By Mike Kline, ASA National

On September 6^th, ASA Director of Communications Mike Kline hosted a Town Hall meeting with Rusty Plowman of Delta Drywall and Immediate Past President of the ASA National board, and Terence Gorman, Managing Director of World Insurance LLC, the underwriter of the new ASAdvantage Health Plan, ASA’s new health insurance option for members.

During the town hall, Mike interviewed Terence and Rusty about the features of the program and potential benefits to members if they switch to one of the plan options available in the program. At the end of the session, the group answered questions from attendees.

Nearly 70 members participated in the event. 

Here are the key parts of the Town Hall.

Rising Healthcare Costs 

Moderator Mike Kline asked Terence Gorman why healthcare costs have risen so dramatically over the past decade. Terence explained that medical inflation has exceeded general inflation for years. Another major factor is the skyrocketing cost of prescription drugs, which now account for over 30% of total health plan costs compared to less than 20% previously. 

However, Terence said the structure of the Affordable Care Act (ACA) (a.k.a. Obamacare) contributed significantly to cost increases in the small group and individual markets. The ACA’s minimum Medical Loss Ratio requirements eliminated incentives for carriers to manage costs. It also required young, healthy enrollees to substantially subsidize premiums for older individuals. But not enough young people enrolled, forcing carriers to raise premiums continuously to make up the shortfall.

Impact on Construction Firms

When Mike asked how these cost increases have impacted his business, ASA Immediate Past President Rusty Plowman gave an example. In 2000, his premiums were only $425 per month with minimal copays and complete coverage. Today, with a $5,000 deductible and higher copays, his monthly premiums have tripled, while coverage has declined dramatically. Rusty said this makes it much harder for construction firms like his to attract and retain top talent.

Association Health Plans 

Mike questioned how an association health plan is possible since the ACA had banned them. Terence explained that rules were later changed under the Trump administration to allow association plans again. He said their program is an LLC model structured to comply with ERISA regulations. This allows it to be offered in all 50 states regardless of state insurance laws.

Potential Savings

When discussing potential savings, Terence estimated their program would reduce costs by 7-35% for 85-90% of ASA members compared to their current plans with similar coverage. He said it may not work for 10-15% of members because high-risk individuals with very expensive conditions could make premiums unaffordable for small groups.

Plan Details

Terence said the plan uses Cigna’s large PPO network, providing access to most doctors. It is comprehensive major medical insurance, not a limited benefit plan. The program includes medical, dental, and vision options. As a level-funded self-insured plan, it comes with no risk for employers or employees. Renewals typically range from a 3% decrease to a 4% increase.

Customer Service  

To address concerns about customer service, Terence assured members they will have phone numbers to call with any questions or issues. World Insurance and the program manager will provide concierge service to resolve any problems not addressed promptly by the third-party administrator.

Rusty’s Interest

When asked about his interest, Rusty said the potential for better coverage and lower copays compared to his current plan is appealing. As a 100-employee firm, they don’t have the purchasing power of very large companies. Rusty believes the program could attract new members to ASA. 

Enrollment Process

Terence outlined the enrollment process. 

1. Interested members complete a census of eligible employees and health questionnaires. 
2. World Insurance reviews the data and provides quotes within 2-3 days. 
3. Coverage can start the first of any month if paperwork is submitted by the 15th of the prior month. 

Summary

The town hall provided an in-depth overview of the features, potential savings, customer service, and enrollment process for the new ASA health program. Both Terence and Rusty strongly encouraged interested ASA members to explore the program as a way to potentially improve benefits while lowering costs.

ASA members can listen to the full recording at [insert link here]. 

To explore the plan further or request a consultation, please visit https://www.asaonline.com/asadvantage-health-plan/. 

For questions about the plan, please contact Terence Gorman at (848) 456-8600 or terencegorman@worldinsurance.com.