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As time runs out for Americans to make decisions on their healthcare future, the Affordable Care Act legislation is also having a tremendous affect on small business owners who have to make those same tough decisions not only for themselves and their families, but for their employees and the long-term sustainability and success of their business.

About 100 members of the Genesee County Chamber of Commerce take health insurance for their businesses through a partnership with Tompkins insurance. The Chamber’s purpose is to represent the unique interests of small businesses and one of the major parts of that mission is providing guidance with health insurance. President Tom Turnbull says it’s a far superior arrangement than depending on an often dysfunctional website.

“We just found that a lot of our members really just want to put a name and a face to their policy with someone they can talk to in person,” he said.

It’s been a hot topic in the media and communities nationwide for months about how something so new and big and, to most, clunky, would transfer to reality. Locally, Turnbull says a seminar on health insurance in October yielded double the attendance for a usual Chamber seminar.

JoAnne McInerney, the vice president of employee benefits at Tompkins Insurance Agencies in Batavia, has been working directly with Chamber members who have to navigate their health insurance options. She says, in theory, the ACA done a good job of providing people with access to a multitude of healthcare plans; but it also has done nothing to control costs -- a major frustration she’s experienced working with small businesses.

For example, McInerney points to MVP Healthcare which has long has been a big carrier in Genesee County. She says reorganizing by the Schenectady-based company (and many other private insurance companies like it) has raised costs significantly.

“Previously with MVP in our county – Genesee, Orleans and Wyoming counties – they had been rated with the Rochester rating region which had lower rates, and now they’re moved to the Buffalo rating region which are much higher rates,” she said.

Same thing goes for plan options, McInerney says. There were previously two simple tiers of ‘single’ and ‘family’.

“Now with all plans, the only things you can get are single, husband and wife, single parent and child or children and then the family,” she said. “What happens when you start tiering those rates is it increases those family rates significantly. You’re seeing 30 to 40 percent rate increases in those areas.”

The Empire State has its own healthcare exchange marketplace called The New York State of Health website. Though significantly more effective than the lambasted federal equivalent,, it has still caused major problems. McInerney says there were times when she was working on the site and would get to a new screen only to be timed out and have to start over. And there were more problems: A company’s name was too long and the exchange wasn’t set up to handle such a long company name. Small businesses had to provide email addresses for their employees, but if they deviated, she said, from the typical ‘.com’ ending, that could also cause problems with the website’s progress.

“We ran into a lot of systems issues,” McInerney said. “For a period of two to three weeks, MVP – which, again, is one of the predominant carriers here, or was, in the Genesee County area – their plans for small businesses completely disappeared. You couldn’t even find them on the exchange.”

Working with Chamber members, McInerney says it’s been a challenge for the Tompkins team to assist so many types of businesses with different perspectives, opinions and needs en masse to meet deadlines in a brand new system.

“I’ve had a mixed variety,” she said. “I’ve had some businesses that say, ‘I want nothing to do with the exchange. Keep me far away from it. It’s a disaster.’ I’ve had others who’ve said, ‘It’s a disaster but I still have to work through it and make it happen,’ and I’ve had some that are all for it.”

Once the Tompkins team is successful in navigating the website and meeting the small business’s needs, the question remains about whether those plans are actually efficient and appropriate. McInerney says some of the plans just don’t make sense, especially when comparing the inexpensive ones versus co-pay plans.

“At the minimal level, that plan, yes, the premium might be slightly less, but it has a $3,500 deductible in most cases for a single person,” she said. “When you think of the Affordable Care Act and you think of someone who may not be able to afford healthcare, a $300 a month payment is going to give them a $3,500 deductible and can they afford the deductible? Whereas if you stuck with a co-pay plan, which is rare up at the platinum level, a single premium for that is four-hundred and almost-70 dollars a month.”

There’s been plenty of bad news about the ACA, but McInerney does see a positive in how it benefits pre-65-year-old retirees.

“Those people didn’t really have a place to go before to get healthcare,” she said. “They’re not eligible for Medicare yet, their individual rate plans pre-2014 were very, very expensive co-pay plans. I know a couple who was paying almost $4,500 a month for a two-person plan and now their rate is down in the $1,400 - $1,500 range and they’re thrilled.”

It’s been a long and arduous process for most parties involved which is why the added complications faced by small businesses make this process all the more frustrating. McInerney and Turnbull both stressed being patient and taking a wait-and-see approach since this entire system is unprecedented.

“It’s going to be continuing, ongoing for the rest of the year and we’re certainly hoping for improvements in the system’s capabilities and speed and access as the year continues,” she said.

“Hopefully it will only get better.”

McInerney says she’s taken care of and filed the paperwork for all the Chamber of Commerce small businesses that went on with the exchange recently. The deadline for registration off the exchange for small businesses is Dec.15.

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