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“We educate our clients and potential clients on the facts”

Benjamin Geyerhahn is an experienced entrepreneur, healthcare policy expert, and member of New York Governor Cuomo’s Health Benefit Exchange Regional Advisory Committee. He is the founder and CEO of BeneStream, which uses a combination of technology and a multi-lingual call center to guide both employers and employees through the Medicaid enrollment process.

Businessinterviews.com: Tell us a little bit about BeneStream. How did your experience in litigation and consulting prepare you to lead a company like BeneStream?

Benjamin: Being an attorney (and later a policy consultant) gave me the skills to understand both the complexity of the regulatory environment insurance brokers operate in and the opportunities the Affordable Care Act has created for brokers. Running a political and policy consulting firm requires a team that can develop and launch a new effort for a new client every year or every election cycle. I understand how to develop a plan and execute that plan. That’s the core of what a startup must do.

Businessinterviews.com: BeneStream’s business model is unique; no other business is offering services specifically related to Medicaid migration. Was there a particular experience that made it obvious that this was a huge need?

Benjamin: No, but I have always believed that only a business model would ensure that every person entitled to public benefits receives those benefits. Some social problems can only be solved by value-creating models because those models can be scaled.

Americans fail to claim about $100 billion in public benefits every year. The nonprofit solution is a storefront, person-to-person model, but this is expensive. Given the magnitude of the problem, it was clear this was never going to meet the need.

The ACA made a more scalable solution possible. It reduced the difficulty of completing government forms and, at the same time, changed the incentives for employees and employers around the delivery of those benefits.

The Ford Foundation provided the capital for our team to refine our model, and we now have a scalable, capital-efficient model that works only when working people claim public benefits. In other words, our model produces revenue only when a low-wage worker receives the benefits he or she is entitled to. In the parlance of Washington and Wall Street, BeneStream has simply allowed for a “regulatory arbitrage” to occur. Unlike other similarly termed techniques, though, ours directly benefits workers and employers — a true win-win.

Businessinterviews.com: The ACA and Medicaid both carry a lot of confusion and ideological noise. What does your team do to alleviate confusion and bring your customers around to the benefits of enrollment?

Benjamin: Medicaid enrollment for low-income employees benefits the employer (who saves up to 90 percent of the cost of paying for insurance) and the employee (who receives complete coverage for his or her whole family at minimal cost).

Businesses that have lots of low-income workers like restaurants and home health aid organizations often run on very thin margins. Most businesspeople are more pragmatic than ideological. They may not like the ACA, but they understand it’s the law. Additionally, the cost of insuring all of their low-income employees is financially devastating, so even for the most ideological, the savings that come by utilizing BeneStream are too compelling to ignore.

We educate our clients and potential clients on the facts: Medicaid expansion was passed to provide quality coverage (including vision and dental) to employees who earn too little to afford health insurance. Expanded Medicaid provides full coverage for families with incomes up to 138 percent of the federal poverty level. That’s a lot of full-time workers who already have a hard time making ends meet. The reality is that for these workers, any additional expenses are expenses they can’t afford.

At the same time, the financial burden on companies in some industries comes at a cost that threatens their ability to operate. This is a community that’s so price sensitive that many turn down Medicaid in states where it comes with a co-pay. Medicaid gives low-wage workers comprehensive coverage while making health insurance affordable for both the employee and the employer. BeneStream takes care of the complexity of employee eligibility screening, enrollment, and tracking.

Businessinterviews.com: Explain to our readers some of the biggest fears and barriers business leaders have or associate with Medicaid migration.

Benjamin: Business leaders don’t understand the ACA. Not only is it complicated, but the regulations surrounding it are also changing in almost real time. Additionally, the regulatory scheme interacts with a host of other laws that impact how they managed their HR (like the Employee Retirement Income Security Act). To get businesses to work with BeneStream, we must demonstrate that we understand those laws and have built a product that is compliant.

BeneStream’s offering reduces fear and confusion because it’s comprehensive: It’s the first step for companies preparing for the Employer Mandate. We handle the entire process of screening employees for Medicaid, and then we enroll those who qualify and track their standing. Employees need to be screened for Medicaid eligibility before open enrollment for the company plan begins so companies know which employees qualify and won’t need the company’s insurance plan. This allows for smarter budgeting and an understanding of the company’s true healthcare costs.

We use a combination of technology, in-person assistance, and a multilingual call center to guide workers through the enrollment process. Employers are provided with real-time reporting that shows who among their staff is eligible and enrolled, with ongoing monitoring so companies have up-to-date information to ensure that all employees are covered.

Businessinterviews.com: Where do you see BeneStream in five years?

Benjamin: The market for BeneStream’s product is several billion dollars. With the first-mover advantage, BeneStream will be a market leader. We’ll deliver not only public benefits for employees, but also ensure that our clients receive the billions in subsidies that are available to businesses that hire these employees. In the next few years, I think public benefits enrollment help will become a standard workplace benefit offered to employees with lower incomes.

Businessinterviews.com: What should leaders know about the current employer-sponsored insurance environments that will have the greatest impact on the way they manage their companies?

Benjamin: First, the world of health insurance has radically changed under the ACA, and the broker’s job has gotten much harder. Having a broker who understands all the ways in which a business can save money is critical for any company. Business leaders need to demand their brokers lay out all their options this year so they can make good decisions.

Second, Medicaid is not the program you remember. It’s comprehensive insurance that includes vision, dental, and prescription drugs in addition to doctor visits and procedures, with no deductible and low or no co-pays.

In the past, typical plans available to low-income workers always came with high deductibles and inadequate benefits. People didn’t buy those plans. The new plans designed as “affordable” and “comprehensive” have even fewer benefits and are more expensive. For companies with very low margins and a lot of low-income workers, these are the only plans they can afford to offer. Medicaid is simply a better option for eligible employees and their employers.

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