Testimonials

Barnstable Patriot

Written by Paul Gauvin

Getting through state health insurance maze

Local company helps individuals, small businesses meet new state law

COVERED – Thick in size and as difficult to understand as some of the prose in the annotated Shakespeare are the expanding laws governing the state’s mandatory health insurance program, says Jeffrey Pepi of Health Plan Solutions of Osterville and Centerville.

From his experiences, only one in five small businesses are completely compliant with the state's mandatory program requiring employee health insurance, says Jeffrey Pepi of Health Plan Solutions in Osterville, a company that says it is "the only company that works hands on with all aspects of the state’s health care reform act."

Conforming with the law, its expansion and its continually changing rules is particularly vexing for small-business owners who don’t have the time or the inclination to read the fine print or comprehend the legal/bureaucratic jargon, he says.

Consequently, Pepi and his partner, William Fields, who has been in the insurance business for 30 years, offer a service that guides small-business owners into compliance.

"If employees qualify for Commonwealth Care or a Choice Plan, we do all the paperwork and follow it through to completion," Pepi said. "After that, we continue to represent individuals and businesses and keep them informed of new changes as they occur."

"We gather all the pieces of the changing laws. We read, understand and explain all the fine print, monitor changes, attend all the meetings of the Commonwealth Care board governing the program and then help mandated businesses make a proper health insurance offering to fulltime employees. Properly offering a health insurance program under the law avoids penalties, some of them substantial, for either not doing it, or not doing it completely.

Pepi said there are "eight state inspectors calling and walking into businesses, some of them ex-IRS auditors, checking to make sure companies falling into the mandated category comply with the law.7qu

A native Cape Codder who lived for a while in northern Maine with his aircraft-mechanic father and former employee of Cape-based airlines, Pepi had been an independent agent selling health insurance to people who didn’t have it at work and/or were self-employed and had to cover themselves.

Pepi explains that health insurers aside from HMOs required blood and urine tests and a physical before offering coverage to an applicant. But in 1998, state law mandated private insurers extend coverage without physicals. "That created a mass exodus of insurance carriers out of the state, except for HMOS like Blue Cross, Tufts and Pilgrim," he said.

Now, Pepi says, the state requires every taxpayer be insured under pain of penalty, and for some small businesses, the penalty can be substantial. "Under certain conditions, it could ruin a business," he said. "Last year the penalty for individuals not having insurance was $214, but this year it is $916 per year."

Another confusing aspect of the law is the requirement of "11 fulltime equivalents,7qu which does not mean 11 full-time employees. Pepi uses a landscape company as an example.

"The company could have one full-time employee, a foreman, and a group of part-time or seasonal employees whose aggregate hours in a season add up to 40,000 hours,7qu he said. "That would exceed the equivalent to 11 full-time employees who would register 22,000 hours, meaning the company would have to offer health insurance to the one full-time worker. Because of this formula, some employers don’t realize they have to comply.7qu

Some employers aren’t aware, either, that they must fill out and sign a Health Insurance Responsibility Disclosure (HIRD) form within seven days of hiring a new employee.

Other regulations fill a tome 7qu the size of the New York City phone book" can, if not followed or implemented, bring penalties down on the employer who isn’t aware of the rules, says Pepi.

"What employers need to know is that the law stipulates they must offer health insurance" if they fall into the parameters of the mandate, "but they don’t have to provide it if an employee doesn’t want it," he said.

That occurs, he said, when an employee might have another family member providing health insurance through his or her work.

Clients include a host of businesses on the Cape such as the Abbicci, Roadhouse and Kettle Ho restaurants; landscapers, painting companies, building contractors, entertainment, temporary-worker companies, automotive firms and a number of other small general services companies.

More information is available at www.healthcaresoutions.us.

Marsha Gorewitz
To Whom It May Concern:

I am the Financial Administrator for a Boston staffing firm. I first met Bill Fields at a staffing industry meeting concerning the pending Mass Health Reform Act and how it affected our industry.

I listened to the presentation, the questions raised and quickly realized that simply being able to read and understand English would not be enough.

I later introduced myself to a gentleman in the audience (Bill Fields) who was asking pertinent questions and seemed to have an "understanding" of the law.

I have known Bill for over a year now and find his knowledge (and pursuit thereof) an invaluable source for my company and me personally.

Bill is Don Quixote like-- he is obsessed with the health care reform act despite the fact that most of it (although we support the basic premise of health care for all) is flawed in inconsistency and lacks clarity and definition.

In summary, I think a presentation by Bill would be, at the very least, informative for your forum.

Sincerely,

Marsha Gorewitz

Jo-An Gladstone
Dear Mr. Lank,

Bill Fields has asked me to write you with regard to his offer to conduct a presentation on the MA Health Care Reform and the value to your members.

First, I am a small business owner and advocate of chamber membership. Secondly, I am grateful to Bill Fields for helping my company work through this nightmare. When the MA Health Care Reform was enacted, I attended numerous seminars run by a wide variety of organizations from AIM to my state association.

Each seminar presented more unanswered questions and I left more confused and concerned then before. At several of these meetings, I heard Bill question the presenters and soon realized that he knew more than the experts.

After speaking with Bill and talking with some of his clients, I engaged Bill for my company. Bill Fields is committed to helping people and companies through this legislative nightmare. Bill is unselfish in his dedication to this issue. Besides working with me, Bill has spent hours helping my employees and applicants to understand the requirements and assist them in understanding their options on his own time.

You can not find a more knowledgeable individual to speak on the MA Health Reform so unselfishly. For whatever reason, Bill has made this his cause, and for that I am truly thankful.

Sincerely,

Jo-An Gladstone

Kathleen Bitetti
Dear Mr. Jack Lank,

I strongly urge you to allow Bill Fields to present Health Care Reform information to your Chamber members. He is more than willing to do it free of charge-which is usually unheard of.

I recently met him at a public hearing for the Fair Share Contribution regulations (we were opposed to the regulation change) and I was so impressed with his grasp of the law that I invited him to join our Artists Health Care Working group and its connected website: www.healthcareforartists.org

In my capacity as Executive Director of the Artists Foundation, I have to know all those aspects of this law and how impacts all of the sectors. I have been involved with the MA health care law implementation since its beginning. I have also attended many informational meetings on the law that have given out incorrect information to attendees (and as a result I have had to correct those giving the meeting). Mr. Fields is one of the few business people who truly understands all of the aspects of this law- its impact on small businesses, large businesses, and on individuals.

I highly recommend him and firmly believe if you do not take advantage of his wonderful offer you are doing a disservice to your membership.

Sincerely,

Kathleen Bitetti
Executive Director of the Artists Foundation
www.artistsfoundation.org

Jonilee Rossi

Bill Fields and his company Health Plan Solutions offer a common sense approach to health care reform. I wouldn't go anywhere else for advice.

Sincerely,

Joni Lee Rossi
CEO
CQ Personnel, Inc.