Even as his law firm, like many businesses around Indiana, routinely struggles with finding and keeping affordable health insurance, Todd Spurgeon was shocked to hear from so many solo practitioners who had profound problems getting coverage.
Attorneys who practice by themselves and just need an individual policy have been seeing their options dwindle. Their stories included tales about some private carriers offering coverage with a monthly premium that was twice the attorney’s monthly mortgage payment. Others said the plans still available on the Affordable Care Act’s health care exchange covered too little and, sometimes, were not accepted by the physicians in their communities.
Small- and medium-sized firms were experiencing the same headaches. So many attorneys were either relying on their spouse’s health insurance or going without coverage altogether.
Spurgeon and others at the Indiana State Bar Association saw the deep need among their members for a health care plan. In fact, for years officials at the ISBA have discussed and explored ways to provide coverage, but no option ever quite fit, in part because the other plans would not cover the true solo practitioner.
However, that has now changed. Working with a health care tech startup company in Colorado and establishing a voluntary employees’ beneficiary association (VEBA) trust, the ISBA has crafted a health insurance plan that it is preparing to offer to members.
While some state and local bar associations across the country do offer health care, Indiana’s is believed to be unique because it is not working through a broker to find a plan from a major carrier. The ISBA is the carrier and is relying on Apostrophe, Inc., to provide support as the third-party administrator of the plan. Ritman & Associates, Inc., a business and professional liability insurance provider in Indianapolis, and Seeman Holtz, an insurance and risk management company based in Florida, are also key partners in designing and implementing the ISBA’s health insurance program.
“We want to cover as much of our membership as possible, and we think this does that,” Spurgeon, president of the ISBA, said.
As of Indiana Lawyer deadline, the ISBA board of directors was still finalizing the details. The board was scheduled to meet Feb. 18 to approve the insurance trust agreement, which included the establishment of the VEBA trust, and to make the decision as to whether attorneys have to be members of the bar association to participate in the plan.
A 2018 online survey of Indiana attorneys by the ISBA indicates there will be strong interest in the new health plan. A full 63 percent of the attorneys who responded said their firm currently does not offer employer-sponsored group health insurance, and 81.1 percent said they would be interested in participating in an ISBA benefit program that was competitively priced.
“Things have finally fallen into place,” Spurgeon said of the ISBA’s health plan. “I’m confident it will be exactly what (our members) are looking for.”
A new model
In speaking of the new plan, Jennifer Ritman, founder of Ritman & Associates, makes the ISBA’s health insurance sound almost too good to be true — better coverage, better service, at a better price. Yet Ritman maintains the plan will deliver as promised because the association found the right people to put together the right product.
According to Joe Skeel, executive director of the ISBA, the savings will come through Apostrophe’s business model of working with doctors directly. Rather than negotiating and setting a maximum amount payable for a particular medical service as traditional insurance companies do, Apostrophe pays quickly so physicians and hospitals do not have to spend time on billings and collections. This, in turn, saves the providers money, which enables them to lower the price for services such as check-ups, tests or surgeries.
The expectation, Skeel said, is for policyholders to see premiums be 10 percent to 12 percent lower.
Premiums from the members who join the plan will be put into the bar association’s VEBA trust and will be drawn out to pay for the medical costs. The ISBA is purchasing stop-loss insurance to cover any large influx of claims while the funds are being built-up in the trust, but otherwise Skeel said the self-funded health plan does not pose any financial risk to the organization.
“From our standpoint,” Skeel said, “it is such a huge need for many attorneys in this state that as long as we’re not putting the ISBA’s financial viability on the line, the time and energy are worth it.”
Signing up customers
Ritman and her team are in the process of introducing the new health plan to attorneys and signing them up for coverage. The program is scheduled to become effective June 1, and the goal is to insure 1,000 people.
Skeel admitted he is apprehensive about how many members will enroll in the ISBA’s insurance. He attributed his trepidation to his background as a journalist and said his concern is whether people will be comfortable signing up for something that is unique and that they may not completely understand.
Jason Massaro, vice chair of the ISBA’s General Practice, Solo & Small Firm Section, was intrigued when he heard about the new plan and was glad to learn the ISBA is offering health coverage. However, Massaro said he has not heard any discussion among the section’s members about their difficultly in finding insurance, and he as a solo practitioner has been able to get family coverage through a major carrier.
As to whether he would switch, Massaro was uncertain.
Massaro’s firm, The Massaro Legal Group, LLC in Indianapolis, employs him and his wife. Most important to them in health insurance is coverage for screenings and pre-existing conditions, he said, so any plan that offered a lower rate but did not provide for complete medical care would not be worth the savings.
Skeel does not have any doubts about the ISBA’s insurance plan. Echoing Ritman, he said the program will give members good coverage at a lower price. Also, as word of the health insurance has circulated, the initial feedback has been positive.
“People are really excited to see what it is,” Skeel said.•