Expert advisers see gold in health reform

Not many people have read all 2,000-plus pages of the Affordable Care Act. David Bottoms has, and with reason. Knowing the health care law inside and out helps him bring in business at The Bottoms Group, a Marietta insurance and benefits firm where he is senior vice president.

In 2012, when his firm started heavily marketing its consulting expertise in the ACA to employers, its business shot up 38 percent, he said. It’s up another 20 percent this year, he added. .

“There is,” Bottoms said, “opportunity in complexity.”

Ever since the Supreme Court ruled the ACA constitutional a year ago, employers have wondered how the law will affect them when it goes into force on Jan. 1, 2014.

But for some health and benefits consultants, health care sector attorneys and bankers, and other professional service providers such as actuaries and accountants, there’s no question. It’s provided awindfall.

Many large employers have had ACA strategies in place for some time. But lots of smaller companies, with fewer than 200 or 300 employees, are just now mappingstrategies for next year and are seeking outside guidance.

Many of these smaller companies can’t afford in-house expertise needed to analyzewhether they should offer health insurance to their workers, and if so what sort of coverage they should provide.

The ACA “is complicated, and not the kind of thing anybody should try to navigate alone unless (your business) is large enough to have an in-house expert,” said Susan Pearson, director of human resources for Northwest Exterminating,a Bottoms Group client.

Still, plenty of small businesses go it alone, whether because of the cost of outside help or because they feel they can make their decisions using widely available information. Many also pick up knowledge and tips at free seminars that are being held around the metro area. Consultants, lawyers and others at the sessions talk about the law and its implications, but they typically don’t provide customized advice for individual businesses at these sessions.

The cost of professional advice ranges widely, according to estimates provided by consultants, and depends on the size of the client, the type of business, whether the employer is a regular client or not, and other factors.

But a small business might pay a consultant $15,000 to $20,000 for ACA compliance work.

Kyle Jackson, Georgia state director of the National Federal of Independent Businesses, said some businesses rely on the help of their insurance broker, sometimes in consultation with an an attorney or accountant, “or all three.” Employers are trying to do right by their company and their workers, he said, and also trying “to stay on the right side of the law.”

Jackson said the ACA is not only complex, but businesses have had a relatively small time window to figure it out.

“The impact on employers of health care reform is dramatic, and it’s happening at a quick pace and in a short time frame,” said Tony Holmes, a partner at Mercer Health & Benefits in Atlanta.

Employers have long struggled with how to hold down health insurance costs. Many have used benefits consultants to help them decide what kind of coverage to offer.

The ACA adds some new decisions. For one thing, companies with 50 or more full-time workers must offer workers affordable health care coverage or face a $2,000-per-employee penalty.

Calculating which option will cost a business more is not simple because of the many variables in coverage options and in employee wage and salary scales. That’s prompted some business owners to look outside for guidance.

David Cole, an employment lawyer with Freeman Mathis & Gary in Atlanta, said his normal work withbusiness owners and human resources managers “led to questions about the ACA.”

Cole spent hours reading the law and its regulations.

“It has turned into a really great area for me, to be honest. I’ve been able to help our firm’s existing clients. And it’s also given me a number of speaking opportunities with various organizations and also a chance to appear on TV. That’s introduced me to new clients. I’ve definitely seen a growth in my client base as a result of this.”

Cole said he doesn’t see his ACA work as a self-sustaining practice in itself, but rather one that augments existing work.

“My goal is to establish long-term relationships with clients to help them run their businesses,” he said.

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