Health Care Reform Planning for the Financial Impact on Businesses

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Health Care Reform Planning for the Financial Impact on Businesses"

Transcription

1 October 13, 2010 Health Care Reform Planning for the Financial Impact on Businesses Joseph Kra, FSA, MAAA, New York Services provided by Health & Benefits LLC

2 Agenda Future of Employer Sponsored Coverage Financial Modeling Case Studies Appendix: Open Enrollment Checklist 228

3 Future of Employer Sponsored Coverage

4 Planning for Patient Protection and Affordable Care Act (PPACA) This presentation provides an overview of the financial impact of healthcare reform and how employers are likely to respond. While legislative changes are staggered over a series of effective dates, employers plan costs are most affected by changes introduced in three phases: 1.Now: Coverage mandates for plan years beginning on or after September 23, January 1, 2014: Individual insurance market change and additional coverage mandates 3.January 1, 2018: Excise tax on Cadillac plans The first phase of changes have financial implications (as shown in the next section) but have not driven dramatic change in employer benefit plans. The effects of the second and third phases can be more significant. 230

5 Drivers of Change for Employer-Sponsored Plans Legislative provisions, especially starting in 2014, will overhaul the current healthcare insurance market. Employers will respond through adapting or terminating their healthcare benefit plans. Comply Prepare Restructure Plan Options Exit New insurance options: Individual insurance will be available without pre-existing condition limitations. Additionally, eligibility for Medicaid will be expanded. Individual mandate: All individuals will be required to purchase coverage or pay a tax. Additional employees may enroll in employer plans. Employer mandate: Employers must offer qualifying insurance to all full time employees or pay a surcharge. If coverage is offered but is unaffordable, a surcharge is also payable. Vouchers: Employees can buy government coverage using their employer s individual coverage subsidy if employer contribution requirements are too high (but not unaffordable ) Excise tax (effective 2018): Employers must pay 40% tax on the cost of coverage in excess of thresholds. Many employers will likely reduce benefits and discontinue 231

6 New Employer Costs What are the sources of new costs and what risk factors will affect employers significantly? Sources of new costs More employees enrolling More dependents enrolling New benefit coverage requirements Expanding eligibility Raising employer contributions to exceed affordability levels New surcharges and vouchers High-cost plan excise tax (2018) Employer high risk factors High employee opt-out/waiver rate High dependent opt-out rate Low-value plans; cover part-timers Full time employees not benefit eligible High employee contributions Lower-paid workforce High plan costs there are a range of options to mitigate the additional costs 232

7 Retiree Medical Outlook Stand-alone retiree medical plans are not subject to coverage mandates however, healthcare reform has a substantial impact on retiree medical plans. Most employers no longer offer retiree medical coverage. Remaining employers may not see a long-term role in continuing to offer coverage. Currently, pre-medicare retirees may not be able to find adequate coverage. As of 2014, pre-medicare retirees should be able to enroll in a range of individual insurance options. Employers that continue to offer coverage will need to address a range of factors as they set long-term strategy Retiree comparison shopping of employer and individual market plan options Reductions in federal Medicare Advantage funding Loss of Retiree Drug Subsidy (RDS) tax benefit for covering Medicare eligible retirees Evolution of alternate prescription drug coverage options for Medicare eligible retirees, including new discounts available to Group Part D plans Expanding outsourced solutions 233

8 Financial Modeling Case Studies

9 Case Studies The following case studies illustrate how certain provisions will impact sample employers. Case Study 1: 2011: Impact of preventive care and age 26 changes Case Study 2: 2014: Employer that does not cover temporary employees Case Study 3: 2014: Employer that minimizes future benefit plan costs Case Study 4: 2014: Shared Responsibility Surcharge and Free Choice Voucher Case Study 5: 2018: Impact of excise tax for high cost medical plan Note: The examples included should not be relied upon for employer-specific financial modeling. The impact on each employer will vary, depending on a range of factors. 235

10 Case Study # Preventive Care and Age 26 Changes Employer with 10,000 employees will incur $2.2 Million cost increase (2.1% of total plan cost) in 2011 to satisfy preventive care and age 26 coverage mandate Employer will not maintain grandfather status and must cover preventive services at 100%. Most preventive services are currently subject to cost sharing provisions. Based on claim experience, additional cost will be $700,000, assuming no addition utilization of preventive services. All children will be covered until the end of the year that they reach age 26. Currently covers children through the year that they turn age 19, or age 25 if a full-time student, as indicated by the blue lines below. The additional cost is projected to be $1.5 Million annually (e.g. $2,500 per child and 600 children). The red line in the graph below illustrates how enrollment may change Covered Children Children Age as of Jan 1,

11 Case Study #2 Employer Does Not Cover Temporary Employees Employer provides qualifying coverage to 7,000 permanent employees. However, 2,500 temporary full-time employees (30+ hours/ week) are not benefit eligible. 3,000 dedicated full-time employees (30+ hours/ week) at contractor are not benefit eligible Employer will incur penalty (not tax deductible) of $5 Million - $19 Million for full time employees who are not benefit eligible It is unclear if the penalty will be computed based on the employees who are not benefit eligible or all employee. Additionally, employer expects subcontractor to pass through $6 Million penalty for dedicated employees 237

12 Case Study 2: Employer Does Not Cover Temporary Employees Shared Responsibility Decision Tree - Effective in Do you have 50 or more full-time equivalent employees? Yes No You will not be subject to any Shared Responsibility penalty. 2. Do you offer a health plan to all full time employees (FTEs) and their dependents? Yes 3. Do all of your employees have a total household income that exceeds 400% of Federal Poverty Level No You will pay a penalty fee of $2,000 annually for every FTE if at least one FTE receives income-based premium assistance to purchase coverage through the exchange. Penalties do not apply to the first 30 FTE s. You will not be subject to any Shared Responsibility penalty. Yes No 4. Does the health plan offered to FTEs pay less than 60% of total benefit costs or is the required employee contribution for plan > 9.5% of total household income? Yes No You will not be subject to any Shared Responsibility penalty. You will pay the lesser of $3,000 times the number of FTE s receiving income based assistance for exchange coverage; or $2,000 times the total number of full-time employees; first 30 FTE s not counted. 238

13 Case Study #3 Employer Minimizes Future Benefit Plan Costs Employer provides comprehensive coverage to 500 employees. Employees pay 20% through payroll contributions Employees pay 10% of provider charges through deductibles and coinsurance 50 employees currently waive coverage and provide evidence of alternate coverage Employer is considering 3 options: Option 1: No change in current benefits Option 2: Terminate all coverage Option 3: Reduce benefits - offer only a high deductible plan and eliminate subsidy for dependent coverage Projected 2014 Costs: Option 1 Status Quo Option 2 Terminate Coverage Option 3 Reduce Benefits Current Enrollment Assumed Migration Gross Cost $5,250,000 $3,500,000 $2,187,500 Employee Contributions ($1,050,000) ($2,100,000) ($1,067,500) ER Cost $4,200,000 $1,400,000 $1,120,000 Penalty $0 $1,100,000 $0 $0 Tax Benefit ($1,470,000) $0 ($490,000) ($392,000) Net ER Cost $2,730,000 $1,100,000 $910,000 $728,000 Projected costs are lower if the employer reduces benefits than if it eliminates coverage! 239

14 Case Study #4 Shared Responsibility Surcharge and Free Choice Voucher For some employers, a significant portion of employees will qualify for Medicaid (e.g. income threshold of $34,314 for family of 5) * Many employees (e.g. below an income threshold of $103,200 for family of 5)* will be eligible for a government exchange plan, triggering employer surcharges or vouchers to subsidize the insurance cost, if contributions are too high, or unaffordable The chart below provides a sample output from our standard model illustrating who could qualify Medicaid / Exchange Qualification - Income Breakpoints Family Size $- $10 $20 $30 $40 $50 $60 $70 $80 $90 $100 $110 $120 $130 $140 $150 $160 $170 $180 $190 $200 Household Income (in thousands) Qualifies for Medicaid Qualifies for Exchange and Surcharge Applies Employer Pays Free Choice Voucher "Affordable Coverage" (< 400% FPL) Over 400% of FPL * Based on 2010 federal Poverty Level table 240

15 Case Study #5 Projected Excise Tax The projected excise tax for a 5,000 employee company is $6 Million - $13 Million (7% - 12%) in 2018 and $34 Million - $86 Million (17% - 29%) in 2030 Excludes cost of dental plans, on-site clinic and assumes employer terminates healthcare FSA Dramatic plan design reductions would be required to fully avoid tax Due to significant regulatory uncertainty, retiree exposure has not been determined. $90,000 $80,000 $70,000 $60,000 $50,000 $40,000 $30,000 $20,000 $10,000 PPO Plan Option (9.0% Trend) Year 2018 (first year of tax) Projected Excise Tax for Active Plans ($ Millions) 6.5% Annual Trend 9.0% Annual Trend $6.0 $ $7.0 $ $8.0 $ $9.4 $ $11.0 $ $12.9 $ $15.1 $ $17.5 $ $20.2 $ $23.1 $ $26.3 $66.8 $ Employee Only Premium Rate Family Premium Rate Single Tax Threshold Family Tax Threshold 2029 $29.8 $ $33.6 $

16 Appendix: Open enrollment checklist

17 Open enrollment checklist Topic Description To do list Done Age 26 mandate and expanded tax-free treatment Health plans offering coverage to dependent children must extend eligibility to adult children to age 26. For plan years before 2014, grandfathered plans may limit extended coverage to adult children ineligible to enroll in another employer-sponsored plan. Craft open enrollment materials to describe new eligibility terms; update other employee communications accordingly. Update administrative processes to offer adult children a special enrollment opportunity of at least 30 days, which may run concurrently with the general open enrollment period. Coverage, if elected, must be effective as of the first day of the plan year. The health reform law also expands the tax-free nature of health plan coverage for these young adults, allowing tax-free treatment to continue regardless of student or marital status through the end of the year in which the child turns 26. Employers payroll and tax-reporting operations will require adjustment. Plans offering dependent child coverage must provide a one-time written notice about an adult child s special enrollment opportunity. The notice may be included in open enrollment materials if prominently placed. Grandfathered plans limiting coverage to adult children ineligible for another employer plan must state that requirement in employee communications. Employers may include an attestation, to be signed by the employee, representing that a dependent isn t eligible for other employer plan coverage. Coordinate revised eligibility category with vendors (including stop-loss carriers) and update vendor contracts as necessary. For insured plans, analyze and coordinate all applicable state mandates on dependent child coverage. 243

18 Open enrollment checklist Topic Description To do list Done Lifetime limits Insured and self-insured group health plans can t impose lifetime dollar limits on individual coverage, but may impose lifetime per-beneficiary limits on nonessential benefits. Open enrollment materials must expressly state that plan has no lifetime dollar limit on the value of total plan benefits and that individuals previously affected by such limits are again eligible for plan benefits. Where applicable, describe per-beneficiary limits on nonessential benefits. Position this information prominently in enrollment materials. Update other employee communications accordingly. Update administrative processes to offer individuals who reached the lifetime limit a special enrollment opportunity running at least 30 days, which may be concurrent with the general open enrollment period. If elected, coverage must be effective as of the first day of the plan year. Plans must provide a notice about the individual special enrollment opportunity described above. While not specifically mentioned in the recent regulatory guidance, we believe this notice may be included in open enrollment materials. Coordinate with vendors and stop-loss carriers and update service contracts as necessary. 244

19 Open enrollment checklist Topic Description To do list Done Annual limits Insured and self-insured group health plans generally cannot impose annual dollar limits on individual coverage, but may impose annual perbeneficiary limits on nonessential benefits. For plan years before 2014, plans can impose restricted annual dollar limits on essential health benefits. Recent regulatory guidance provides specific dollar amounts (increasing over the next three years) that qualify as permitted restricted annual dollar limits. Craft open enrollment materials to describe permitted annual limits ($750,000 minimum for 2011) for essential health benefits and describe any applicable perbeneficiary limit on nonessential benefits. Update other employee communications accordingly. Coordinate with vendors and stop-loss carriers and update service contracts as necessary. Pre-existing condition exclusions for kids under 19 Insured and self-insured plans cannot impose pre-existing condition exclusions for children under age 19. This ban will apply to all enrollees beginning in Craft open enrollment materials to delete pre-existing condition exclusions for children under age 19 and update other employee communications accordingly. Coordinate with vendors and stop-loss carriers and update vendor contracts as necessary. 245

20 Open enrollment checklist Topic Description To do list Done Preventive Services* No cost sharing permitted for preventive services such as immunizations and women s preventive care. Craft open enrollment materials to delete cost sharing provisions for preventive services and update other employee communications accordingly. Coordinate with vendors and update vendor contracts as necessary. Physician designations * Plans calling for designation of primary care physicians and pediatricians must ensure participants choices are not too restrictive. Craft open enrollment materials to amend designation requirements and update other employee communications accordingly (see model language in recently issued regulations). If designation is part of an electronic enrollment process, reprogramming may be necessary. Coordinate with vendors and update vendor contracts as necessary. * Only required for new and non-grandfathered plans. A grandfathered plan is one in place before March 23, 2010, that meets certain limitations regarding plan changes made since that date. 246

21 Open enrollment checklist Topic Description To do list Done OB/GYN preauthorization * Plans may not require a referral for OB/GYN services. Craft open enrollment materials to delete these preauthorization and referral requirements and update other employee communications accordingly Coordinate with vendors and update vendor contracts as necessary. Emergency services* Emergency services coverage cannot require preauthorization, be limited to in-network providers or impose higher cost sharing for out-of-network services. Craft open enrollment materials to delete preauthorizations, network limits and higher cost sharing; update other employee communications accordingly Coordinate with vendors and update vendor contracts as necessary. * Only required for new and non-grandfathered plans. A grandfathered plan is one in place before March 23, 2010, that meets certain limitations regarding plan changes made since that date. 247

22 Open enrollment checklist Topic Description To do list Done Over-thecounter medications Starting Jan. 1, 2011, costs of overthe-counter medications will not be reimbursable from health flexible spending accounts (FSA), health savings accounts, Archer medical savings accounts or health reimbursement arrangements. Taxfree reimbursements will be available only for medicines or drugs (other than insulin) prescribed by a physician. Coordinate with service providers, such as health FSA and payroll vendors, to determine their administrative capabilities regarding these reimbursements. Clarify expectations related to expenses vendors will reimburse and adjust service agreements to reflect new responsibilities. Craft descriptions of new limitations for inclusion in open enrollment materials if plan currently permits tax-free reimbursement for over-the-counter medications and drugs; update other employee communications accordingly and claim forms if necessary. With respect to health FSAs, consider differing implications this new rule may have on non-calendar year and calendar year plans with a post year-end grace period. Employers using debit cards to pay for certain medical expenses must coordinate with card vendors to ensure non-prescribed, over-the-counter medications and drugs (except insulin) can no longer be purchased with the debit card. Employee communications related to debit card use should reflect this change. * Only required for new and non-grandfathered plans. A grandfathered plan is one in place before March 23, 2010, that meets certain limitations regarding plan changes made since that date. 248

23 Open enrollment checklist Topic Description To do list Done CLASS program Employers can voluntarily participate in the CLASS program, a national, government-run long-term care program set to begin Jan. 1, Because the law doesn t require the Department of Health & Human Services to release draft program details until 2012, transition rules or delayed implementation may occur. Participating employers must automatically enroll employees and facilitate payroll deductions. Craft open enrollment materials to describe the program and related costs; update other employee communications accordingly. Coordinate with payroll vendors and update service contracts as necessary. Rescission Insured and self-insured group health plans may not retroactively terminate coverage, except in limited situations, such as when the covered individual commits fraud against the plan or makes intentional misrepresentations. When rescission is permitted, plan must give prior notice. Update employee communications to describe coverage cancellation practices meeting the new standards and update other employee communications accordingly. Work with vendors to ensure individuals will not be improperly dropped from coverage beginning in Prepare a notice of coverage rescission to distribute beginning in Notice content rules are not specified in the law, but should likely include plan name, notification of rescission, date coverage ends and reason for the rescission. Notice must be provided at least 30 calendar days before coverage is rescinded. 249

24 Open enrollment checklist Topic Description To do list Done HSA and Archer MSA penalties for nonqualified distributions Beginning Jan. 1, 2011, individuals must pay income tax and a 20 percent penalty tax on improper distributions from health savings accounts and Archer medical savings accounts. While compliance burdens fall on the account owner, employers may consider updating employee communications related to these accounts and describe the updated penalties. Employers working with financial institutions offering HSA or MSA accounts may want to confirm the third party is aware of these changes and will timely update explanatory materials. 250

25 Disclaimers has prepared this document exclusively for seminar attendees to reflect the impact of federal Health Reform. This document may not be used or relied upon by any other party or for any other purpose. is not responsible for the consequences of any unauthorized use. Further, final Health Reform regulations have not been issued, including clarifications and technical corrections. Actual plan experience will differ from potential assumptions: future changes in enrollment, in claims and administrative costs and in administrative process may have a material impact. Some Reform provisions will likely involve calculations at the individual employee level. Financial and design decisions should be made only after each employer s careful consideration of alternative future financial conditions and legislative scenarios, and not on the basis of the items illustrated here. The information contained in this document and in any attachments is not intended by to be used, and it cannot be used, for the purpose of avoiding penalties under the Internal Revenue Code or imposed by any legislative body on the taxpayer or plan sponsor. 251

26

Chart: Key employer health care reform elements

Chart: Key employer health care reform elements Chart: Key employer health care reform elements Health care reform with major implications for employers has now become law, with a package of revisions heading for Senate action. The approved measure

More information

Health care reform at-a-glance. August 2014

Health care reform at-a-glance. August 2014 Health care reform at-a-glance August 2014 Employer mandate Shared responsibility payment for failing to offer coverage to at least 95%* of all fulltime employees (FTE) and children if any FTE gets subsidy

More information

Health Reform. Employer Penalty Delay: What are the Consequences? Impact of the Delay on Employers

Health Reform. Employer Penalty Delay: What are the Consequences? Impact of the Delay on Employers Health Reform Employer Penalty Delay: What are the Consequences? Martin Haitz (484) 270-2575 martin.haitz@marcumfs.com Issued date: 07/29/13 The employer penalty provisions and two reporting requirements

More information

Health care reform at-a-glance. December 2013

Health care reform at-a-glance. December 2013 December 2013 Employer mandate Play or pay penalty for failing to offer coverage to at least 95% of all full-time employees (FTE) and children if any FTE gets subsidy in exchange $2,000 (indexed) times

More information

Christy Tinnes, Brigen Winters and Christine Keller, Groom Law Group, Chartered

Christy Tinnes, Brigen Winters and Christine Keller, Groom Law Group, Chartered Preparing for Health Care Reform A Chronological Guide for Employers This Article provides an overview of the major provisions of health care reform legislation affecting employers and explains the requirements

More information

Health Care Reform. Employer Action Overview

Health Care Reform. Employer Action Overview Health Care Reform Page 1 of 6 Health Care Reform Immediatemmediate Employer Action Required Notes Employers must provide a reasonable break time for employees who are nursing mothers to express breast

More information

Health Care Reform Impacts Grandfathered Employer-Sponsored Group Health Plans: Now What?

Health Care Reform Impacts Grandfathered Employer-Sponsored Group Health Plans: Now What? April 2010 EMPLOYEE BENEFITS & EXECUTIVE COMPENSATION UPDATE Health Care Reform Impacts Grandfathered Employer-Sponsored Group Health Plans: Now What? This bulletin discusses certain provisions of The

More information

The Impact on Business

The Impact on Business The Impact on Business Affordable Care Act Reform addresses access to coverage not healthcare cost or population health ACA passed in 2010. The Supreme Court upheld ACA in 2012 and President Obama was

More information

THE PATIENT PROTECTION AND AFFORDABLE CARE ACT and THE RECONCILIATION ACT

THE PATIENT PROTECTION AND AFFORDABLE CARE ACT and THE RECONCILIATION ACT THE PATIENT PROTECTION AND AFFORDABLE CARE ACT and THE RECONCILIATION ACT On Sunday, March 21 st, the U. S. House of Representatives passed the Patient Protection and Affordable Care Act (H. R. 3590) by

More information

Health Care Reform Frequently Asked Questions

Health Care Reform Frequently Asked Questions Health Care Reform Frequently Asked Questions On March 23, 2010, President Obama signed federal health care reform into law, also known as the Patient Protection and Affordability Act. A second, or reconciliation

More information

The Large Business Guide to Health Care Law

The Large Business Guide to Health Care Law The Large Business Guide to Health Care Law How the new changes in health care law will affect you and your employees Table of contents Introduction 3 Part I: A general overview of the health care law

More information

Answers about. Health Care REFORM. for your business

Answers about. Health Care REFORM. for your business Answers about Health Care REFORM for your business Since the time of its enactment in 2010, the health care reform law has remained controversial at least in part due to a constitutional challenge to the

More information

Health Care Reform How it Will Affect Employers and their Group Health Plans. Benecon Comments and Observations

Health Care Reform How it Will Affect Employers and their Group Health Plans. Benecon Comments and Observations Health Care Reform How it Will Affect Employers and their Group Health Plans This Health Care Reform Summary applies to all employers (including government and church plans) that provide health coverage

More information

InSight. A Littler Mendelson Report. Health Care Reform: Are You Prepared? A Timeline for Employers to Follow

InSight. A Littler Mendelson Report. Health Care Reform: Are You Prepared? A Timeline for Employers to Follow A Littler Mendelson Report InSight An Analysis of Recent Developments & Trends In This Issue: April 2010 The Patient Protection and Affordable Care Act was signed into law on March 23, 2010. Amendments

More information

Health-Care Reform. Begley Insurance Group, Inc. Mary Angelo 5225 Old Orchard Rd. Skokie, IL 60077 800-867-7074

Health-Care Reform. Begley Insurance Group, Inc. Mary Angelo 5225 Old Orchard Rd. Skokie, IL 60077 800-867-7074 Begley Insurance Group, Inc. Mary Angelo 5225 Old Orchard Rd. Skokie, IL 60077 800-867-7074 Health-Care Reform August 14, 2012 Page 1 of 8, see disclaimer on final page One primary goal of the Patient

More information

Health Care Reform Implications for Employers with Seasonal Employees

Health Care Reform Implications for Employers with Seasonal Employees Health Care Reform Implications for Employers with Seasonal Employees Many industries (e.g. ski resorts, retail, restaurants, agriculture, fishing and tourism) have a significant number of seasonal employees.

More information

Your guide to health care reform provisions

Your guide to health care reform provisions Your guide to health care reform provisions February 2014 edition Since the Patient Protection and Affordable Care Act (PPACA) was enacted in March 2010, businesses have been impacted by federal health

More information

Simple answers to health reform s complex issues facing every employer, and what you can do now to protect your business and your future.

Simple answers to health reform s complex issues facing every employer, and what you can do now to protect your business and your future. Simple answers to health reform s complex issues facing every employer, and what you can do now to protect your business and your future. If you have any questions, please contact: Health Reform: A Guide

More information

Health Care Reform: Answers for Employers

Health Care Reform: Answers for Employers For Immediate Release: April 2010 Issue 2010 Volume 5 Contact: Lisa R. Nelson, Esq. (858) 875-3017 lisan@barneyandbarney.com Health Care Reform: Answers for Employers The Patient Protection and Affordable

More information

Prescribed Side Effects of the Patient Protection and Affordable Care Act (PPACA): Healthcare Reform Update

Prescribed Side Effects of the Patient Protection and Affordable Care Act (PPACA): Healthcare Reform Update August 14, 2013 Presented by: Jay Hutto, CPA Prescribed Side Effects of the Patient Protection and Affordable Care Act (PPACA): Healthcare Reform Update Click HERE to listen to webinar. August 14, 2013

More information

Health Reform: A Guide for Employers

Health Reform: A Guide for Employers Updated with information on the Supreme Court health reform decision July 2012 Health Reform: A Guide for Employers Simple answers to health reform s complex issues facing every employer and what you can

More information

ABC Company 123 Main Street Anywhere, USA 12345 www.sampleabccompany.com 800.123.4567

ABC Company 123 Main Street Anywhere, USA 12345 www.sampleabccompany.com 800.123.4567 WHAT HEALTH CARE REFORM MEANS FOR YOUR BUSINESS Your promotional imprint here and/or back cover. ABC Company 123 Main Street Anywhere, USA 12345 www.sampleabccompany.com 800.123.4567 The Patient Protection

More information

Health Care Reform Frequently Asked Questions

Health Care Reform Frequently Asked Questions Health Care Reform Frequently Asked Questions On March 23, 2010, President Obama signed federal health care reform into law, also known as the Patient Protection and Affordability Act. A second, or reconciliation

More information

Important Effective Dates for Employers and Health Plans

Important Effective Dates for Employers and Health Plans Brought to you by Krempa Associates, Inc. Important Effective Dates for Employers and Health Plans On March 23, 2010, President Obama signed the health care reform bill, or Affordable Care Act (ACA), into

More information

Important Effective Dates for Employers and Health Plans

Important Effective Dates for Employers and Health Plans Brought to you by Sullivan Benefits Important Effective Dates for Employers and Health Plans On March 23, 2010, President Obama signed the health care reform bill, or Affordable Care Act (ACA), into law.

More information

Important Effective Dates for Employers and Health Plans

Important Effective Dates for Employers and Health Plans Brought to you by Hipskind Seyfarth Risk Solutions Important Effective Dates for Employers and Health Plans On March 23, 2010, President Obama signed the health care reform bill, or Affordable Care Act

More information

WHAT HEALTH CARE REFORM

WHAT HEALTH CARE REFORM WHAT HEALTH CARE REFORM MEANS FOR YOUR BUSINESS Celebrating A Tradition our of Excellence 85th Year of Since Excellence 1924 2322 Tremont Drive Baton Rouge, LA 70809 225.928.4770 www.htbcpa.com 178 Del

More information

Health Reform. Presented by USI Affinity

Health Reform. Presented by USI Affinity Health Reform Presented by USI Affinity USI Affinity Introduction USI Affinity has been working with Associations and their members for over 50 years. USI Affinity has offices in Philadelphia, Harrisburg,

More information

Health Care Reform Overview

Health Care Reform Overview Health Care Reform Overview By Marcia S. Wagner The Wagner Law Group 99 Summer Street, 13th Floor Boston, MA 02110 www.erisa-lawyers.com Introduction President Obama signed the Patient Protection and Affordable

More information

Health Care Reform Management Alert Series Roadmap of Plan Changes Needed For Upcoming Plan Years

Health Care Reform Management Alert Series Roadmap of Plan Changes Needed For Upcoming Plan Years Health Care Reform Management Alert Series Roadmap of Plan Changes Needed For Upcoming Plan Years Seyfarth Shaw has generously given permission to Lawyers Alliance for New York to circulate this chart

More information

National Health Insurance Reform

National Health Insurance Reform JANUARY2011 National Health Insurance Reform Impact Year by Year With the passage of National Health Insurance Reform it is crucial that employers and plan sponsors have clear information about the impact

More information

Health Care Reform Key Points

Health Care Reform Key Points Health Care Reform Key Points Contact Us 855.220.8634 HealthCareReform@eidebailly.com Individual Implications Individual mandate to have health insurance Penalties applies if NO health insurance 2014 -

More information

Health Care Reform frequently asked questions

Health Care Reform frequently asked questions Version 1 updated 04/30/2010 Health Care Reform frequently asked questions Health Care Reform... As the health reform provisions come into focus, this document is a collection of those frequently asked

More information

Introduction. Healthcare Reform Reference Guide. Release Date: 7.29.10. General Questions Exchanges Adult Dependents Grandfathering Early Retirees

Introduction. Healthcare Reform Reference Guide. Release Date: 7.29.10. General Questions Exchanges Adult Dependents Grandfathering Early Retirees q individual market q small group market Small Business Tax Credits Small Business Wellness Grants q large group market Blue Cross and Blue Shield companies are committed to working with the Administration

More information

Health Reform in a Nutshell: What Small Businesses Need to Know Now.

Health Reform in a Nutshell: What Small Businesses Need to Know Now. Health Reform in a Nutshell: What Small Businesses Need to Know Now. With the passage of the most significant reform of America s modern-day health care system, many small business owners and human resources

More information

Affordable Care Act (ACA) Frequently Asked Questions

Affordable Care Act (ACA) Frequently Asked Questions Grandfathered policies Q1: What is grandfathered health plan coverage? A: The interim final rule on grandfathering under ACA generally defines grandfathered health plan coverage as coverage provided by

More information

Advisory. The Health Care Reform Bill: How Will Its Tax Provisions Impact You and Your Business? April 2010. Impact on Employers

Advisory. The Health Care Reform Bill: How Will Its Tax Provisions Impact You and Your Business? April 2010. Impact on Employers certified public accountants business consultants Advisory April 2010 The Health Care Reform Bill: How Will Its Tax Provisions Impact You and Your Business? The recently passed Patient Protection and Affordable

More information

Employee Benefits Update Including PPACA

Employee Benefits Update Including PPACA Employee Benefits Update Including PPACA Christine Burke Worthen, Esq. Assistant General Counsel Eastern Maine Healthcare Systems Brewer, Maine Recap: PPACA Provisions Already in Effect (2011 Plan Year)

More information

Timeline of New Health Care Law and Its Impact on American Businesses

Timeline of New Health Care Law and Its Impact on American Businesses Timeline of New Health Care Law and Its Impact on American Businesses Summaries of the Patient Protection and Affordable Health Care Act (Public Law 111-148) Health Care and Education Reconciliation Act

More information

Health Care Reform: General Q&A for Employees

Health Care Reform: General Q&A for Employees From Baugher Financial & Associates, Inc. Health Care Reform: General Q&A for Employees Common questions answered I ve heard a lot about the health care reform law. When do the reforms become effective?

More information

Preparing for 2015. A compliance and decision guide for large (more than 50 employees) private, government, and not-for-profit employers

Preparing for 2015. A compliance and decision guide for large (more than 50 employees) private, government, and not-for-profit employers Preparing for 2015 A compliance and decision guide for large (more than 50 employees) private, government, and not-for-profit employers 1 This guide is intended to provide information to help employers

More information

Health Care Reform Update. Spring 2014

Health Care Reform Update. Spring 2014 Health Care Reform Update Spring 2014 Quincy Quinlan Texas Association of Counties 512 478 8753 quincyq@county.org http://www.county.org Today s Agenda Timeline Fees/Taxes Individual Mandate Marketplace

More information

Bankers Insurance, LLC Your Health Care Reform Partner

Bankers Insurance, LLC Your Health Care Reform Partner Bankers Insurance, LLC Your Health Care Reform Partner Are you in compliance with health care reform regulations? We can help you stay on top of health care reform to avoid penalties from legislative briefs

More information

What an employer should know about Health Care Reform

What an employer should know about Health Care Reform What an employer should know about Health Presented By David L. Fear, Sr. RHU NAHU Education Foundation Sponsored by PPACA - history Signed into law in March, 2010 2,700 page rough draft became the law

More information

Section 2: INDIVIDUALS WHO CURRENTLY HAVE

Section 2: INDIVIDUALS WHO CURRENTLY HAVE Section 2: INDIVIDUALS WHO CURRENTLY HAVE COVERAGE OR AN OFFER OF COVERAGE FROM THEIR EMPLOYER Section 2 covers enrollment issues for individuals who have coverage or an offer of coverage whether through

More information

Employer s guide to health care reform requirements

Employer s guide to health care reform requirements Employer s guide to health care reform requirements June 2015 edition As the Affordable Care Act (ACA) continues to be implemented, you ll need to remain aware of the policies and provisions that affect

More information

Selected Employer Provisions in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010

Selected Employer Provisions in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 Selected Employer Provisions in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 This chart outlines, in depth, selected provisions in the Patient

More information

Health Care Reform: A Guide for Self-Funded Plans. Key steps to prepare for 2014 Preparing for the future Snapshot of reform (2010-2019)

Health Care Reform: A Guide for Self-Funded Plans. Key steps to prepare for 2014 Preparing for the future Snapshot of reform (2010-2019) Health Care Reform: A Guide for Self-Funded Plans Key steps to prepare for 2014 Preparing for the future Snapshot of reform (2010-2019) Table of Contents Health Care Reform is Here: Are you ready? 3 Key

More information

Keeping up with the new health care reform law. Helping you better understand what to expect and when to expect it. anthem.com/ca 14376CAEENABC 8/10

Keeping up with the new health care reform law. Helping you better understand what to expect and when to expect it. anthem.com/ca 14376CAEENABC 8/10 Keeping up with the new health care reform law Helping you better understand what to expect and when to expect it. 14376CAEENABC 8/10 anthem.com/ca 1 Staying up to date Here s a timeline of what you can

More information

Tax Implications of Health Care Reform

Tax Implications of Health Care Reform Tax Implications of Health Care Reform Presented by: Art Sparks, CPA Partner Certified Public Accountants Summary Summary The Patient Protection and Affordable Care Act (PPACA) and the companion Health

More information

Basics of Health Care Reform. What You Should Know

Basics of Health Care Reform. What You Should Know Basics of Health Care Reform What You Should Know The Affordable Care Act (ACA) has resulted in major across the U.S. health care system. This brochure provides an overview and timeline of the that have

More information

HEALTH CARE REFORM AND STOP LOSS INSURANCE APRIL, 2013

HEALTH CARE REFORM AND STOP LOSS INSURANCE APRIL, 2013 HEALTH CARE REFORM AND STOP LOSS INSURANCE APRIL, 2013 Bruce A. Richards, FSA, MAAA, FCA Partner, Chief Healthcare Actuary & Quality Leader Mercer Health and Benefits, LLC Richmond Key Elements of Health

More information

Self-insured Plans under Health Care Reform

Self-insured Plans under Health Care Reform Brought to you by Good Neighbor Insurance Self-insured Plans under Health Care Reform The Affordable Care Act (ACA) includes numerous reforms affecting the health coverage that employers provide to their

More information

Health Reform: A Guide for Employers

Health Reform: A Guide for Employers updated with new grandfather rules issued june 14, 2010 Health Reform: A Guide for Employers Simple answers to health reform s complex issues facing every employer and what you can do now to protect your

More information

Health-Related Revenue Provisions in the Patient Protection and Affordable Care Act (P.L. 111-148)

Health-Related Revenue Provisions in the Patient Protection and Affordable Care Act (P.L. 111-148) Health-Related Revenue Provisions in the Patient Protection and Affordable Care Act (P.L. 111-148) Janemarie Mulvey Specialist in Aging Policy April 8, 2010 Congressional Research Service CRS Report for

More information

Healthcare Reform: Top 10 Issues for Employers

Healthcare Reform: Top 10 Issues for Employers Healthcare Reform: Top 10 Issues for Employers presented by Thomas A. Walker (612) 604-6568 twalker@winthrop.com Are Companies Required to Provide Health Coverage to Employees? NO requirement to provide

More information

Effective dates for provisions of the PPACA are spread out from 2010 through 2018. This document focuses on 2013 and 2014.

Effective dates for provisions of the PPACA are spread out from 2010 through 2018. This document focuses on 2013 and 2014. As part of our ongoing initiative to provide added value to our customers, this health care reform summary is being provided on an information only basis. This is NOT a legal document and is not intended

More information

Health care reform is once again

Health care reform is once again Marjorie M. Glover and Rachel M. Kurth Employee Benefit Plan Review Reprinted from April 2010 Health Care Reform: How It May Impact Employers, Employees, and Benefit Plans Health care reform is once again

More information

A Digital Insurance Health Care Reform Handbook for Employers

A Digital Insurance Health Care Reform Handbook for Employers A Digital Insurance Health Care Reform Handbook for Employers Health care reform is complicated. Sifting through all the regulations and provisions can be time-consuming and confusing. That s why Digital

More information

HEALTH CARE REFORM FREQUENTLY ASKED QUESTIONS

HEALTH CARE REFORM FREQUENTLY ASKED QUESTIONS HEALTH CARE REFORM FREQUENTLY ASKED QUESTIONS Consumers When will the health care reform law take effect? The health insurance reforms adopted as part of the Patient Protection and Affordable Care Act

More information

Key Provisions of 2010 Healthcare Reform Legislation for Small (under 50) Employers. By Alice Eastman Helle. October 2013 Update

Key Provisions of 2010 Healthcare Reform Legislation for Small (under 50) Employers. By Alice Eastman Helle. October 2013 Update Key Provisions of 2010 Healthcare Reform Legislation for Small (under 50) Employers By Alice Eastman Helle October 2013 Update The sweeping healthcare reform legislation enacted in 2010 is exceedingly

More information

Affordable Care Act (ACA) Violations Penalties and Excise Taxes

Affordable Care Act (ACA) Violations Penalties and Excise Taxes Brought to you by The Insurance Exchange Affordable Care Act (ACA) Violations Penalties and Excise Taxes The Affordable Care Act (ACA) includes numerous reforms for group health plans and creates new compliance

More information

Health Care Law Implementation: What Nonprofits Need to Know WELCOME!

Health Care Law Implementation: What Nonprofits Need to Know WELCOME! Health Care Law Implementation: What Nonprofits Need to Know WELCOME! Health Care Law Implementation: What Nonprofits Need to Know (PPACA) Health Care Law Implementation: What Nonprofits Need to Know Heather

More information

Self-insured Plans under Health Care Reform

Self-insured Plans under Health Care Reform Brought to you by Cottingham & Butler Self-insured Plans under Health Care Reform The Affordable Care Act (ACA) includes numerous reforms affecting the health coverage that employers provide to their employees.

More information

COMPLIANCE ADVISOR. 2014 Affordable Care Act Compliance Checklist

COMPLIANCE ADVISOR. 2014 Affordable Care Act Compliance Checklist COMPLIANCE ADVISOR August 2013 2014 Affordable Care Act Compliance Checklist IN THIS ISSUE: 1 2 3 4 5 6 7 8 9 10 11 12 Grandfathered Plan Status Confirmation No Annual Dollar Limits on Essential Health

More information

The Patient Protection and Affordable Care Act ( ACA ) and Your Facility

The Patient Protection and Affordable Care Act ( ACA ) and Your Facility The Patient Protection and Affordable Care Act ( ACA ) and Your Facility By Christine Garrity: Chief Administrative Officer & General Counsel for The Professional Golfers' Association of America President

More information

Considerations for a Long Term Health Reform Strategy Or Health Care Goes Portlandia! May 2013

Considerations for a Long Term Health Reform Strategy Or Health Care Goes Portlandia! May 2013 Considerations for a Long Term Health Reform Strategy Or Health Care Goes Portlandia! May 2013 Important Note This presentation is Vegan, Freegan, Sea-gan, Polyamorous, Dog-Friendly (NO CATS), Cat-Friendly

More information

American employers need prompt action on these six significant challenges. We urge Congress and the administration to address them now.

American employers need prompt action on these six significant challenges. We urge Congress and the administration to address them now. In June 2014, the Board of Directors of the American Benefits Council (the Council) approved a long-term public policy strategic plan, A 2020 Vision: Flexibility and the Future of Employee Benefits. It

More information

Health Care Reform Highlights

Health Care Reform Highlights Caring For Those Who Serve 1901 Chestnut Avenue Glenview, Illinois 60025-1604 800-851-2201 www.gbophb.org March 26, 2010 (Updated April 27, 2010) Health Care Reform Highlights This week, Congress and the

More information

Health Care Reform Legislation and You

Health Care Reform Legislation and You (Customizable space for CPA Firm Logo to go here) Health Care Reform Legislation and You Timelines and Implications of the New Law for Individuals Updated as of January 2011 The Health Care Reform Legislation

More information

Navigating the New Health Insurance Environment THE AFFORDABLE CARE ACT AND PROFESSIONAL EMPLOYER ORGANIZATIONS (PEOS)

Navigating the New Health Insurance Environment THE AFFORDABLE CARE ACT AND PROFESSIONAL EMPLOYER ORGANIZATIONS (PEOS) Navigating the New Health Insurance Environment THE AFFORDABLE CARE ACT AND PROFESSIONAL EMPLOYER ORGANIZATIONS (PEOS) EXECUTIVE SUMMARY The recent health care overhaul affects how businesses administer

More information

Counties as Employers Health Reform Toolkit: Making Sense of Complex Issues

Counties as Employers Health Reform Toolkit: Making Sense of Complex Issues NATIONAL ASSOCIATION OF COUNTIES Counties as Employers Health Reform Toolkit: Making Sense of Complex Issues 25 MASSACHUSETTS AVENUE, NW SUITE 500 WASHINGTON, DC 20001 CONTACT Emmanuelle St. Jean, MPH

More information

Health Care Reform and You

Health Care Reform and You Health Care Reform and You Timelines and Implications of the Law for Individuals Updated as of December 2013 Health Care Reform and You The Patient Protection and Affordable Care Act and the Health Care

More information

Sandy Wood, CEBS (Certified Employee Benefit Specialist) Healthcare Consultant sandy@thebenefitsacademy.com 206-669-3345

Sandy Wood, CEBS (Certified Employee Benefit Specialist) Healthcare Consultant sandy@thebenefitsacademy.com 206-669-3345 1 Sandy Wood, CEBS (Certified Employee Benefit Specialist) Healthcare Consultant sandy@thebenefitsacademy.com 206-669-3345 2 Terms you need to know Required Notices 2014 Plan Requirements The Grandfathered

More information

HEALTH CARE REFORM TIME TO PREPARE FOR 2014 OCTOBER 2012

HEALTH CARE REFORM TIME TO PREPARE FOR 2014 OCTOBER 2012 HEALTH CARE REFORM TIME TO PREPARE FOR 2014 OCTOBER 2012 Key elements of health reform for employers Change in tax treatment for overage dependent coverage Accounting impact of change in Medicare retiree

More information

Sage HRMS The healthcare reform survival guide. Checklists and explanations to help you meet changing health benefits compliance mandates

Sage HRMS The healthcare reform survival guide. Checklists and explanations to help you meet changing health benefits compliance mandates Sage HRMS The healthcare reform survival guide Checklists and explanations to help you meet changing health benefits compliance mandates Table of contents Welcome to healthcare reform 3 The big question

More information

The IRS and its 46 new powers to enforce ObamaCare Galen Institute

The IRS and its 46 new powers to enforce ObamaCare Galen Institute BLOG» The IRS and its 46 new powers to enforce ObamaCare June 5, 2013 The power granted to the IRS to enforce ObamaCare s mandates, taxes, penalties, reporting, and other requirements is unprecedented.

More information

Patient Protection and Affordable Care Act of 2009: Immediate Health Insurance Market Reforms

Patient Protection and Affordable Care Act of 2009: Immediate Health Insurance Market Reforms Patient Protection and Affordable Care Act of 2009: Immediate Health Insurance Market Reforms Provision Notes Standards Development Applicability Effective Date PPACA Statutory Annual and Lifetime Limits

More information

Navigating the New Health Insurance Environment

Navigating the New Health Insurance Environment Navigating the New Health Insurance Environment The Affordable Care Act and Professional Employer Organizations (PEOs) This white paper is an overview of eight building blocks of an effective small-business

More information

Health Reform Employer Impact Analysis. Sample Employer. Prepared for. Date

Health Reform Employer Impact Analysis. Sample Employer. Prepared for. Date Health Reform Employer Impact Analysis Prepared for Sample Employer Date 2 Health Reform Employer Impact Analysis Overview Beginning in 2014, an applicable large employer becomes subject to what are referred

More information

FAQ New Health Insurance Law

FAQ New Health Insurance Law FAQ New Health Insurance Law (Enacted on March 21, signed into law on March 23, and amended on March 25) On March 23, 2010 President Barack Obama signed the Patient Protection & Affordable Care Act (H.R.

More information

Employee Benefits Compliance

Employee Benefits Compliance Employee Benefits Compliance Pay or Play Delay, Does it Apply and Strategies to Comply Wells Fargo Insurance 2014 Issues and beyond. U.S. citizens and legal residents are required to have "minimum essential

More information

Legislative update. March 2011. In this issue. Wells Fargo Insurance Services

Legislative update. March 2011. In this issue. Wells Fargo Insurance Services Wells Fargo Insurance Services March 2011 Legislative update In this issue Health reimbursement arrangements to comply with the new Medicare Secondary Payer Rule disclosure requirements IRS issues new

More information

HEALTH CARE REFORM CHECKLIST

HEALTH CARE REFORM CHECKLIST HEALTH CARE REFORM CHECKLIST As a small employer, you need to be aware of the new regulations tied to the Affordable Care Act. Refer to this checklist to ensure you understand each one and that you re

More information

Healthcare. Reform. Guidance for Groups. Blue Cross and Blue Shield of Louisiana incorporated as Louisiana Health Service & Indemnity Company

Healthcare. Reform. Guidance for Groups. Blue Cross and Blue Shield of Louisiana incorporated as Louisiana Health Service & Indemnity Company Healthcare. Reform Guidance for Groups 01MK4428 R8/10 Blue Cross and Blue Shield of Louisiana incorporated as Louisiana Health Service & Indemnity Company Table of contents Overview of the Patient Protection

More information

HEALTH CARE REFORM INFORMATION FOR BUSINESSES March 2013

HEALTH CARE REFORM INFORMATION FOR BUSINESSES March 2013 PARTNERS: Dennis V. King, CPA Charles R. Alleman, Jr., CPA Robert N. Jensen, Jr., CPA Thomas E. Engman, CPA SENIOR PARTNER: David F. King, CPA 27200 Tourney Road, Suite 475 Valencia, California 91355 tel

More information

HEALTH REFORM UPDATE GRANDFATHERED GROUP HEALTH PLANS August 3, 2010

HEALTH REFORM UPDATE GRANDFATHERED GROUP HEALTH PLANS August 3, 2010 HEALTH REFORM UPDATE GRANDFATHERED GROUP HEALTH PLANS August 3, In July, the Departments of Treasury, Labor, and Health and Human Services jointly released the Interim Final Rules for Group Health Plans

More information

Health care reform for large businesses

Health care reform for large businesses FOR PRODUCERS AND EMPLOYERS Health care reform for large businesses A guide to what you need to know now DECEMBER 2013 CONTENTS 2 Introduction Since 2010 when the Affordable Care Act (ACA) was signed into

More information

Healthcare Reform Timeline

Healthcare Reform Timeline Healthcare Reform Timeline Provisions That Will Impact Individuals & Employers September 2013 No one sees the direct results of the Patient Protection and Affordable Care Act (PPACA) like the health insurance

More information

IRS Proposes Rules for Federal Subsidy of Health Insurance Purchased in State Exchanges

IRS Proposes Rules for Federal Subsidy of Health Insurance Purchased in State Exchanges IRS Proposes Rules for Federal Subsidy of Health Insurance Purchased in State Exchanges August 2011 The Internal Revenue Service (IRS) on August 12, 2011 issued proposed regulations relating to the federal

More information

Shared Responsibility: What It Means for Your Business

Shared Responsibility: What It Means for Your Business Shared Responsibility: What It Means for Your Business The provisions of the Affordable Care Act (ACA) apply to nearly all companies in the United States. The ways they apply, however, can be different

More information

Health Care Reform Legislation and You

Health Care Reform Legislation and You Health Care Reform Legislation and You Timelines and Implications of the New Law for Individuals Updated as of May 2011 Health Care Reform Legislation and You The Patient Protection and Affordable Care

More information

Health Care Reform: Health Plans Overview. Presented by: Brian Lenzo, Preferred Benefits Services

Health Care Reform: Health Plans Overview. Presented by: Brian Lenzo, Preferred Benefits Services Health Care Reform: Health Plans Overview Presented by: Brian Lenzo, Preferred Benefits Services Agenda What is the legal status of the law? Which plans must comply? Grandfathered plans Reforms currently

More information

Health Reform in a Nutshell: What Small Businesses Need to Know Now.

Health Reform in a Nutshell: What Small Businesses Need to Know Now. Health Reform in a Nutshell: What Small Businesses Need to Know Now. With the passage of the most significant reform of America s modern-day health care system, many small business owners and human resources

More information

HCR Bulletin. Guidance Issued on PPACA Market Reform Application to HRAs, FSAs, Individual Policy Premium Arrangements and EAPs.

HCR Bulletin. Guidance Issued on PPACA Market Reform Application to HRAs, FSAs, Individual Policy Premium Arrangements and EAPs. HCR Bulletin Guidance Issued on PPACA Market Reform Application to HRAs, FSAs, Individual Policy Premium Arrangements and EAPs Summary Employers will generally be prevented from using individual accounts,

More information

CUPA-HR New York Metro Chapter Fall Event

CUPA-HR New York Metro Chapter Fall Event CUPA-HR New York Metro Chapter Fall Event Introduction to Panel Discussion on Health Care Reform and Compliance Strategies October 18, 2012 The Compliance Timeline 2011 Plan Year 2011 2012 2013 2014 2018

More information

Regulatory Update Overview of Regulations and Other Developments Regarding PPACA s Employer- Sponsored Group Health Plan Provisions

Regulatory Update Overview of Regulations and Other Developments Regarding PPACA s Employer- Sponsored Group Health Plan Provisions Reprinted with permission from Employee Benefit Plan Review, March 2011. All rights reserved, WoltersKluwer Company, New York, N.Y. Regulatory Update Overview of Regulations and Other Developments Regarding

More information