Combs' key insight was that many of his small-business clients could do better dropping their small group coverage and helping their workers sign up for individual insurance on the exchange. The law allows companies with fewer than 50 full-time workers not to offer insurance.
Cedric Anthony and Alysia Greer are two of the navigators working in Houston neighborhoods for United Labor Unions Local 100.
Frisch's Big Boy, a bustling franchise diner off the highway in London, is the kind of small business where Combs always sold insurance. The restaurant's policy was available only to full-time workers, and, in the past, it was expensive costing the company and the workers each $150 a month per person. On top of that, they were facing an 86 percent rate increase in 2014.
Before the federal health law offered new options, few of the restaurant's workers who were eligible to buy insurance policies through Frisch's actually did so. Given the new options of Obamacare, "it didn't make sense for [the restaurant] to continue to offer health insurance," explains Combs. "It was actually a detriment to their employees."
Here's why: Because most of the restaurant's employees were low-income, they would qualify for free or low-cost coverage on Kynect Kentucky's state health insurance exchange. Switching everybody over to the exchange was win-win-win: cheaper for the restaurant, cheaper for the employees; plus, more people got coverage, including some part-time workers.
"I thought to some degree it was too good to be true, what people were paying," says the franchise diner's co-owner Herman Hatfield. "But it worked out to where a lot of people got better care for less money."
Mary Gray bought health insurance through Combs. Gray qualified for subsidies under the Affordable Care Act and is paying a lot less than she did for last year's policy.
Mary Gray bought health insurance through Combs. Gray qualified for subsidies under the Affordable Care Act and is paying a lot less than she did for last year's policy.
Combs earns a commission of $20 per month for each person he enrolls, including spouses and children. That commission is paid by the insurer and is already built into premiums. Combs enrolled all the employees at Hatfield's London, Ky., diner in just two days.
Before the advent of Obamacare, waitress Mary Gray was one of only 12 people at the restaurant who bought her health insurance the old, expensive policy through Frisch's. This year, she enrolled in a silver plan through Kynect that was completely subsidized, so she pays nothing toward her premium. She is one of the 28 employees at Frisch's whom Combs helped enroll in a private Kynect plan; most of the rest of the 60 full- and part-time employees at the London restaurant qualified for Medicaid, while a few had employer-sponsored coverage through a spouse or parent.