How Restaurants can help provide insurance

One size does not fit all.  Shelby helps us understand the options and how to decide what is right for you and how employers can help their employees get coverage.

With over 5 years of experience as an insurance agent, Shelby Freeman has the skill set, background, and credentials to advise you on the best insurance plans for your situation. She has worked diligently to assist countless clients in finding plans that fit their lifestyles and give them peace of mind in all 24 states she is licensed in. Shelby became an insurance agent to help people navigate tricky policies and to ensure all policyholders are aware of their risk exposures. Her mission is to build customized insurance policies tailored to each client’s specific personal, business, or family health coverage needs. 
Shelby has a passion for helping small businesses and is well equipped to help you in choosing the perfect insurance plans for your company. Her areas of expertise include insurance solutions for food and beverage businesses, builders and real estate operations, and legal professionals. She believes that putting her clients first and maintaining a high level of professionalism on their behalf is what makes clients eager to refer her to their family and friends. 

Transcript

Nan Wilkinson  0:03  
Hi, everybody. Welcome back to restaurant radio. Today, my special guest is Shelby Freeman. Shelby is a licensed agent and advisor for health and life insurance. Shelby, thanks for being with us today.

Shelby Freeman  0:15  
Thanks so much for having me, Nan. I'm excited to talk about my passion.

Unknown Speaker  0:19  
Yay. Well, so in the restaurant industry in particular, you know, so often, people don't provide health insurance, because it's expensive. People think it well, let's just say people think it's expensive. And it's a cost they can't incur for their employees. But I think the other piece of it, Shelby is that, it really sort of a daunting thing to take a look at and try to understand what's out there, what's available to people what the different choices are. So thank you for being here and helping us take a look at a little bit of this and see if we can break it down and make it a little more user friendly, if you will. Absolutely. Well, so I guess the first question is, why is health insurance in particular so important to have?

Unknown Speaker  1:08  
Yeah, so the simple answer to that is, you don't want an illness or an accident to put you in a situation where your life is going to be financially ruined forever. And I often hear people who say, you know, I don't go to the doctor, so I don't really need health insurance. But to me, you know, you're not really paying that monthly premium just to go to those doctor's visits that would maybe cost you you know, 100 to $200 out of your pocket, that really wouldn't make sense to pay those premiums for that. And every single time I would tell you to self pay, instead of having insurance. If that was the case, what you're more paying for there is that peace of mind, and that financial protection, in the event that you do have a serious illness or an accident, that is going to be catastrophic?

Unknown Speaker  1:58  
Yes, I agree. And I can remember, you know, again, when you're young and kind of, let's just say, not too smart. You know, you don't you know, you kind of don't think about things, those things. But I can remember hearing my mom say exactly that, like, it's not those one or two visits that you get, or one or two prescriptions that maybe you need here and there, or going to the doctor, because you got the flu, it's for those catastrophic things. And but again, I think it's hard for a young person to go back, you know, okay, peace of mind, they kind of think you feel invincible. So I do think it is, it's important for, I think people in the restaurant industry, in particular, to start looking at how they may be able to supply some of these different insurances for their employees. So let me ask you this, before we get kind of going down the insurance and availability route, is there an age that on average, insurance becomes more important, or let's just say, is there an age when people start to get sick more, that insurance should definitely be more of a primary thing that you look at?

Unknown Speaker  3:05  
Well, man, in my opinion, there's not necessarily like a set age, where you would need to be insured more than another age. Unfortunately, in our world illness shows no age discrimination, and accidents can occur to anybody. We hear stories about toddlers that have cancer or teenagers that are in you know, tragic accidents, where they're put in comas. And, you know, unfortunately, we can't predict the future to know what it holds regarding our health situations. Now, with that being said, you know, premiums obviously are most of the time going to be based on age. So it is going to be cheaper, you know, to get locked in at a rate when you're, you know, 30 versus when you're 50 or 60. So that's kind of going to be, you know, the the balance there, but I don't think there's a set age, you know, where it's more critical, I think that anything can happen to anyone.

Unknown Speaker  4:02  
I definitely agree with that. So alright, let's go down that road of looking at different insurances. So, again, we've talked about this sort of that catastrophic thing. And, again, my mom used to talk about what we call, like a major medical plan, versus all the other different plans. You know, I think it's can be overwhelming to try to figure out what sort of a plan you need. And again, as a business owner, what what they could provide like it at any level for their employees. I know there's still I guess, it's still called Obamacare.

Unknown Speaker  4:39  
But so the name changes yearly. Right. So it's a it's been the Obamacare, the Affordable Care Act, the marketplace. It's, it's whatever they're trying to market that year to make it look like something new and exciting.

Unknown Speaker  4:52  
Right, right. Right. Well, tell me a little bit about sort of different insurances that are health plans that are out there. Like Obama are major medical, and how people could try to figure out what's either right for them or right for their employees.

Unknown Speaker  5:09  
Absolutely. So I'm going to touch first on the major medical, when Obamacare did come out, they kind of coined that phrase, and, you know, made it where it was a trademark to their plans only. So there are actually not any other plans now that can use the term major medical other than the marketplace. And while they may have very similar coverages, and allow for catastrophic events, and any kind of major medical accident or illness, they can't actually use that phrase. So there are two main types for individual insurance. And that's going to be the public market, which is going to be the Obamacare marketplace Affordable Care Act. And then there's also going to be a private market. And that's going to be any other plan that you can source on your own, that is not going to be based on your income, and is not going to be through the government. Now, in regards to the restaurant industry, there are group policies, and there are also going to be two branches of those, the first branch is going to be you know, a, just a set group policy. And those are going to be really beneficial for those larger restaurants that have you know, more than about 25 to 50 employees. And then there are also going to be small business plans that are going to be better for those businesses that have less than 25 employees. And those are going to save the employer and the employee and the cost of that premium, going that route with those few employees. So I don't think it's a one size fits all type of industry. And I do think it's really beneficial to work with an advisor to ensure you are getting the best plan both for your employees, your medical needs, and also your wallet.

Unknown Speaker  7:00  
Okay, so with that being said, let's just say an employer decides that they want to start giving health insurance for their employees. First of all, can they pay if someone doesn't qualify for free? Obamacare, I can't Affordable Care Act? Can the employer pay for that? Or is that? Is that something they can do? Or or not? Is that off limits?

Unknown Speaker  7:29  
So typically, through the Obamacare plans, your employer is not necessarily going to pay for those directly through the insurance carrier. Now, if the employer wanted to offer like a stipend, you know, and say, we'll give every employee you know, $200 a month to go towards health insurance, the employer or the employee, I'm sorry, could then apply that towards that premium. But typically, in that type of situation, you're not going to have the employer paying that. Whereas in those small business plans, or the group plans, the employer could pay, you know, that option, and then either deduct from payroll or the employee would pay the full amount, and the employer would reimburse them, or however they decide to do that.

Unknown Speaker  8:21  
Okay, so, so many questions. So let's just say there are some employees, just say my restaurant to make it easy. I've got some employees, and they qualify, some of them qualify for Obamacare, and they get can get it for free. But I still want to say I provide health and health insurance. I guess I'm just sort of talking this through with you, but other people can't decide they want to use a different plan. I mean, I guess it can kind of be across the board about what they use. And like you're saying, you can say okay, if you, I'll give you $200 towards health insurance. Again, I'm just kind of talking this through and a person doesn't need any money for the health insurance. Do you give that to them anyway, as just extra funds, do you? If someone's like, Well, my, you know, husband or wife already gets insurance? I don't need it. Do you still give them the $200? I mean, I guess that's sort of just a not a moral question. But you know,

Unknown Speaker  9:27  
it's really an employer question and make it as short and sweet answer there, that would be something they would decide with their employees. So it really just depends on what their preferences and how they want to operate that. Now if you know the employees are offered that free option, they can opt out of you know, employer coverage, as well as you know, if their spouse offers insurance through their job and they decide to take that they can opt out as well there, you know, on the employer plans Typically the employers don't pay that stipend if the employee is getting coverage, you know, in a different means. However, if they are paying for to be on their husbands group plan or anything, their spouses group plan, they are, it's possible they would give them that stipend to go towards that.

Unknown Speaker  10:22  
Right. Okay. So for an employer to give their employees health insurance, um, are there group plans that just provide major medical other group plans that just provide even like, you know, like, let's just say, prescription drugs, maybe wellness visits, mental health insurance and mental health coverage? Are there plans like that, that? I guess I'm just trying to help people understand what is sort of the not that I want people to do the minimal that they can. But if they're not doing anything, somethings better than nothing, it's the step in the right direction. I mean, what's sort of the like the small the first step off point for people to try to provide insurance?

Unknown Speaker  11:09  
Yeah, absolutely. So I would definitely say that it's gonna depend on how many employees they have, as well as kind of the age range and healthiness of their employees. And I'm going to kind of skip to it a little bit of a different topic here, when we roll into this just because it's going to make more sense. So on those two branches of plans, you know, you kind of have pre existing conditions that are going to come into play too. So on a lot of those small business plans, those are going to have underwriting requirements for the cheapest rates. So that's going to really be the cheapest coverage that you can get is going to be an underwritten plan. Now, if you have employees that are going to need a guaranteed insurability plan, which means that all pre existing conditions, you know, are allowed, there is no you know, disqualification or denial or premium increase, or anything like that, due to health conditions. Those, you know, they're going to be a little more expensive through the, you know, private market of small business plans, but they're still going to be cheaper than those marketplace plans, if they're not qualifying for a subsidy to get that discounted rate. So that's really the cheapest option there is if you can qualify for those. And if you go the private market route, if you're not qualifying for a subsidy, now, if you're getting a subsidy to get the Obamacare plans for free or cheap, and that's going to be based on an employee by employee basis, just based on their income, their household, and you know, how many members are in there and their ages, then, you know, the the private market is going to be the next next cheapest option, if that's not a qualification that they meet.

Unknown Speaker  13:00  
Okay. And so, if there's so you see, there's only I can I keep forgetting, there's Obamacare, and then there's private industry, you know, some big businesses have these big group plans, or because you're part of this, you get really great discounts, or better pricing, does that exist? When you're talking about groups of employees that a business? Does that? Does that apply to restaurants or, or smaller businesses? Can they get it? Can they become a part of something bigger to get better? Rate?

Unknown Speaker  13:40  
Yeah, so let's say you know, you have a chain restaurant, so we'll just use, you know, Olive Garden, as an example, say that their corporate office decided that they were going to offer health benefits to every single employee that worked more than, you know, 30 hours a week, they can offer those at a corporate rate. And yes, it would be cheaper, it would be significantly cheaper for the employee. And the reason for that is, when you offer a group plan, the employer is responsible for at least 50% In most states, and that is going to be you know, state by state regulation. But that's the typical amount that they're going to be responsible for, that they have to pay. So the employee is getting a cheaper rate than they would if they were just paying for it on their own. But the employer is also having to pay that, you know, extra half. Now, if you've got, you know, 1000 employees, yes, that rate is going to continue to go down, the more people you get. But if you're talking about a local restaurant that has 15 employees, that is going to be an astronomically high price for them because they're not getting those discounts for having more employees.

Unknown Speaker  15:00  
Right, that's what I'm thinking. So how does the average Mom and Pop local 123 restaurants? I mean, let's just take one restaurant, a lot of people just have one restaurant. And you know, who knows 20 or less employees? How do they get those really great rates? Is there not any sort of group that you can join to get better ratings that are better rate? Whether you paid the 50%? Or not? I mean, let's just say, Yeah, they'll pay the 50%. That's not a problem. But it's just kind of like bulk buying, you want to be a part of that by that somebody else gets? I mean, how do they is there? Is there an opportunity for that?

Unknown Speaker  15:39  
Right. So that's why those small business plans would come into play.

Unknown Speaker  15:44  
Okay, and what was, I'm sorry, explain that one. Again, the small business plan?

Unknown Speaker  15:51  
Yes. So this small business plans are mostly going to be underwritten, there are some that are not underwritten, and the underwriting is just the health qualifications. But those are going to be geared towards small businesses and self employed individuals. So if you have, you know, 1099 contracted employees, or if you have less than around 25, employees, those are going to definitely be the cheapest option for your group.

Unknown Speaker  16:20  
Okay, so it sounds like to me, what you're saying is that really the best thing to do for any particular business if they're considering providing insurance at whatever level or price to actually talk to someone like you who can, who can advise them. And so, because, again, you just, it's hard to know where to go and what's right, and what the best options are, I mean, so it sounds like finding somebody like you to guide them is the right way to go.

Unknown Speaker  16:52  
Right? Well, and everyone, each different business is going to have a different situation. So I do think that that's definitely the case, you know, you're going to get more personal care that way. And you're also going to find something where you're not paying way too much for the same coverage, you could be getting for cheaper. So I do think that that is going to be the best way, because everyone's going to have a different pain point, everyone's going to have a different budget for health coverage. And everyone's going to have a different situation of how they want to operate health coverage in their small business. You know, as well as differences in age of employees, if you brought me a group of 15, you know, Busboys and waiters that are all guys in their late 20s to early 30s, I'm gonna be able to get them some really good rates on, you know, some private market plans, because they're probably for the most part super healthy, and not using their health insurance very much unless something crazy happens, right. But if you bring me a group that are, you know, a 761 year olds, it's going to be a different situation than what I would give you for those, you know, late 20s to early 30s. Guys, because they're going to use their health coverage a lot more. So they're going to need something that's going to cover more of that day to day stuff, instead of just covering a catastrophic event if that happens. So I would definitely have different recommendations based on each situation.

Unknown Speaker  18:26  
Gotcha. And is are there any laws? And do you know, around? Like, if an employer says they're gonna offer health insurance? I know you mentioned like, if you're, you know, they're 30 hours a week or more? I mean, are there any laws around like, what they, if they're going to offer it what they have to offer? Or is it just basically their call.

Unknown Speaker  18:45  
So that's really going to be on a state to state basis. So I always would recommend looking into the health care laws in your state or reaching out to an attorney in regards to those. That's just not my not my specialty to speak on all 50 states. I would definitely look at your local, you know, laws there so that you're not getting in trouble with that.

Unknown Speaker  19:12  
Gotcha. Well, Shelby, this is been eye opening. And as I kind of already knew the insurance business is vast and varied and a little bit tricky. And so I appreciate you being on here today. And I will share your information with people so that they can reach out and hopefully get some guidance and get some more people getting insurance because I do think it is really important these days, especially after this pandemic, obviously, you know, the government stepped in with this sort of thing. But, you know, just kind of the other thing I think is is looking at our mental health. I mean, I think a lot more people these days are looking at mental health is something that they want to address. You know, all of us have, I guess I want to say all of a sudden Have some sort of mental health, we all got minds. And so, you know, their stresses and that sort of thing. I don't think we all have to be, you know, quote unquote diagnosed with something to say that we want to have some relief for our mental health. And so even that I think has become a big deal. So insurance, I think is, in my mind more and more important these days.

Unknown Speaker  20:20  
Absolutely, yes. And the mental health aspect of that is super important. There are a lot of tele doctors now that are actually offering therapy and psychiatry that way, for you know, the working individuals that can't take off, you know, an hour each week or two hours each week to go and actually physically see a therapist. So they are offering a lot of extended hours tele doctors for that as well.

Unknown Speaker  20:46  
And that's fantastic. Again, because of the pandemic, you know, I mean, we I think we've realized that we don't always have to be right in front of somebody, especially, you know, something like mental health when because you really need to be talking with someone and and obviously, it's good if you can, but it's not like you got to be seen for you know, what's wrong with my head or my eyes or whatever, you know, that's, you know, you definitely be in front of somebody, but um, I think that's great. And just the, you know, the time of traveling back and forth and gas prices being what they are. I think the telehealth thing for something like that is actually pretty cool.

Unknown Speaker  21:21  
Yeah, absolutely. It's one of my favorite new features that has come from COVID. So

Unknown Speaker  21:25  
that's, that's great. I know, the whole the whole tele thing is pretty neat. I I navigated that a little bit. As you know, I'm technologically challenged, if I can navigate, other people give so anyway. Well, Shelby, this has been a pleasure. And I hope we can do another recording at some point and talk about some more points of pain in the the healthcare industry. And I'm going to share your information with people so that they can reach out and hopefully we can help find the right plan for people and get more people covered.

Unknown Speaker  21:57  
Absolutely. Thank you so much for having me on the podcast and letting me share all this information with you and all your listeners.

Unknown Speaker  22:03  
I appreciate it. Thank you. I hope you have a great day. Take care. Thank you. You'd see All right. Bye