Countdown to Healthcare Reform

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1 Newtek Insurance Agency & Town of North Hempstead Business & Tourism Development Corp Countdown to Healthcare Reform Presented by: Kyle Sloane Senior Vice President Newtek Insurance Agency

2 Newtek Insurance Agency Newtek Insurance Agency, LLC, Licensed in all 50 states Work with clients with Property & Casualty and Life and Health Products General Liability, Property, Professional Liability, Worker s Compensation, Group Benefits Work with more than 40 highly rated carriers Endorsed by Credit Union National Association, Navy FCU, the Latino Coalition, AIG and more Dedicated sales and servicing representatives specifically assigned to you. Offer help with understanding and complying with insurance regulations when transacting business in multiple states

3 Newtek Market Sentiment Survey January 2013 Poll Question Poll Answer Percentage Re-bid your policy 13% Reduce benefits to What is your plan to 8% employees manage your Ask employees to pay a healthcare costs over the 14% greater share next 12 months? I have not decided a 65% course of action

4 Newtek Market Sentiment Survey July 2013 Poll Question Poll Answer Percentage With healthcare reform 6 months away, how are you preparing? Rebid your policy 13% Reduce benefits to employees Reduce other business expenses I do not know what to do 24% 11% 52%

5 Goals of Today s Presentation What are the Individual/Employer Mandates? What is a Health Insurance Exchanges (Online Marketplace) and How do I access it? What are Small Business Health Care Tax Credits? How do I ensure that I m compliant?

6 Individual Mandate Upheld with the Supreme Court decision that was announced in June of The ruling stated that all Americans are required to obtain health insurance.

7 Individual Mandate Requirements, Exemptions Seeing as every American is required to obtain coverage, employees have the opportunity to purchase coverage on their own through a private or state exchange, or enroll in a company sponsored group health insurance plan. If one does not obtain coverage there will be a tax/penalty/fine assessed when they file their taxes the following year. Newtek Insurance Agency is appointed to operate on the federal exchange as well as state exchanges

8 How can I avoid paying an individual penalty? If you are not already personally covered, please reach out to Newtek Insurance Agency to start exploring the coverage options that are right for you ahead of the January 1, 2014 ACA implementation date. Small business owner s will not be subject to a penalty for not offering coverage, however you may risk losing top talent if employees can obtain the coverage elsewhere more affordably.

9 Employer Mandates Requirements, Exemptions If you have less than 50 employees: Will not be required to offer a company health plan Employees will still be required to purchase insurance Individual premiums can jump 100%+ Small group pricing is expected to jump about 20% 50% with the implementation of community rating (no longer medically underwriting groups)

10 What does this mean for me as a business owner? As a business owner, you need to understand your current health insurance program, and make sure that all benefits are being administered as efficiently and effectively as possible. By integrating your processes (payroll, employee benefits and commercial insurance) you have the ability to streamline the underwriting and administration process, while ensuring the best price, coverage, and compliance.

11 Who qualifies as an employee? Anyone who works more than 30 hours per week (or 130 hours per month) is considered a full time employee. Anyone who works for the company and receives a W2 form.

12 Health Insurance Exchanges - Notice of Exchanges and Subsidies Depending on your state of residence, citizens will be eligible for one of two types of exchanges: State Exchange An online marketplace called an exchange is where consumers (both individual and small group) will have the ability to go to purchase health insurance.

13 Health Insurance Exchanges - Notice of Exchanges and Subsidies Federal Exchange For states that chose not to create a state exchange, the Federal Government will set up an exchange for the states. Currently there are about 26 states that have chosen not to set up an exchange, and therefore, participants will be directed to the federal exchange option. Newtek Insurance Agency will be appointed on the federal exchange when it opens on October 1.

14 Subsidized Insurance through the Exchange Many of the expected consumers of the exchanges will be eligible for tax credits to help reduce the costs of purchasing health insurance. These subsidies would be passed down to consumers in the form of tax credits, and be taken in a monthly credit towards your premium, or as an overall deduction at the end of the year.

15 Minimum Essential Coverage All qualified health plans offered effective 1/1/2014 will be required to cover the following services: ambulatory patient services emergency services hospitalization maternity and newborn care mental health and substance use disorder services including behavioral health treatment prescription drugs rehabilitative and habilitative services and devices laboratory services preventive and wellness services and chronic disease management pediatric services (including oral and vision care) Provide coverage towards at least 60% or more towards the cost of certified coverages. The plan must offer coverage to children up to the age of 26 The following types of coverage are not considered under the ACA Dental, vision, disability, accident, critical illness

16 Health Insurance Exchanges Notice of Exchanges and Subsidies Notice of Exchanges and Subsidies Disclosure requirements New deadline: 10/1/2013 Description of services provided by exchange You can pull a copy of the required form from our website at

17 Tax Credits Small Business Health Options Program (SHOP) Small Business with less then 50 employees are able to purchase insurance through SHOP, and can receive tax credits as well. Newtek Insurance Agency can walk you through the plan options and tax credits that are available to your business.

18 Key Considerations If an employer chooses to pay the penalty and discontinue health benefit coverage, the penalty is not a deductible expense. If other employers in your industry continue to offer coverage, will it put you at a disadvantage for recruiting qualified workers? While employer costs continue to rise companies still have the ability to increase the share of the employee contribution to higher levels. By offering a competitive benefits plan, employers should be able to attract a higher quality staff, and can retain their staff longer who may otherwise leave because of the benefits that are being provided.

19 Benefits Administration Benefits Administration The benefits renewal process can be tedious. Not only are you implementing a new plan, but you also need to go back and readjust the employee deductions for health care. Seeing as this information is in house with Newtek, we can set this up for you, saving your business time and money. All financial underwriting documents (quarterly wage and tax documents and payroll records) can be obtained internally, with client permission, in order to expedite the health insurance renewal process. Full option of H.S.A and H.R.A plan options, as well as wellness programs available to staff. We represent all of the names in healthcare that your employees know and trust: United Healthcare, Aetna, Humana, Blue Cross Blue Shield, Kaiser, Guardian and many more.

20 HR Services Health Care Reform Compliance The employee handbook is a critical part of protecting any business Having an effective handbook in place will help the business stay out of court, improve overall operations, motivate employee performance and establish clear communication Business will benefit from real-time ealerts for instant notifications of federal and state law changes. It is a quick and efficient way to stay on top of any law updates that may impact the business. Our HR Support Center database is run, managed and maintained by Certified HR Professionals governed by the National Employment Law Firm Monthly HR Newsletters and Podcasts Eliminate or reduce the investment of time and money used to train or hire an employee to achieve the same level of understanding and expertise

21 Benefits + Payroll = Savings Traditional Solution Payroll Company Payroll Call Center Client Question / New Hire WC Broker Broker s CSR Benefits Broker Broker s CSR Newtek Solution Dedicated Payroll Rep Client Question / New Hire Newtek Representative Dedicated WC Rep Dedicated Benefits Rep

22 Online Human Resource Options Whether you already have HR personnel, or you need to incorporate HR into your business, Online HR Support services can help your organization prevent a lawsuit, promote best practices, and ensure effectiveness. Value Human Resource Package gives you access to: Employee Handbooks Job Descriptions All State & Federal Employment Laws inclusive of ealert notifications HR Forms and Letters HR Q&A Database Employee Demographics HR Laws inclusive of ealert notifications Deluxe package includes access to all of the above, plus Unlimited Human Resource Consultations with live experienced HR Professionals

23 Recap Newtek will be able to walk individual employees and employers through enrolling in the exchanges The Employer mandate for businesses of over 50 employees has been postponed to We can help you determine the credits available as you enroll on the exchanges. Small businesses need to make sure they have the affordable Human Resource tools to ensure that businesses remain compliant within healthcare reform.

24 Thank you! Kyle Sloane Senior Vice President Newtek Insurance Agency

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