA was the best option—either because the health status of their group benefited by the community rating feature of ACA or the subsidies available due to the income of the owner or their employees were of benefit.  For the vast majority of our members, however, the best option was to preserve the ability to stay on their current plan—either by allowing them to elect “grandfathered” status or enrolling them in a transitional or “grandmothered” plan to delay their move to ACA.

Now, the next wave of ACA changes will require that as of January 1, 2018, all small businesses that want group insurance and that are not “grandfathered” must be in an ACA compliant plan. The law requires that the “grandmothered” transitional fully insured plans will be eliminated. The only way to stay on an old plan is if you were on it before the law was enacted in 2010 and you’ve done everything required to establish and maintain “grandfathered” status.  While some of those plans will still fit, they limit the ability to make any significant benefit changes. The shift to ACA compliant plans is going to result in rates that are more expensive for most companies and, for many, rate increases of 30 percent to 70 percent are likely.  The COSE Health and Wellness Trust is an option to access coverage outside of the requirements of ACA.

The Solution

The COSE Health and Wellness Trust leverages more than 40 years of experience within COSE providing small business benefit solutions and our long term relationship with Medical Mutual. We have selected Medical Mutual to continue to work with us to support several of the underlying actuarial and insurance functions of the COSE Health and Wellness Trust.  Medical Mutual’s long-term commitment to the small business community as a local, Northeast Ohio company that is significantly invested in the small business market distinguishes them as a part of this solution. We also have engaged actuaries, legal advisers and a variety of other resources to help structure and guide the COSE Health and Wellness Trust to ensure it is a solid, viable, long-term resource for our members.

We are pleased to announce that after more than a year of work on developing this plan and a rigorous review, the Ohio Department of Insurance awarded our Certificate of Authority earlier this week.

We are confident that the COSE Health and Wellness Trust will be a great option for the vast majority of our members. The licensed COSE team at Medical Mutual and more than 200 specially trained brokers are able to talk with small business owners about the fit of this option with their needs.  As with other self-funded arrangements, there are some additional responsibilities involved in utilizing this plan, but based on the way we have structured it, we think they will be manageable and make sense for a broad set of small business owners.

To learn more about the COSE Health and Wellness Trust and to find out if it is a good solution for your benefit needs, contact the COSE Sales and Service team at Medical Mutual at (440) 878-5930 or talk with your broker. 

And, if you like the plan you are on now, know that COSE will continue to offer a range of fully insured plans side-by-side with the COSE Health and Wellness Trust through Medical Mutual and we will continue to make our members’ grandfathered plans available.

We hope you’ll take the time to evaluate the fit of the COSE Health and Wellness Trust with your own needs.  As the ACA continues to evolve, we have continued to update what we can do to help you adapt to it.   In every area of your business, since 1972, our goal has been to be here to help you grow and succeed.  We hope that once you take a look at the plans available in the COSE Health and Wellness Trust, you’ll agree these options give you one more tool to achieve your success.