Scott Lyon, Senior Vice President Small Business Association of Michigan
|
|
- Edgar Russell
- 8 years ago
- Views:
Transcription
1 Scott Lyon, Senior Vice President Small Business Association of Michigan
2 Patient Protection and Affordable Care Act H.R Health Care & Education Affordability Reconciliation Act H.R ,000 30,000 pages of Regulation
3 Access to Qualified Coverage Guaranteed Issue, Subsidies, Medicaid Expansion Standardize Product Choices Exchange/Marketplace and metal levels Level Playing Field for Insurance Carriers Standard Rating rules, Essential Health Benefits and Risk Sharing Shared Financial Responsibilities Taxes, fees and Out-of-Pocket Maximums Quality and Delivery System Reforms
4 Increasing Cost of Health Care Drives Insurance Premiums Higher Erosion of Employer Sponsored Health Insurance due to cost Increasing Number of Uninsured Rapid Growth in Medicaid Costs and Enrollment Pressure on Budgets
5 2012 $6,515 $15, $5,049 $13,770 Family Premium 2005 $4,024 $10,880 Single Premium 2000 $2,471 $6,438 $- $2,000 $4,000 $6,000 $8,000 $10,000 $12,000 $14,000 $16,000 $18,000
6 Private Sector Employers Offering Coverage Total % Under 50 Employees 36.9% Over 50 Employees 98.3% The Kaiser Family Foundation, 2011 State Health Facts
7 55 50 Millions Uninsured US Census Bureau
8 The conversation is same as it has been for 30 years Small businesses need access to affordable health insurance for themselves, their families and their employees The rising cost of health care, and therefore health insurance premiums, continues to be the number one conversation/concern
9
10 Tax Credits for Small Businesses (Phase 1) Cover Children to Age 26 No Pre-Ex for Children Restrictions on Recession and out-of-pocket maximums Over the Counter Drug Exclusion Summary of Benefits and Coverage Simple Cafeteria Plan W2 - All employers must include on their employees W2s the aggregate cost of employer sponsored health benefits. Delayed for small business. Required if 250+ W-2s are issued
11 Section 125 Limits: FSA contributions are limited to $2,500/year/participant Tax Change: Threshold for deducting unreimbursed medical expenses from federal taxes increased from 7.5% to 10% Medicare Tax Rate: For individuals who earn $200,000+ (family $250,000+) the Medicare tax rate increases by.9% (1.45% %) for employee share only and 3.8% tax on unearned income Exchange Notification October 1 - employer is required to notify all employees of the Insurance Exchange/Marketplace
12 New Insurance Rules Medicaid Expands Employer Mandate Health Insurance Exchange Individual Mandate
13 Insurance Exchanges/Marketplaces Online marketplace for purchase of insurance (Oct. 2013) Mi Health Marketplace Waiting Period For plan years beginning on or after Jan.1, 2014, a group health plan or health insurance issuer offering group health insurance coverage shall not apply any waiting period that exceeds 90 days. Individual Mandate - Requires all U.S. citizens and legal residents to have qualifying health coverage or face a penalty if they do not. Those under FPL or those that do not file a tax return no penalty Employer Mandate /Free Rider/Shared Responsibility - Employers with more than 50 full-time equivalent employees must offer affordable coverage that meets minimum essential health benefit standards, to 95% of employees, or potentially be subject to a free rider penalty.
14 Individual Mandate - Penalties $95/year or 1% of taxable income 2015 $325/year or 2% of taxable income $695/year or 2.5% of taxable income and increased by COL Individual Coverage Subsidies Coverage must be purchased at the Exchange Family incomes between 133% and 400% of FPL. Under 250% of FPL also receive reduced cost sharing Individuals and their dependents who have been offered employer coverage that meets the minimum value and affordability tests are not eligible for the subsidy The subsidy is a refundable and advanceable tax credit paid directly to the insurer via the Exchange The tax credit is based upon the second lowest cost silver plan in the Exchange
15 50 Employee Calculation 2014 and 2015: 1 50 FTE = Small Group 2016: FTE = Small Group Full-time Employee working 30 hours or more per week in an average month (130 hours in a calendar month - including paid vacation, sick time, etc.). Part-Time Part-time employees count toward the total number of employees on a pro-rated basis. Divide the total hours worked by part-time employees in a month by 120. Seasonal Seasonal employees count unless the group s workforce exceeds 50 full-time employees for 120 days or fewer during a calendar year and those seasonal employees are what put the employer above the threshold (50). Control Group All members of a controlled group count.
16 Don t assume that because your companies have separate employer identification numbers (EIN) that the employees will be counted separately for the determination of the Affordable Care Act, and for that matter COBRA. They most likely will not be. Types of Control Groups: Parent Subsidiary A parent-subsidiary controlled group exists wherever a parent organization owns 80% or more of the equity in a subsidiary organization. (For corporations, the 80% + test is based on attaining that level of voting power or total value based on all classes of stock; for partnerships, the 80% + test is based on attaining that level of profits interest or capital interest; for trusts and estates, actuarial interests are used.) Brother-Sister - common control group exists wherever the same five or fewer persons (counting individuals, estates and trusts as "persons") (i) collectively own 80 percent or more of the equity in two separate trades or businesses, and (ii) taking into account the level of ownership each of those five persons holds in each of the two organizations (using a lowest common denominator approach) collectively own more than 50 percent of the equity in both of the trades or businesses. Affiliated Service Group - exists wherever several organizations regularly collaborate in the services they provide to the public (typically, integrated services), and the several organizations are linked by a material level of cross-ownership. Failure to correctly identify the "employer" can cause you or your customers to not properly understand which ACA rules apply to the company(s).
17 Variable Hour Employees 1. Initial Measurement Period New Employees 2. Standard Measurement Period 3 12 months chosen by employers and can vary by employee class uniform and consistent for all employees in the same category 1. Collective bargaining vs. non-collective bargaining 2. Salaried vs. hourly 3. Employees of different entities 4. Employees in a different state 3. Administrative Period Up to 3 months to determine plan eligibility 4. Stability Period If employee is full-time during the measurement period, coverage is extended during the stability period as long as the employee remains an employee, but hours can decrease. 5. Stability Period (2) Stability period must be at least 6 consecutive calendar months and it must begin after the standard measurement period
18 50+ FTEs Coverage Offered Does ANY Employee receive a premium subsidy? Employer Penalty No Yes $2,000 per full-time employee, excluding the first 30 employees Yes No None Yes Yes Lesser of: $3,000 x number receiving assistance at the Exchange or $2,000 per employee (minus the first 30)
19 Cost of Coverage Thresholds Employee portion of premium vs. W-2 Box 1 Employee Employer Penalty % Is not eligible for Exchange Tax Credits None 9.5% and up May be eligible for Exchange Tax Credits if under 400% FPL Lesser of: $3,000 x number receiving assistance at the Exchange or $2,000 per employee (minus the first 30)
20 Federal Poverty Limit - FPL 2011 FPL Hourly Rate (40 hr week) W2 Wage 100% (Possibly Medicaid Eligible) $10,890 $5.24/hr 9.5% $86/mo 133%(Possibly Medicaid Eligible) $ $6.96/hr 9.5% $114/mo 150% (Minimum Wage) $16,335 $7.85/hr 9.5% $130/mo 200% $21,780 $10.47/hr 9.5% $172/mo 250% $27,225 $13.09/hr 9.5% $216/mo 300% $32,670 $15.71/hr 9.5% $259/mo 350% $38,115 $18.32/hr 9.5% $302/mo 400% $43,560 $20.94/hr 9.5% $345/mo 400% family of 4 $89,400 $20.94/hr 9.5% Employee Share of Single Premiums per 9.5% income Standard $345/mo since employer only has to use the single rate for lowest tier plan to calculate affordability
21 Drop coverage all together $2,000 x (80 30) = $ 100,000 annual, $8,333 monthly Provide coverage at minimum value, but not affordable to some Lesser of: $3,000 x # of employees purchasing coverage on the exchange and qualifying for a subsidy or $2,000 X (see above) Maintain coverage at minimum value, employee contribution does not exceed 9.5% of household income No penalty
22 If an employer drops coverage and sends employees to the exchange, employees do not see the penalty money the employer pays. Many employers think that if they drop coverage and send people to the exchange that their employees will get free or drastically reduced coverage. For many employees, particularly those without dependents, the subsidy may not exist or will be small.
23 IRS reporting will begin in 2015 for health insurance coverage provided on or after January 1, Information to be reported includes: Your company's name and employer identification number A certification as to whether your company offers its full-time employee* (and their dependents) the opportunity to enroll in a health plan that meets the definition of a minimum value plan. If your company certifies that it does offers its employees and dependents the opportunity to enroll, then you must also report: The length of your waiting period* (cannot exceed 90 calendar days) The months during the calendar year for which coverage was available The monthly premium* for the lowest cost option available by category of employee Your (employer's) share of the total allowed cost of benefits provided under the plan The number of full-time equivalent employee (FTE)* for each month during the calendar year The name, address, and tax identification number of each full-time employee* during the year (by month) when the employee (and dependents) were covered under your group health plan Such other information the Secretary may require
24 Small Business Tax Credits treating the symptom 2014 Part II 2 years Tax credit equal to 50% in Part II of the employers health insurance costs, if: 10 or fewer full-time equivalent employees Average annual wages of less that $25,000 (not including owner s or owner s family member wages) Employer pays 50% or more of the premium Must Purchase via Exchange Companies with between 11 and 25 workers and an average wage of less than $50,000 are eligible for partial credits If currently offer Qualify or Not? Or, enough to maintain plan If you do not offer, is the incentive enough to begin?
25 Products & Underwriting Pricing New Products (Metal Levels) Guarantee Issue New Deducible and Out of Pocket Max. Member Level Age Rates Rating Regions Tobacco Surcharge Taxes and Fees Taxes and fees to fund various initiatives and expenses Risk Sharing Stabilizing Risk Pools Across Insurance Carriers
26 Today Individual 10:1 age rating - Group 5:1 age rating Tomorrow Individual and group 3:1 age rating Single, Two-Party and Family rates for group Member level rating each covered individual gets their own rate (children 0-20 one band, age 64+ one band)
27 No Employer Mandate or Penalty New Product Menu New Essential Benefits One Subscriber Groups to Individual Plans Guaranteed Issue No Pre Ex and No Annual or Lifetime limits Eligibility requirements (30/hrs = fulltime) Invoice will look different Contribution Strategy New Deductible cap ($2,000/$4,000) Out of pocket max ($6,350/$12,700) SHOP Exchange Grandfathered plans exempt No longer Single, Two-person or Family rates Rates will be per person based on ages, smoking status and area of enrolling members, with a maximum of 3 oldest children Additional taxes will apply on top of these changes
28 Comparative Effectiveness (PCORI) Federal Tax on Insurance Premiums Reinsurance Fees Phase out in 2017 When How Much Individual and Small Group ASC July 2013 $1 - $2 PMPY Yes Yes No 2014 % of premium Yes Yes (stop loss) Marketplace Fee % of premiums on marketplace Medicare Yes $5.25 PMPM Yes Yes No Small Group only No No Risk Adjustment fee 2014 $.96 PMPY Yes No No High Cost health plan (Cadillac Tax) % excise tax on premiums above limit Yes Yes Yes, if in a Group plan
29 Insurers estimate there will be a 5% - 7% increase in rates due to new PPACA taxes and fees (before trend) New deductible and out of pocket maximums will impact rates Loss of Industry Factor will impact rates Change in age bands will impact rates? Member level rating will impact rates
30 Rating Standards Age, Tobacco, Geography and Family Status Member Level Rating Rating Regions 2014 for Individual Plans 2014 for groups with 1 50 employees 2016 for groups with employees 2017 for groups with 100+ employees Taxes and Fees 2013 for all size groups
31 March 23, 2010 coverage is Grandfathered Allowable changes Addition of New Employees and Family Copayment increase Greater of Total Medical inflation + 15% or $5 Deductible increase Total Medical inflation + 15% Non-allowable changes Company merger cannot be to make grandfather status available to combined workforce. Elimination of all or substantially all benefits to diagnose or treat a particular condition causes a plan or health insurance coverage to cease to be a grandfathered health plan. Any increase in a percentage cost-sharing requirement (such as coinsurance). A greater than a 5% change to the contribution rate No change in insurance companies even for the same plan Does not apply when self-insured employers switch TPAs or union CBAs.
32 Individuals Self- Employed Small Employers (2-50) Health Insurance Exchange Blue Cross Blue Shield of Mi/BCN Priority & Health Plus HAP & United Consumers Mutual New Health Care CO-OP National Plan(s)
33 American Health Benefit Exchanges for Individuals and Small Business Health Options Program (SHOP) where small businesses with up to 100 employees can purchase qualified coverage. (states can limit to 50 employees until 2016). An online marketplace. October 1 - Employer to Employee notice requirement of Exchange - FLSA Section 18B for model notice October 2013 Up and running and accepting applications for coverage period beginning in January 2014 Subsidies If an individual is eligible for a subsidy they must purchase coverage from the Exchange Subsidies are Based on Income From 133% of FPL ($15,282) - 400% of FPL ($45,960 single and $94,200 family). Sliding scale credits.
34 Subsidies are only available on the individual exchange Individual premiums are paid with after tax dollars Group coverage (2-50 only) can be purchased on the SHOP Exchange Some groups may be eligible for a small business tax credit if the group has fewer than 25 full time employees, pays an average wage of less than $50,000/year, and pays at least 50% of employee premiums Employee Choice Employer picks the metal tier and employees have the option to choose the plan they would like based on employer choices
35 Individuals and Groups with 1 50 employees can enroll in October 2013 for coverage in 2014 Groups over 50 employees can enroll in the Marketplace Jan. 1, 2016 Groups over 100 employees can enroll in the Marketplace Jan. 1, 2017 (at option of the State) Open Enrollment - October 1, 2013 March 31, 2014
36 Coverage Options Multiple Insurance Carriers Plans at the: Platinum: 90% actuarial value (+/- 2%) Gold: 80% actuarial value (+/- 2%) Silver: 70% actuarial value (+/- 2%) Bronze: 60% actuarial value (+/- 2%)
37 1. Ambulatory patient services 2. Emergency services 3. Hospitalization 4. Maternity and newborn care 5. Mental health and substance use disorder services including behavioral health treatment 6. Prescription drugs 7. Rehabilitative and habilitative services and devices, 8. Laboratory services 9. Preventive and wellness services and chronic disease management 10. Pediatric services, including oral and vision care Reviewed annually by HHS Plans and Rates embargoed until October by Michigan OFIR
38 All small group plans must adhere to deductible and out-of-pocket limits in 2014 Deductible Range $0.$2,000 individual $4,000 family Out-of-pocket range for all EHBs includes deductible *Out-of Pocket Maximums only apply to Essential Health Benefits $ 6,350 individual* $12,700 family* (tied to HSA limits)
39 PPACA s premium tax credit (subsidies) only are available to qualified individuals purchasing coverage through health insurance exchanges after January 1, 2014 Individuals with family incomes between % of the federal poverty level, who are not covered by an employer sponsored plan that is available and affordable, are eligible for a premium subsidy Individuals with family incomes at or below 250% of the FPL also qualify for reduced cost-sharing Individuals and their dependents who have been offered coverage through an employer that meets an affordability and minimum value test are not eligible to purchase coverage through an exchange and cannot get a subsidy.
40 Considerations for Employers: Exchanges are new and untested Coverage will be available for purchase outside the exchange more options Coverage may be available through a private exchange If the employer drops coverage, then everyone has to go to the exchange to get coverage
41 The premium subsidy will come in the form of a refundable and advanceable tax credit paid directly to the individual s insurer The amount of the refundable premium tax credit received is based on the premium for the second lowest cost Silver Level Plan on the exchange and in the rating area where the individual is eligible to purchase coverage Exchange subsidies do not mean free coverage and they will benefit lower income individuals and families very differently from higher compensated individuals Plan decision makers and their families generally will not qualify for subsidies
42 Individual Family Status Income Percentage of income that may be spent on health insurance Estimated value of the employee s annual tax credit in year old with qualified employer coverage Married, two children $35, % of household income No one in the family qualified to buy coverage in the exchange or get a subsidy 30 year old with no employer coverage Single $35, % of household income $155 (based on Kaiser Family Foundation s projection of a $3440 annual single premium in 2014) Individual s annual premium costs would be $ year old with no employer coverage Married, two children $35, % of household income $8,720 (based on Kaiser Family Foundation s projection of a $10,108 annual family premium in 2014) Family s annual premium costs would be $1, Year old with qualified employer coverage Married, three children $55, % of household income $0 -- No one in the family is qualified to buy coverage in the exchange or get a subsidy 45 year old with no employer coverage Single $55,000 N/A $0 Individual may buy coverage in the exchange but would not qualify for subsidy Individual s annual premium payments would be $5,609 based on Kaiser Family Foundation s projection of 2014 single premium 45 year old with no employer coverage Married, two children $55, % of household income $10, 100 (based on Kaiser Family Foundation s projection of a $14, 250 annual family premium in 2014) Family s annual premium costs would be $4,135
43 2018 Cadillac Tax An excise tax on insurers or employer health insurance plans with aggregate values that exceed $10,200 for an individual and $27,500 for a family takes effect. Tax is indexed to the CPI-U beginning in 2020 Cadillac Tax is 40% of the value above the threshold. Have you done the math? We have
44 2014 Health Benefit Purchase Scenario EMPLOYER Premium Credits & Cost Sharing. Who will be Eligible?
45 Employee Base - Mix of full and part-time employees. What side of 50 is your company on? Coverage Offered If you currently offer health insurance coverage to your employees, why do you do that? Does coverage offered meet the affordability and minimum value tests? Send Employees to the Exchange - If you stop offering employer coverage and send employees to the Exchange, what will the reaction be? Will employees still look to you for answers? Will they buy coverage or take their chances and pay the fine? Exchange Subsidies Subsidies do not mean coverage will be free, lower income families will benefit the most, with middle and upper income people receiving very limited subsidies. Health of Workforce Impact on productivity, absenteeism and employee morale. Tax Issues - Employer premiums are tax-deductible, individual premiums paid to the Exchange are after tax. In you increase the employee salary to make up for lost benefits, employer FICA taxes also increase. Impact on Workers Comp. If employee remain uninsured, will non-workplace injuries that before would have been covered by health insurance suddenly become a work related injury? Competitors Will your best and brightest become your competitors best and brightest?
46
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 informationHealth insurance Marketplace. What to expect in 2014
Health insurance Marketplace What to expect in 2014 Overview The Affordable Care Act (ACA) includes several provisions geared to extend greater access to health insurance benefits to more people. Beginning
More informationHealth Care Reform Update
Small Businesses No Financial Requirements for Small Businesses: The ACA imposes no financial requirements for small businesses to contribute to their employees health insurance. However, beginning in
More informationThe Patient Protection and Affordable Care Act What Employers need to know
The Patient Protection and Affordable Care Act What Employers need to know Presented by: Misty Baker mbake@iiat.org 800-880-7428 This update is based on the known provisions of the PPACA. This is not to
More informationHow The Affordable Care Act will Affect You and Your Business. Logo
How The Affordable Care Act will Affect You and Your Business. AFFORDABLE CARE ACT (ACA) DISCLOSURE The information provided is to be used as a guide. Since the ACA is still a work in progress, changes
More informationHealthcare Reform Preparedness for Small Businesses
Healthcare Reform Preparedness for Small Businesses Blue KC on Wheels Community awareness initiative Health screenings Wellness information Seminars on healthcare reform, health insurance and wellness
More informationIntroduction. Affordable Care Act Overview of Changes
Introduction Affordable Care Act Overview of Changes Presented by: Tim Dillingham, CLU Benefit Resource Group, Inc. 201 E Broad Street, Suite 1 Linden, MI 48451 810-735-6500 810-735-6610 (fax) tim@benefitresourcegroup.net
More informationThe New Health Insurance Marketplace. Choices and Opportunities for Small Groups
The New Health Insurance Marketplace Choices and Opportunities for Small Groups What is the Affordable Care Act? The Patient Protection and Affordable Care Act (ACA) was signed into law on March 23, 2010
More informationHealth Insurance Marketplace. vhealth insurance exchanges. What to expect in 2014. What to expect in 2014
vhealth insurance exchanges Health Insurance Marketplace What to expect in 2014 What to expect in 2014 The basics of exchanges As part of the Affordable Care Act (ACA or health care reform law), starting
More informationHealth 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 informationto Health Care Reform
The Employer s Guide to Health Care Reform What you need to know now to: Consider your choices Decide what s best for you Follow the rules 2013-2014 Health care reform is the law of the land. Some don
More informationExchange 101. August 2013
Exchange 101 August 2013 455430 27517 Penalties for individuals 2017 and beyond: Annual adjustments 2016: Greater of $695 or 2.5% of taxable income 2015: Greater of $325 or 2% of taxable income 2014: Greater
More informationPrescribed 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 informationEmployer s Guide To Health Care Reform
Employer s Guide To Health Care Reform A nonprofit independent licensee of the Blue Cross Blue Shield Association National strength. Local focus. Individual care. SM As part of our commitment to being
More informationPatient Protection and Affordable Care Act (ACA) ACA Guide for Group Employers Employer Information
Patient Protection and Affordable Care Act (ACA) ACA Guide for Group Employers Employer Information DISCLAIMER 2 This information is being provided in an effort to alert you to changes required by the
More informationFederal Health Reform FAQs
Federal Health Reform FAQs Individuals 1. What is an exchange? An exchange, as created under the Affordable Care Act (ACA), is a place where consumers can purchase subsidized health insurance coverage.
More informationThe Vermont Health Benefit Exchange: An Update for Small Business Owners
The Vermont Health Benefit Exchange: An Update for Small Business Owners Today s Presentation Health Reform Goals Overview of Health Care Reform What is the Exchange? What Does the Exchange Look Like?
More informationExchanges and the ACA What You Need to Know for 2014
Exchanges and the ACA What You Need to Know for 2014 How the Affordable Care Act affects the Individual Health Insurance Market This presentation is for informational purposes only and does not constitute
More informationPatient Protection and Affordable Care Act (ACA) ACA Guide for Group Employers Agent and Broker Information
Patient Protection and Affordable Care Act (ACA) ACA Guide for Group Employers Agent and Broker Information DISCLAIMER 2 This information is being provided in an effort to alert you to changes required
More information2015-2016: What You Need To Know About The Affordable Care Act
2015-2016: What You Need To Know About The Affordable Care Act A nonprofit independent licensee of the Blue Cross Blue Shield Association National strength. Local focus. Individual care. SM We are committed
More informationNebraska Health Insurance Exchange Update
Nebraska Health Insurance Exchange Update Overview of the Affordable Care Act and the Federally Facilitated marketplace. September 2014 AFFORDABLE CARE ACT» The Affordable Care Act: Establishes a Health
More informationSimple 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 informationSection 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 informationHow To Comply With The Health Care Act
AFFORDABLE CARE ACT Employers that provide health coverage to employees are responsible for complying with many of the provisions of the Affordable Care Act (ACA). Provisions take effect on staggered dates
More information4/8/2013. Health Care Reform and the. NYS Exchange. Dr. Arthur Vercillo, MD Regional President April 8, 2013. Health Care Reform and the NYS Exchange
Health Care Reform and the NYS Exchange Presentation to the Health Planning Council Advisory Board April 8, 2013, Ithaca NY By Dr. Arthur Vercillo, MD Additional resources on next to last slide. Health
More informationHealth Care Reform: Ready or Not, Here it Comes! Presented by:
Broader Perspective. Business Solutions. Health Care Reform: Ready or Not, Here it Comes! Presented by: Ryan Fridborg, MAOD, SPHR Executive Vice President, Employee Benefits rfridborg@boltonco.com Marilyn
More informationAFFORDABLE CARE ACT LARGE EMPLOYER HEALTH REFORM CHECKLIST. Edition: November 2014
AFFORDABLE CARE ACT Employers that offer health care coverage to employees are responsible for complying with many of the provisions of the Affordable Care Act (ACA). Most health reform changes apply regardless
More informationHealth 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 informationA f f o r d a b l e C a r e A c t. S u s a n L. G r a s s l i, J D M a y 2 0 1 4
Health Care Reform T h e B i g T h r e e P r o v i s i o n s o f t h e A f f o r d a b l e C a r e A c t S u s a n L. G r a s s l i, J D M a y 2 0 1 4 Agenda Background The Big Three o Individual Mandate
More informationIssue Brief: The Health Benefit Exchange and the Small Employer Market
Issue Brief: The Health Benefit Exchange and the Small Employer Market Overview The federal health care reform law directs states to set up health insurance marketplaces, called Health Benefit Exchanges,
More informationWhat You Need to Know About Health Care Reform
What You Need to Know About Health Care Reform A Toolkit for Small Employer Group Administrators What s inside Health care reform offers new choices for small businesses... 1 Why New Jersey businesses
More informationHealth Policy Essentials: Private Health Insurance. Bernadette Fernandez, Annie Mach, & Namrata Uberoi February 13, 2015
Health Policy Essentials: Private Health Insurance Bernadette Fernandez, Annie Mach, & Namrata Uberoi February 13, 2015 Briefing Agenda What is the purpose of private health insurance (PHI)? How is PHI
More informationHEALTH REFORM AND MULTIEMPLOYER PLAN COVERAGE 2014 AND BEYOND
WWW.BKLAWYERS.COM HEALTH REFORM AND MULTIEMPLOYER PLAN COVERAGE 2014 AND BEYOND ABA SECTION OF LABOR AND EMPLOYMENT LAW EMPLOYEE BENEFITS COMMITTEE MID- WINTER MEETING 201 BLITMAN & KING LLP Franklin Center,
More informationHHealth HEALTH INSURANCE EXCHANGE FAQs
HHealth HEALTH INSURANCE EXCHANGE FAQs Page 1 TABLE OF CONTENTS Introduction... 3 Background... 3 Health Insurance Exchange FAQs... 4 What is the Patient Protection and Affordable Care Act (PPACA)?...
More informationSURVIVAL GUIDE FOR SMALL BUSINESS
HEALTH INSURANCE MARKETPLACE SURVIVAL GUIDE FOR SMALL BUSINESS Vermont edition NAVIGATING NEXT STEPS IN HEALTH CARE REFORM There s a constant stream of changes and updates related to health care reform,
More informationwww.thinkhr.com 877-225-1101 Employer Health Reform Checklist
www.thinkhr.com 877-225-1101 Employer Health ThinkHR grants the reader non-exclusive, non-transferable, and limited permission to use this document. The reader may not sell or otherwise use this document
More informationHealth Care Reform Frequently Asked Questions (FAQ) Consumers Employers
This page provides answers to frequently asked questions (FAQ) regarding The Patient Protection and Affordable Care Act (PPACA; P.L. 111-148) and the Health Care and Education Reconciliation Act of 2010
More information#21 - Should You Provide Health Insurance in 2014?
#21 - Should You Provide Health Insurance in 2014? Yes, for all size groups, but only if you can afford it and it serves other purposes (such as controlling competition for employees or you don t want
More informationAFFORDABLE CARE ACT SMALL EMPLOYER HEALTH REFORM CHECKLIST
AFFORDABLE CARE ACT SMALL EMPLOYER Employers that offer health care coverage to employees are responsible for complying with many of the provisions of the Affordable Care Act (ACA). Most health reform
More informationOVERVIEW OF PRIVATE INSURANCE MARKET REFORMS IN THE PATIENT PROTECTION AND AFFORDABLE CARE ACT AND RESOURCES FOR FREQUENTLY ASKED QUESTIONS
OVERVIEW OF PRIVATE INSURANCE MARKET REFORMS IN THE PATIENT PROTECTION AND AFFORDABLE CARE ACT AND RESOURCES FOR FREQUENTLY ASKED QUESTIONS Brief Prepared by MATTHEW COKE Senior Research Attorney LEGISLATIVE
More informationEffective 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 informationHealth Reform Changes: What s New for 2014? New Hampshire Insurance Department September 11, 2013
Health Reform Changes: What s New for 2014? New Hampshire Insurance Department September 11, 2013 1 New Hampshire Insurance Department Presentation Overview What s New in 2014 Key Questions for Individuals
More informationHEALTH INSURANCE MARKETPLACES FACT SHEET
HEALTH INSURANCE MARKETPLACES FACT SHEET INFORMED ON REFORM Overview A Health Insurance Marketplace, also known as a Health Insurance Exchange, is available in every state as a public option for individuals
More informationStrategic Considerations in Group Health Insurance Walking Through 2014 Options. NAHU Compliance Corner Webinar December 19, 2012
Strategic Considerations in Group Health Insurance Walking Through 2014 Options NAHU Compliance Corner Webinar December 19, 2012 Preparing for the Big Year Ahead! 2014 is going to bring great changes to
More informationKansas Insurance Department
Kansas Insurance Department The Affordable Care Act What Happens Now? Kansas Society of CPAs June 5, 2013 Linda J. Sheppard, Special Counsel & Director of Health Care Policy and Analysis 2010 Affordable
More informationwww.thinkhr.com AFFORDABLE CARE ACT SMALL EMPLOYER HEALTH REFORM CHECKLIST
www.thinkhr.com AFFORDABLE CARE ACT SMALL EMPLOYER HEALTH REFORM CHECKLIST Employers that provide health coverage to employees are responsible for complying with many of the provisions of the Affordable
More informationTHE AFFORDABLE CARE ACT IN VIRGINIA --THE BASICS-- MARY FRANCES CHARLTON Attorney and ACA Coordinator LEGAL AID JUSTICE CENTER
THE AFFORDABLE CARE ACT IN VIRGINIA --THE BASICS-- MARY FRANCES CHARLTON Attorney and ACA Coordinator LEGAL AID JUSTICE CENTER Overview Affordable Care Act, aka Obamacare Goals Affordable Insurance Coverage
More informationThe Effect of the Affordable Care Act on Your Small Business. Presented to : Greater Kansas City Chamber Business Class
The Effect of the Affordable Care Act on Your Small Business Presented to : Greater Kansas City Chamber Business Class November 6, 2013 KHN Kaiser Health News Current Headlines October 31- November 4,
More informationAFFORDABLE CARE ACT LARGE EMPLOYER HEALTH REFORM CHECKLIST. Edition: October 2015
AFFORDABLE CARE ACT Employers that offer health care coverage to employees are responsible for complying with many of the provisions of the Affordable Care Act (ACA). Most health reform changes apply regardless
More informationHEALTH INSURANCE MARKETPLACE SURVIVAL GUIDE FOR SMALL BUSINESS. New York Edition
HEALTH INSURANCE MARKETPLACE SURVIVAL GUIDE FOR SMALL BUSINESS New York Edition NAVIGATING NEXT STEPS IN HEALTH CARE REFORM PAGE 2 www.discovermvp.com There s a constant stream of changes and updates related
More informationSURVIVAL GUIDE FOR SMALL BUSINESS
HEALTH INSURANCE MARKETPLACE SURVIVAL GUIDE FOR SMALL BUSINESS New York edition NAVIGATING NEXT STEPS IN HEALTH CARE REFORM PAGE 2 www.discovermvp.com There s a constant stream of changes and updates related
More informationThe New Healthcare Law and Its Impact on Small Business
U. S. Small Business Administration Washington Metropolitan Area District Office The New Healthcare Law and Its Impact on Small Business Julie C. Verratti Advisor U.S. Small Business Administration Julie.Verratti@sba.gov
More informationThe Affordable Care Act: Health Coverage Options & Considerations in 2014
The Affordable Care Act: Health Coverage Options & Considerations in 2014 J A C K S O N V I L L E A R E A C H A M B E R O F C O M M E R C E A U G U S T 2 7, 2 0 1 3 L A U R A M I N Z E R E X E C U T I
More informationHEALTH INSURANCE MARKETPLACE SURVIVAL GUIDE FOR SMALL BUSINESS. Vermont Edition
HEALTH INSURANCE MARKETPLACE SURVIVAL GUIDE FOR SMALL BUSINESS Vermont Edition NAVIGATING NEXT STEPS IN HEALTH CARE REFORM There s a constant stream of changes and updates related to health care reform,
More informationHEALTH BENEFIT EXCHANGE SURVIVAL GUIDE FOR SMALL BUSINESS. New York Edition
HEALTH BENEFIT EXCHANGE SURVIVAL GUIDE FOR SMALL BUSINESS New York Edition NAVIGATING NEXT STEPS IN HEALTH CARE REFORM PAGE 2 www.discovermvp.com There s a constant stream of changes and updates related
More informationAn Employer s Guide to Health Care Reform
An Employer s Guide to Health Care Reform Important details to navigate employer-provided benefits amidst a changing health care landscape. PAGE 1 Navigating a new health care landscape Health care reform,
More informationThe Healthcare Law April 19, 2010
The Healthcare Law April 19, 2010 This healthcare bill, recently made law, is a comprehensive overhaul that increases coverage to 94% of Americans and makes sweeping changes to our current healthcare system.
More informationLegislative Brief: COMPREHENSIVE HEALTH COVERAGE ESSENTIAL HEALTH BENEFITS PACKAGE
Laurus Strategies Legislative Brief: COMPREHENSIVE HEALTH COVERAGE ESSENTIAL HEALTH BENEFITS PACKAGE The Affordable Care Act (ACA) requires non grandfathered health insurance plans in the individual and
More informationHEALTH INSURANCE EXCHANGE FAQS
HEALTH INSURANCE EXCHANGE FAQS 0 TABLE OF CONTENTS INTRODUCTION... 1 BACKGROUND... 1 HEALTH INSURANCE EXCHANGE FAQS... 1 1 INTRODUCTION IN EARLY 2010, CONGRESS PASSED THE PATIENT PROTECTION AND AFFORDABLE
More informationThe Affordable Care Act:
The Affordable Care Act: An Update on the Employer Mandate William A. Dombi, Esq. MARCH ON WASHINGTON Conference & Exposition March 24, 2014 Health Care Reform Framework Health insurance reforms Expanded
More informationIt goes by many names: Patient Protection and Affordable Care Act (PPACA) or ACA or Obama Care or simply Healthcare Reform.
WHAT IS HEALTHCARE REFORM? Healthcare Reform (HCR) is a law passed by Congress that provides many different requirements. A very important aspect of the law is that it is designed to provide individuals
More informationAmerican Health Benefit Exchanges Fact Sheet A Provision of the Patient Protection and Affordable Care Act (PPACA)
American Health Benefit Exchanges Fact Sheet A Provision of the Patient Protection and Affordable Care Act (PPACA) This Fact Sheet reflects the Final Ruling published by the Department of Health and Human
More informationThe Vermont Health Benefit Exchange: An Update
The Vermont Health Benefit Exchange: An Update Today s Discussion Health Reform Goals & Timeline Overview of Health Care Reform What is the Exchange? What Does the Exchange Look Like? Plan Design Enrollment
More informationState of Wisconsin / OFFICE OF THE COMMISSIONER OF INSURANCE
State of Wisconsin / OFFICE OF THE COMMISSIONER OF INSURANCE Scott Walker, Governor Theodore K. Nickel, Commissioner Wisconsin.gov 125 South Webster Street P.O. Box 7873 Madison, Wisconsin 53707-7873 Phone:
More informationPresentation for Licensed Producers The Affordable Care Act
Presentation for Licensed Producers The Affordable Care Act Bruce Donaldson, CHC Producer & Stakeholder Specialist Arkansas Insurance Department Affordable Care Act The ACA was passed by Congress and signed
More informationAffordable Care Act Resource Guide
Affordable Care Act Resource Guide for Businesses with fewer than 50 employees Effective October 29, 2015 Form No. 3-1018 (11-15) The information in this document is a general overview of the rules, regulations
More informationHealthcare Reform: Preparing Your Practice For Implementation of the. HMWC Healthcare Education Leadership Program. Affordable Care Act (ACA)
Healthcare Reform: Preparing Your Practice For Implementation of the HMWC Healthcare Education Leadership Program Affordable Care Act (ACA) September 12, 2013 Main Provisions Signed into law on March 23,
More informationPresented by South Dakota Community Action Partnership
Presented by South Dakota Community Action Partnership The project described was supported by Funding Opportunity Number CA-NAV-13-001 from the U.S Department of Health and Human Services, Centers for
More informationNebraska Health Insurance Exchange Update
Nebraska Health Insurance Exchange Update Overview of the Affordable Care Act and the Federally Facilitated marketplace. September 2015 AFFORDABLE CARE ACT OVERVIEW» The Affordable Care Act was enacted
More informationA Consumer s Guide to the Affordable Care Act
A Consumer s Guide to the Affordable Care Act The Affordable Care Act was designed to help make health care affordable for everyone. This guide will help you understand how the ACA affects individuals
More informationHealth 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 informationHealth 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 informationThe Affordable Care Act: What Does it Mean for Individuals and Families?
The Affordable Care Act: What Does it Mean for Individuals and Families? FIRM Team Fact Sheet 13-04 Available at http://www.firm.msue.msu.edu David B. Schweikhardt Adam J. Kantrovich Brenda R. Long Michigan
More informationOne of the more visible changes soon to be brought MONTANA S HEALTH INSURANCE A PREVIEW OF MARKETPLACE
A PREVIEW OF MONTANA S HEALTH INSURANCE MARKETPLACE by Gregg Davis and Christina Goe One of the more visible changes soon to be brought to the forefront by passage of the Affordable Care Act (ACA) is the
More informationState Based Exchange - How to Qualify For a FTE
Presented by: Kevin Kuhlman National Federation of Independent Business State Decision Update Small Employer Responsibilities Individual Mandate Individual and Small Business Exchanges Affordable Coverage
More informationDavid Lyons Founding Director and Chief Executive Officer
The New Health Insurance Marketplace Changes Impacting Small Employers and the SHOP Opportunity David Lyons Founding Director and Chief Executive Officer CoOportunity Health 10/1/2013 1 Why the Change?
More informationNevada Employer s Guide to the Affordable Care Act. Nevada Division of Insurance
Nevada Employer s Guide to the Affordable Care Act Nevada Division of Insurance Nevada Employer s Guide to the Affordable Care Act State of Nevada Department of Business and Industry Division of Insurance
More informationState of Wisconsin / OFFICE OF THE COMMISSIONER OF INSURANCE
State of Wisconsin / OFFICE OF THE COMMISSIONER OF INSURANCE Scott Walker, Governor Theodore K. Nickel, Commissioner Wisconsin.gov 125 South Webster Street P.O. Box 7873 Madison, Wisconsin 53707-7873 Phone:
More informationState of Wisconsin / OFFICE OF THE COMMISSIONER OF INSURANCE
State of Wisconsin / OFFICE OF THE COMMISSIONER OF INSURANCE Scott Walker, Governor Theodore K. Nickel, Commissioner Wisconsin.gov 125 South Webster Street P.O. Box 7873 Madison, Wisconsin 53707-7873 Phone:
More informationUnderstanding Self-Funded Concepts In Light of Health Care Reform
Understanding Self-Funded Concepts In Light of Health Care Reform Benefit Advisors Network August 21, 2013 Stacy H. Barrow sbarrow@proskauer.com Agenda Overview Differences between self-funded and fully
More informationHow To Prepare A Health Care Plan For A Job Interview
Health Care Reform 2013 & 2014 Planning Employers should review the fast-approaching 2013 and 2014 health care reform requirements. State Exchanges will be opening enrollment as soon as October 1, 2013
More informationHealthcare Reform Update. as of February 15, 2013
Healthcare Reform Update as of February 15, 2013 March 23, 2010: Patient Protection and Affordable Care Act (PPACA aka ACA) signed into law Underlying goals of PPACA: Expand access to healthcare Make healthcare
More informationHow the Affordable Care Act Affects Medical Support Orders in Oklahoma Frequently Asked Questions Spring, 2014 1
How the Affordable Care Act Affects Medical Support Orders in Oklahoma Frequently Asked Questions Spring, 2014 1 General 1. Did Oklahoma expand Medicaid? No, Oklahoma did not expand Medicaid. 2. Who is
More informationHealth 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 information5Want to know more about the health
www. WHAT S INSIDE STEPS TO UNDERSTANDING OBAMACARE Introduction 4 Step 1 Does your current health insurance plan need to change? 6 Step 2 How will you pay for health insurance in 2014? 10 Step 3 What
More informationCountdown to 2014: HEALTH CARE REFORM WHAT YOU NEED TO KNOW
Countdown to 2014: HEALTH CARE REFORM WHAT YOU NEED TO KNOW Coordinated by: -The Affordable Care Act- -Employer Notification- Monday, September 9, 2013 Registration 8:15 a.m. 8:45 a.m. Welcome 8:45 a.m.
More informationHealth Care Reform Checklist: Provisions, Obstacles and Solutions
Health Care Reform Checklist: Provisions, Obstacles and Solutions HEALTH CARE REFORM PROVISION: COVERAGE FOR CHILDREN UNTIL AGE 26 Summary of Benefit: Benefits are the same as those for other dependent
More informationParker, Smith & Feek - ACA Update: 2014 November 2013
Affordable Care Act (ACA) Background Core of law is an attempt to reduce # of uninsured Multiple approaches to expanding insurance coverage Requires most in US to have health insurance Creates state-based
More informationHow ACA is Changing Employer Health Benefits and the Marketplace Presented by:
North Carolina State Health Plan How ACA is Changing Employer Health Benefits and the Marketplace Presented by: J. Richard Johnson Senior Vice President, Public Sector Health Practice Leader rjohnson@segalco.com
More informationPPACA/Healthcare Reform CHANGES
PPACA/Healthcare Reform CHANGES beginning in 2014 for small employers A guide to understanding the administrative provisions, benefit changes, new taxes and credits, market reforms and purchasing options
More informationPresented by Marianne Fazen, PhD. Texas Business Group on Health
1 Presented by Marianne Fazen, PhD President & CEO Texas Business Group on Health June 20, 2013 A state-wide coalition of Texas employers committed to maintaining a market-based healthcare system that
More informationThe Health Benefit Exchange and the Commercial Insurance Market
The Health Benefit Exchange and the Commercial Insurance Market Overview The federal health care reform law directs states to set up health insurance marketplaces, called Health Benefit Exchanges, that
More informationHealth 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 informationIntroduction to the New Health Care Laws Michelle Walker, Rocky Mountain Health Plans January 14, 2015
Introduction to the New Health Care Laws Michelle Walker, Rocky Mountain Health Plans January 14, 2015 Agenda Basics of Health Care Reform Changes in Individual Healthcare Coverage Mandates Affordability
More informationState of Wisconsin / OFFICE OF THE COMMISSIONER OF INSURANCE
State of Wisconsin / OFFICE OF THE COMMISSIONER OF INSURANCE Scott Walker, Governor Theodore K. Nickel, Commissioner Wisconsin.gov 125 South Webster Street P.O. Box 7873 Madison, Wisconsin 53707-7873 Phone:
More informationAffordable 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 informationQ. My company already offers employee health coverage, how does the law impact me?
Frequently Asked Questions Q. Will my business be required to provide employee health insurance under the health care law? A. The law does not mandate employers provide employees health care coverage.
More informationBasics 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 informationKansas Insurance Department
Kansas Insurance Department A Kansas Guide to Health Insurance Changes Public Policy Session Panel Discussion KAMU Annual Conference Sept. 26, 2013 Sandy Praeger, Commissioner of Insurance 2014 Affordable
More informationThe Small Business Guide to Health Care Law
The Small Business Guide to Health Care Law How new changes in health care law will affect you and your employees Table of Contents Introduction 3 Part I: A General Overview of Health Care Law 4 The Affects
More information