Geoffrey W. Hoffa, DHSc, PA-C, is a business development consultant and a research-based strategies advisor with an interest in health policy, as well as principal of Geoffrey W. Hoffa, PLLC.
Working with the International Brotherhood of Teamsters (IBT) and Ullico to respond to the challenges of health care reform, he helped develop the Teamsters Stop Loss Program, a successful partnership between IBT and The Union Labor Life Insurance Company (Union Labor Life). Prior to his work in the business realm of health care, Dr. Hoffa practiced as a physician assistant in the clinical disciplines of GI, hepatology and transplant surgery.
A graduate of Michigan State University, Dr. Hoffa additionally earned a master’s degree in physician assistant studies, and a doctorate of health sciences with a focus in leadership and organizational behavior from A.T. Still University (ATSU), Arizona School of Health Science (ASHS).
In addition to his work to preserve important labor benefits, Dr. Hoffa currently serves as chairman of the State of Arizona Regulatory Board of Physician Assistants, is an adjunct assistant professor at ATSU, as well as chairman of the ASHS Alumni Chapter board, and is a member of the advisory board for the George Washington University-International Brotherhood of Teamsters Labor History Research Center.
Dr. Hoffa is also the grandson of IBT President (1958-71) Jimmy Hoffa, and son of current IBT President James P. Hoffa (1999-present).
His paper published recently by the International Foundation of Employee Benefit Plans (IFEBP) outlines the challenges that Taft-Hartley health care plans face under the implementation of the Affordable Care Act (ACA).
Dr. Hoffa answered our questions on what the ACA means for union heath care plans.
Q: The Affordable Care Act has changed the landscape for Taft-Hartley health care plans. What are the major issues facing these plans in 2014, the ACA’s first year of implementation?
A: There are many. In a 26 question survey of the Teamster leaders of health plan funds, we found that the potential loss of the ability to negotiate with employers for health benefits translated into great concern for the continued ability to organize workers into the Teamsters Union. As well, the loss of the ability to negotiate with employers for health benefits, from a potential exodus out of existing plans, would negatively affect the level of health benefits that workers receive in the eyes of these leaders.
The excise tax, or "Cadillac tax," was another great concern for most union-side trust leaders, as it will more than likely affect the level of benefits offered to fund participants, even though only a little over half of the respondents indicated that their plan would actually be subject to the tax.
Finally, most perceived that the additional administrative work and documentation required under the ACA would force greater expenditures upon the health and welfare funds.
It is important to note that there seem to be revelations about the ACA almost on a daily basis, and that one of the limitations of the study is that it is impossible to include all of the challenges, potential or realized.
Q: Why do these new regulations affect unions differently than traditional group insurance plans?
A: If we are speaking strictly about private contract, Employee Retirement Income Security Act (ERISA) covered group health care plans, we have to divide them into Taft-Hartley plans and employer-only plans. There may not be much in the matter of non-union employer plans resisting the urge to wash their hands of health care responsibilities as employees are ushered to tax-supported exchanges. The penalties for doing so do may not outweigh the lure of potential cost-savings.
For Taft-Hartley health and welfare funds (and other union-affiliated health entities) the ACA, and the regulations that accompany it, threaten the long-term future of the funds as they are forced to compete with tax-subsidized individual plans offered through the exchanges. Unions will be in the fight of their lives when employers threaten to walk away from the bargaining table if discussions include increased contributions to health and welfare funds.
Q: What are you hearing from plan administrators as they comply with the new changes?
That they are often frustrated by the lack of government leadership and the slow roll-out of regulations that determine what work the plans have to do to be in compliance with the law. The trustees often feel the same way, anecdotally.
Q: What solutions are available for these plans to protect their assets from high-dollar claims?
A: There are many companies that offer stop loss, and many that are aggressively marketing a solution to the new (as of 2014) unlimited liabilities in health care expenditures. Ullico Inc. and Union Labor Life are leaders in the stop loss business and offer the hope of a future that includes complete participation and organization from the Taft-Hartley funds.
I can tell you that there is a consensus among unions that have created the very best examples of private contract health plans, regarding the pressures of the ACA. These pressures, along with the common problems that have existed prior to the ACA, will only be overcome if we work together. Ullico provides possibly the last opportunity for unions to track every dollar they spend on benefits to ensure their money isn’t being utilized by organizations that oppose their efforts–and that should factor into every trustee meeting when it comes time to choose a product!