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With reform, chance to profit

The new health care law looms as a potential life saver for some clients of Paul Carroll’s WesTek Insurance Group.

One 55-year-old beautician wanted to get health care insurance, but she had breast implants 25 years ago after surgery for cancer.

The insurance company said she could get coverage if they were saline implants, but, if they were silicon, she was ineligible.

The implants were saline, Carroll said. But the insurance company still refused because she no longer had documents from the operation 25 years ago. The new health care reform law will change that.

In an interview, Carroll outlined health care legislation highlights and told about how his business can grow by helping employers comply.

Question: So the beautician will be able to get health insurance under the new law?

Answer: Yes. She and people like her can buy health insurance at the same price as others. They cannot be charged a surcharge because they are sick.

If you get every new cancer patient and every diabetic and they don’t have to pay more in premiums, they are going to have to raise everybody’s price.

If the beautician was a low-income person, she would be eligible for a federal subsidy to help pay part of the premium.

But how are they going to verify the insurance you have and premiums you pay? What poverty level are you? Nobody knows how they are going to enforce it.

Question: Where did you live before you came to Las Vegas?

Answer: Spain; Philippines; Washington, D.C.; Colorado Springs, (Colo.); Hawaii. My father was a colonel in the Air Force. I graduated from Clark High School. I received a scholarship at (the University of Nevada, Las Vegas) and graduated in 1986 with a degree in finance.

I was captain of the swim team and made it to Olympic trials. My wife also was a swimmer at UNLV.

Then, my wife and I spent five years in Germany. She was a Department of Defense contract worker. I wound up running the post office on an Army base.

When our son was born, she stopped working and we moved back to Las Vegas.

Question: What did you do in Las Vegas?

Answer: I first worked for New York Life Insurance. Then, I transferred to Assurance Ltd., an employee benefits firm. In 13 years, I became a part-owner of the firm. Then, I started WesTek Insurance, which helps employers with their benefits programs.

We have some clients that have two employees and we have some clients that have 850 employees. I have a dentist with two employees. Another client is Ted Weins Firestone, which has 13 stores and about 250 employees.

Question: Has the health care bill changed your work?

Answer: The day after the health care bill passed, I was able to produce literature that described the health care reform, how it affects employers. We also produced a sheet for employees.

Question: What else do you do?

Answer: We do a lot of claims adjudication for employees. Employers don’t have to do anything. We can be your HR (human resources) department and your benefits enrollment, payroll service. We have relationships with all of those vendors.

Question: Did it help to have old friends in Las Vegas?

Answer: Just about every client that we have is somebody I have personally met through my years in Las Vegas and coaching the kids (for sports) and getting to know the parents that way.

Question: How will the health care law affect individuals?

Answer: The law says individuals have to have insurance or pay a penalty. It starts off in 2014 at $750 up to 2.5 percent of your income.

Question: How will the new health care law affect your clients?

Answer: For groups under 50, the ones with health insurance will get a tax credit starting later this year. The tax credit is a sliding scale and it starts out as $750 per employee (and declines for larger employers).

For a large group, 50 employees and above, it’s going to be mandatory that you offer health insurance to your employees or you pay a penalty. The penalty for not providing insurance is $750 a year, but that may be less than the cost of insurance.

Question: How will you help employers deal with the health care law?

Answer: WesTek Insurance wants to be the first one to offer solutions to employers.

There are also an awful lot of administrative details that they don’t want to go through. As an employee benefits provider, we’re trying to completely erase that (burden) for employers.

Question: How well has WesTek done?

Answer: In 2009, our business grew by 30 percent in revenues. The average insurance agency in Las Vegas decreased by 30 percent.

Question: What’s the secret of your success?

Answer: I’m not afraid of change. I like to do things and I’m very persistent.

Contact reporter John G. Edwards at
jedwards@reviewjournal.com or 702-383-0420.

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