By ROBB MANDELBAUM
Today we meet Ann Gish, who designs high-end bed linens from offices in Manhattan. As we proceed with this series, we’d like to hear from you. What questions would you like us to ask of the business owners we profile? Do you have an interesting health insurance story to tell? Please drop us a line.
THE OWNER Ann Gish, 63.
THE COMPANY Ann Gish Inc.
designs and distributes luxury bed and table linens and pillows, which
are sold at Bergdorf Goodman, NeimanMarcus.com and boutiques nationwide.
In 2011, the company opened its own store in Manhattan. Excluding Ms. Gish and her husband, Ann Gish Inc. employs 10 people in the United States.
WHAT THE COMPANY PAYS The company bears the entire premium cost for its workforce, $472 a month per employee. It provides individual coverage only, but Ms. Gish said that most of her employees are either unmarried or have spouses who get insurance through their jobs. One sales manager, however, has a self-employed husband with a pre-existing condition and a child. Ms. Gish pays the employee’s premiums, and the employee pays the insurance for the rest of her family — an additional $1,300 a month. “She used her agent, we used our agent, and this was the best we could do,” Ms. Gish said. “If she could find a better deal, we’d give her the $500.” Ms. Gish said she is giving serious thought to reducing the share of employee premiums that her company pays: “I want to see what happens business-wise over the next year, and I want to see what happens when the health care reform kicks in.”
THE PLAN Ann Gish offers preferred provider organization coverage, a form of managed care that favors doctors and hospitals that are in-network. One aspect of the plan that galls Ms. Gish is that doctors must seek permission from the insurer before prescribing some treatments. However, Ms. Gish said, the plan is “non-gated,” meaning that employees don’t need permission from their primary doctor to see a specialist.
THE INSURER Currently, it’s Aetna; before that, it was Oxford. “We’ve changed either every year or every two years,” Ms. Gish said, “because they take away the policy that you have, and they give you a new one that’s more money and generally fewer benefits.” In recent years, premiums have bounced around, Ms. Gish said: $422 in 2009, $479 in 2010, back down to $443 last year, and now back up again. Meanwhile, she said, this year employees face slightly higher co-payments and much steeper deductibles.
THE HEADACHE Pounding and relentless. Even simple tasks, she said, like adding or removing employees from the rolls, are complicated: “My husband, who does all of the C.F.O. stuff, has spent hours and hours and hours on this. And I spend a couple days a year on it. And I’m not stupid. I’ve started a successful business.”
WHAT DIFFERENCE THE OVERHAUL HAS MADE SO FAR None. She looked into the health care tax credit available to small businesses under the law but found that the average wages her company pays exceed the law’s $50,000 threshold for the credit.
WHAT SHE WANTS FROM REFORM Simplification. Health insurance, Ms. Gish said, “should be put together in a way that any idiot could understand.” Though Ms. Gish has occasionally read press accounts of how the Affordable Care Act will change insurance, she concedes that she still does not know what to expect. “I figure when 2014 comes, I’ll have to learn it,” she said. “But since I feel pretty powerless about doing anything, and since it could all change before then, what’s the point in trying to sink your teeth into it now?”
Do you have any thoughts on Ms. Gish’s situation? What percentage of employee premiums does your company pay?
The Agenda
How small-business issues are shaping politics and policy.
Robert Caplin for The New York TimesAnn Gish: “I’m not stupid.”
Occasionally in the coming weeks and months, The Agenda will
introduce you to small-business owners who are wrestling with how to
provide health insurance to their employees. Over time, we hope to delve
into all aspects of a crucial decision — not just managing the costs
but sorting out benefit packages, weighing alternatives, and dealing
with insurers and brokers. Along the way, we hope to get a better
understanding of how the 2010 health-care legislation will, or won’t,
affect small businesses.Today we meet Ann Gish, who designs high-end bed linens from offices in Manhattan. As we proceed with this series, we’d like to hear from you. What questions would you like us to ask of the business owners we profile? Do you have an interesting health insurance story to tell? Please drop us a line.
THE OWNER Ann Gish, 63.
THE COMPANY Ann Gish Inc.
designs and distributes luxury bed and table linens and pillows, which
are sold at Bergdorf Goodman, NeimanMarcus.com and boutiques nationwide.
In 2011, the company opened its own store in Manhattan. Excluding Ms. Gish and her husband, Ann Gish Inc. employs 10 people in the United States. WHAT THE COMPANY PAYS The company bears the entire premium cost for its workforce, $472 a month per employee. It provides individual coverage only, but Ms. Gish said that most of her employees are either unmarried or have spouses who get insurance through their jobs. One sales manager, however, has a self-employed husband with a pre-existing condition and a child. Ms. Gish pays the employee’s premiums, and the employee pays the insurance for the rest of her family — an additional $1,300 a month. “She used her agent, we used our agent, and this was the best we could do,” Ms. Gish said. “If she could find a better deal, we’d give her the $500.” Ms. Gish said she is giving serious thought to reducing the share of employee premiums that her company pays: “I want to see what happens business-wise over the next year, and I want to see what happens when the health care reform kicks in.”
THE PLAN Ann Gish offers preferred provider organization coverage, a form of managed care that favors doctors and hospitals that are in-network. One aspect of the plan that galls Ms. Gish is that doctors must seek permission from the insurer before prescribing some treatments. However, Ms. Gish said, the plan is “non-gated,” meaning that employees don’t need permission from their primary doctor to see a specialist.
THE INSURER Currently, it’s Aetna; before that, it was Oxford. “We’ve changed either every year or every two years,” Ms. Gish said, “because they take away the policy that you have, and they give you a new one that’s more money and generally fewer benefits.” In recent years, premiums have bounced around, Ms. Gish said: $422 in 2009, $479 in 2010, back down to $443 last year, and now back up again. Meanwhile, she said, this year employees face slightly higher co-payments and much steeper deductibles.
THE HEADACHE Pounding and relentless. Even simple tasks, she said, like adding or removing employees from the rolls, are complicated: “My husband, who does all of the C.F.O. stuff, has spent hours and hours and hours on this. And I spend a couple days a year on it. And I’m not stupid. I’ve started a successful business.”
WHAT DIFFERENCE THE OVERHAUL HAS MADE SO FAR None. She looked into the health care tax credit available to small businesses under the law but found that the average wages her company pays exceed the law’s $50,000 threshold for the credit.
WHAT SHE WANTS FROM REFORM Simplification. Health insurance, Ms. Gish said, “should be put together in a way that any idiot could understand.” Though Ms. Gish has occasionally read press accounts of how the Affordable Care Act will change insurance, she concedes that she still does not know what to expect. “I figure when 2014 comes, I’ll have to learn it,” she said. “But since I feel pretty powerless about doing anything, and since it could all change before then, what’s the point in trying to sink your teeth into it now?”
Do you have any thoughts on Ms. Gish’s situation? What percentage of employee premiums does your company pay?
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