TBA Health Insurance Benefit Is Here!

Want to have good quality health insurance at 20 to 30 percent below market rates, even if you have a very small firm?

Want to save enough on your health insurance to more than cover your TBA dues?

Why do I ask? Let me give you some background information.

In the 2017-2018 bar year, the Tennessee Bar Association retained a consultant to survey TBA members and some nonmembers on a variety of issues. One of the primary goals was to determine how the TBA might best assist and support its members. The end result, which became available in July of 2018, is a 182-page document containing a vast amount of information, distilled down to six recommendations. Those included the following: Update membership benefits package to include more reliable and cost-effective health insurance programs. ...

Okay, so, how hard can that be?

Once upon a time, health insurance programs and premiums were no big deal. Insurance companies wanted to insure. Employers wanted to provide insurance benefits. I can recall worrying much more about the cost of car insurance for a teenage son than the availability and cost of health insurance. But that was a number of years ago.

As time has passed, health insurance premiums have increased, coverage has decreased and availability has been more and more difficult. The number of bankruptcies resulting from people having no or grossly inadequate coverage is shocking, and it includes lawyers. The Affordable Care Act helped with certain aspects, such as pre-existing conditions. But for some group coverage, “affordable” is a relative term.

IPSCO, our partner in Tennessee Bar Association Member Services (TBAMS), has done a great job of brokering insurance coverage for our members in a number of areas, including but not limited to professional liability, long-term care, telehealth and cyber-security insurance. They have also brokered health insurance, helping our members find a company to provide coverage to a particular law firm.

The task at hand is different, however. While our membership fluctuates, we have approximately 13,000 members. With a larger group, the economies of scale kick in, and rates are typically significantly better than they would be for a three- or four-member firm with a handful of employees. Our TBAMS partner worked with us to find a way to establish a group insurance policy in which the group is the Tennessee Bar Association, not your law firm.

After some initial difficulties, and with the assistance of a team that included your executive director, general counsel, and some lawyers learned in ERISA, the problem was solved using a Multiple Employer Welfare Arrangement (MEWA), which permits multiple employers (in our case, law firms) to band together to form a group for purposes of coverage.

Implementing this approach required a bylaws change to meet ERISA requirements. The Board of Governors approved the change in August.

Here’s how it works: If you want to take advantage of our group policy and buying power, all of the lawyers in your firm must be members of the TBA, although they need not all participate in the insurance plan. The firm can seek to have a non-voting law firm membership in the TBA. This triggers eligibility for your firm’s lawyers and qualified employees and their dependents to apply for coverage as part of the group.

Three facets of the group, which is through Humana, strike me as tremendously important. You won’t have to answer questions about the current status of your health. The rates are reportedly 20 to 30 percent below market rates. Also, the plan is fully insured. In other words, it’s not a self-funded plan in which the assets of the TBA are at risk.

As explained more thoroughly elsewhere in this publication and on our website, there are three different levels of coverage from which to choose. Open enrollment for 2020 runs from Oct. 1 to Dec. 1.

As always, when looking at insurance, the devil is in the details. If you are in the midst of treatment for a specific problem and want to stay with your current provider, you will want to check with Humana to determine whether that provider is covered. But for the rest of us, the opportunity to obtain cost effective coverage on a fully insured plan with no underwriting for pre-existing conditions is a marvelous member benefit. And under ERISA, this benefit is available not only for the large firm but, more importantly, also for the tiny law firm — the solo practitioner with only one W-2 employee who works 30 hours per week. And all size firms in between.

This bar year, we are focusing on providing benefits to the rural and small firm practitioners. We hope this insurance program will be a game changer for some of them, as well as for the rest of you. Your TBA continues to work to make the business of the practice of law easier. 

SARAH Y. SHEPPEARD  is a shareholder in the Knoxville office of Lewis Thomason and a Rule 31 Listed Mediator. You can reach her at SSheppeard@LewisThomason.com.

          | TBA Law Blog