ADVERTORIAL

The predicament is twofold. Long term and post-acute care (LT/PAC) providers need to attract and retain quality staff while offering competitive wages at a time of tight margins, occupancy challenges, and uncertain reimbursement from state and federal sources.

At the same time, potential employees and active frontline workers across the country require health insurance benefits that do not have crippling deductibles, which can rapidly siphon off hard-earned wages or curtail access to health care because of economic concerns.

Enter American Health Care Association/National Center for Assisted Living (AHCA/NCAL) Insurance Solutions and its broker partner, Compass Total Benefit Solutions.

Plan Designed for LT/PAC

The pairing now offers a variety of employee health insurance programs designed for the LT/PAC profession, including a new minimum essential coverage plan (MEC) for only $161 per month that provides the most commonly utilized health benefits employees want, with copays they can afford, and also meets the Affordable Care Act (ACA) individual mandate.

Nick Cianci, president of Compass Total Benefit Solutions, says AHCA/NCAL Insurance Solutions feature not only health insurance options, but group and voluntary benefit packages, an aggressive Stop-Loss insurance program, the aforementioned MEC plans, as well as cloud-based Human Resource platforms that will help AHCA/NCAL members achieve savings and greater efficiencies on employee health benefits.

On the MEC product—the Compass Plan—Cianci says from an employer perspective, the health insurance package gives employers another option to use as a recruiting and retention tool that costs the owner/operator exactly $1 an hour for a typical full-time employee on top of whatever wages are being offered.
“As an employer, you can subsidize this from 0 percent to 100 percent if you want to make it so that you can recruit off the offering,” Cianci says. “And, it can be for part-time or full-time workers.”

Cianci says the MEC plan was specifically designed with long term care staff members in mind. “It was developed to help long term care employees who cannot afford traditional ACA-compliant plan premiums, or the high deductibles associated with many ACA plans. Even though traditional ACA-compliant plans are classified as ‘affordable,’ they are not an option that many long term care employees can afford,” he says.

A Recruitment Tool

Cianci notes that the Compass Plan, which features two tiered options to choose from, originated a few years back as a solution for a LT/PAC provider in need of a recruitment tool.

“An AHCA/NCAL member came to me and said he had been putting ads in newspapers offering to pay a little higher than everyone else, but he still could not get people to apply. He asked, what can we do, and I said, ‘Well, what are you paying, $12.50 an hour? What’s minimum wage, $12? Okay, so you’re paying a little more than minimum wage, and just beating McDonald’s.’”

Instead of upping the wage range 50 cents or so to top a fast food company’s wages, Cianci suggested instead that the provider keep his salary around $12 an hour but add
a free health care plan that would add around $1 to total compensation. From this idea came a lot of work to come up with the Compass Plan, which adheres to the ACA,
keeps employers happy with its low costs, and satisfies employees.

Cianci explains that the traditional ACA-compliant plan is a major medical plan with an affordable premium, but one that includes a not-so-easy-to-afford high deductible. For an employer, putting the Compass Plan as an option to the major medical plan makes sense.

“A provider can make it a third option. You don’t displace your current options because your employees like those as some of them are going to need them. So, what you do is you layer this right in, and it becomes another option for employees who don’t need the more expensive coverage,” he says.

What Is the Plan?

The MEC plan is run by a third-party administrator, the entity that processes claims and distributes health insurance cards to members who choose this option. The plan includes a national network of 960,000 providers, and also includes the Teladoc Health telemedicine benefit that is free and unlimited 24/7, 365 days a year for anyone on the plan.

“You can get as many consults as you want with Teladoc, which is important because some of these rural areas that LT/PAC providers are in makes this a very helpful benefit,” Cianci says.

Copays for regular doctor visits are $20 and for specialists the copay is $50 per use for up to three times a year, per person. Three Urgent Care visits per year, per person on the plan are also billed at a $50 copay, he says.

Annual physicals and mammogram visits are 100 percent covered in the plan as well.

“This plan is not designed for the very sick person, but for someone who has minimal needs as they go and who cannot afford the $6,000 deductible,” Cianci says. There are, he adds, provisions for X-rays, blood work, and full coverage for COVID-19 testing.

Prescription drugs are also included in the plan, with a six-tier offering, including select generic pricing at $1 per script.

“For major medical needs, the standard plan would say if you’re admitted to the hospital it’s a $1,000 indemnity benefit automatically, and it’s $200 per day for up to a 10-day stay. There also might be an anesthesia benefit, or a surgery benefit based on the state involved, but we designed Plan 2 to cover roughly 70 percent of the traditional labor and delivery,” he says.

To explore the Compass Plan, go to the Member Benefits section of the AHCA portal at www.AHCABenefits.org. Members can also call Cianci at 202-898-2841 or email Nick@compasstbs.com.