Benefits: Health Care Reform

Health Care Reform

What It Means to My BusinessPresented by: eESI

Ken BargeShannon Schumacher

•What is Health Care Reform?•Why was Health Care Reform passed?•Where are we now?•What’s up next? •Questions for my business?•What can I do?

Benefits: Health Care Reform

What is Health Care Reform?

• Patient Protection and Affordable Care Act (PPACA) – Signed by President

Obama March 23, 2010

• Health Care and Education Reconciliation Act of 2010– Signed by President

Obama March 30, 2010

– Amends PPACA provision and adds new provisions

Benefits: Health Care Reform

• Provide Broader Coverage for Americans– Implementing a health exchange program

– Implement employer and individual mandates

• Increase Level of Care – Removing annual and lifetime limitations

– Removing pre-existing limitations

• Control Costs– Minimum loss ratios

– Provide new regulations and policies

Was Reform a Necessity or Political?

Why was Health Care Reform passed?

Benefits: Health Care Reform

Where Are We Now?Benefits: Health Care Reform

• Expansion of preventative services • Dependants coverage up to age 26• No pre–existing conditions for children

under the age of 19• Changes to lifetime maximum benefits

and annual limits• Expansion of non-discrimination

requirements• Annual rebates on fully insured plans• Elimination of FSA reimbursements for

over-the-counter drugs• Small employer tax credits• Waiting periods no longer than 90 days• Coverage appeals• Grandfather plans • High risk pools

Where Are We Now?Benefits: Health Care Reform

• Enforcement delayed on 105 (h) non-discrimination rules for all fully insured non-grandfathered plans– IRS solicited comments in March– Guidance expected later this year

• W2 Reporting made optional for 2011– New guidance issued March 29 for 2012– Relief for smaller employers (those filing

fewer than 250 W-2 forms) by making this requirement optional for them at least for 2012 and possibly longer (till more guidance is issued)

– For larger employers - includes information on how to report, what coverage to include and how to determine the cost of the coverage

• 1099 Reporting requirements repealed• Employee Free Choice Voucher Program

eliminated• Most of the funding for Cooperative

Plans eliminated

What Up Next?• 2012

– Form W-2 reporting– Uniform summary of benefits

• 2013– Increase in medical

deduction – Medicare tax on High Income

earners/Self Employed/Unearned income

– Premium Tax-Research– Flexible spending

arrangement maximum imposed ($2500)

– Notice of insurance exchanges due to employees

Benefits: Health Care Reform

• The Big 2014– Individual health insurance mandate fine 1%

– Employer Mandate 50+(less than 50 exempted)

– Small employer tax credit increased to 50% (less than 25)

– Auto enrollment for companies with 200+ employees

– Waiting period greater than 90 days eliminated

– Pre existing conditions eliminated

– Premium assistance credit

– Insurance exchanges begin

– Penalties and vouchers for unaffordable insurance

• 2015-2017– Large employers now eligible for health insurance exchanges

– Increase on medical deduction threshold for tax payers 65+

What Up Next?

Benefits: Health Care Reform

Questions For My Business

• Can I anticipate health care costs to increase at a smaller percentage?

• Should I prepare for government health care system?• Should I offer health insurance in the future?• How will the exchanges work? • Why and How do I need to pay attention?

Benefits: Health Care Reform

• Pray

• Take Action– Education

– Wellness

– Change in Philosophy

What Can I Do?

Benefits: Health Care Reform

• Education– Review key components of the Act

• Keep up-to-date

– Work with subject matter experts

– Health Insurance Exchanges• How do you manage risks

• Rates may look attractive

• Will this work for my Company?

What Can I Do?

Benefits: Health Care Reform

• Wellness – Government tried but fell a little short

– Health Conditions• According to BCBS of TX 5 most expensive medical conditions

– Heart Disease, Ortho-Back, Renal Failure, Hypertension, Diabetes

• Among minority groups two major health concerns – Hypertension & Diabetes

• For every pound of weight that you lose, it removes 3 pounds of pressure off your knees and back.

– Benefits of Wellness• Increase productivity

• Reduce absenteeism

• Reduce health insurance rates

What Can I Do?

Benefits: Health Care Reform

• Change in Philosophy – Understand

• Consumer Driven Health Plans

• Employees have skin in the game

• Work with subject matter experts – Understand how your plan works

– Deductibles, Out of pocket maximums, HSA’s Gap Products, Supplemental Insurance Products

– Pay Penalty vs. Offering Health insurance?• 30% of companies are considering canceling insurance

plans

• Penalties less than the offering health Insurance– AT&T – 2.4 billion to offer insurance vs. 600 million penalty.

– Chance employees will leave to other companies

What Can I Do?

Benefits: Health Care Reform

• Updates – Subject matter experts

• Take action– Education

– Philosophical changes

– Wellness

Overview

Benefits: Health Care Reform

Questions?

Benefits: Health Care Reform

Contact Information

Benefits: Health Care Reform

Web: www.eesipeo.com/peopletalk_eevents

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Twitter: @eESI_Talk

Thank you to the North Chamber, members and guest

for the opportunity to participate in the

Small Business How 2 Series.