Failures in Journalism and pimping Jost

“The two types are known as the "self-insured" and the "fully
insured," and historically, smaller companies gravitate toward the second
classification. They don't insure themselves … because, with too few employees,
a couple of major illnesses or surgeries could be financially calamitous.”

This paragraph displays a complete lack of understanding of insurance.
Self-insured and fully insured refer to a type of insurance and don’t in any
way accurately portray risk. With a self-funded plan, companies are able to
manage the claim and the risk that comes along with it. With a fully insured
plan, you usually don’t even know it exists until you get a 30-40% rate
increase from your carrier, at which point there’s precious little you can do
about it.

"There's a reason most small businesses -- those with 50 or fewer
employees -- don't directly pay the health care expenses of their employees --
it's too risky. Instead, small companies that offer employee health coverage
purchase group policies from health carriers, allowing the insurer to assume
the risk."

As an insurance professional for 20 years, this is a pretty amazing quote to
read in the news section of a paper, because its completely ignorant of what
has actually been happening in the market for over 5 years now, long before
PPACA. For example, my own company has hundreds of clients under 50 lives that
take risk. The company has specialized in this segment since the mid 1980s. And
a large number of small employers take some risk: they purchase a fully insured,
high deductible plan then self fund back down to lower deductibles, calling
them HRA or MERP plans. Brokers do this for their clients, all the carriers
offer it, third party administrators (TPAs) like mine do it. There are
thousands of firms offering this type of small group “self funding.”  and they have been doing it long before Obama
even ran for President, let alone passed ObamaCare.

“These are unconventional times, though, and with federal health overhaul
measures taking effect and a new online insurance marketplace set to be
operational in 2014, smaller companies are taking a second look at
self-insurance.”.

Why would Jost and/or the reporter leave out that small employers have been
taking a second look at self funding since 2007-2008 and there have always been
small self-funded groups? Did Toland speak to any employers, brokers, or TPAs
prior to reprinting Jost’s propaganda? Apparently not.

“Self-insurance becomes possible when a company also buys "stop-loss"
insurance.”.

Again factually incorrect: you can self-fund under a fully insured policy just
as easy as you can under stop loss. You can also self-fund portions of risk
without any reinsurance at all. In his attack on small business, Jost is trying
to equate stop-loss to nefarious attempts to circumvent PPACA in order to call
for the elimination of stop loss. But if it is ok to self fund under a $5,000
fully insured policy, why shouldn’t employers be allowed to self fund under a
$5000 stop loss policy?

“But some experts are concerned that insurance companies, in trying to win new
business, are offering stop-loss coverage at artificially low prices by
poaching the healthiest of small groups.”.

Toland means to say ‘artificially low specific attachment point;’ if he had spoken
to anyone in the business he would know the prices are *not* low. The
attachment point is not the price, a mistake the “journalist” should not be
making if he understood what he was talking about, or had bothered to learn. And who are these "experts" and why are they not named? Are we suppose to trust Toland that they exist and are really experts? More likely they are partisans pushing a political agenda, only expert in their ideology.

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