Offering Attractive Employer Provided Health …...Restaurant with 40 employees Advantages of...
Transcript of Offering Attractive Employer Provided Health …...Restaurant with 40 employees Advantages of...
Copyright Gravie 2015
Offering Attractive Employer
Provided Health Benefits
in This Changing Environment
Presented by First Franchise Capital and
Michael Haffey - Sales Leadership - Gravie
Today’s Presenter:
Michael Haffey
Michael has helped employers of all sizes for
over 25 years find the best solutions to provide
health coverage for their employees.
His roles include founder and principal of
successful insurance agencies and leadership
for a top national independent brokerage firm.
He and the team at Gravie are assisting
employers in providing innovative health plan
solutions that:
• control spend
• provide more choice
• eliminate hassles
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Today’s Agenda
• Review the options available for providing
a health plan today
• What might the future hold – The AHCA
• Review real success stories - 3 Case studies
• A new option – the Small Employer HRA
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• What are my options other than group health insurance if it
really doesn’t work for my business?
• How can we mitigate or eliminate the employer mandate
penalties and will they be around in the future?
• How can we help our employees access subsidies and/or
tax friendly employer provided dollars to buy individual
health insurance plans?
• How does a defined contribution health plan work?
Some of the questions we will answer…
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How are employees offering
health benefits?
Traditional Group Health Insurance Model Common approach for many employers where the executive team works with an advisor to
determine the plans that will be offered as well as the premium price point for the employees.
Employees then opt in or waive coverage during their enrollment.
TODAY’S ENVIRONMENT
PERCENT OF PRIVATE-
SECTOR ESTABLISHMENTS
THAT OFFER HEALTH
INSURANCE
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Legislative update as of 5-8-2017Now that the House has passed the AHCA,
what might the future hold for employers?
• Eliminates the Employer and Individual Mandate Penalties
• Subsidies will continue
• Gives states more control in what is covered in health
plans, Essential Health Benefits
• Gives states a say in how to cover pre-existing conditions
Continuous Coverage rules
• Opens up HSA and FSA contributions
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What the ACA continues to provide
and most likely the AHCA…
1. Cover pre-existing conditions
2. Guarantee availability and renewability
3. Cover adult children up to age 26
4. Cap out-of-pocket expenditures
5. No health status underwriting
6. No lifetime and annual limits
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1. Fully Insured Group Health Plan
2. Partially Self-Funded Group Health Plan
3. Fully Insured Individual Market Health Plan
What are my options today to provide
competitive employer provided health benefits?
A. Provide a plan, you have 3 options:
B. Don’t provide a plan;1. < 50 EES no penalty, not so happy employees
2. > 50 EES pay the penalty or use a strategy
to mitigate or eliminate the penalty
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Case Study #1 –
Restaurant with 40 employees
Fact Pattern:• Currently providing a group plan
• Can't afford the premiums anymore • Can't meet the insurance companies participation requirements
• Just 10 of 40 employees on the plan
Solution:• Provide a Defined Contribution approach using the Individual market
private exchange
• Taxable and Discriminatory Contributions
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Case Study #1 –
Restaurant with 40 employees
Advantages of defined contribution health benefits:
• Employers set their own budget
• Employers get out of choosing one-size-fits-all group plans that fit few
employees’ needs
• Employees get more options than they would with traditional group
benefits and are able to choose benefits that fit their unique needs
• In some cases, employees may be eligible to receive tax credits, which
could lower the cost of benefits or use the new Small Employer Health
reimbursement Arrangement –HRA to provide tax friendly dollars
Defined Contribution Strategy
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Case Study #2 –
Home Health Agency with 200 full time
employees and 100 on their plan
Fact Pattern:• Currently providing a self funded group plan
• Can’t afford the claims cost anymore
• Want to offer a plan that allows them to provide more choice and control their spend
Solution:• Provide a Defined Contribution approach using the Individual market
private exchange
• Taxable and Discriminatory Contributions with a MEC – Minimum
Essential Coverage plan to reduce the employer mandate penalty
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Individual Market Case Study #2
FINANCIAL ANALYSIS DETAIL-197 Employees, PSF 15 years
Actual Enrollment Results
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When Given a Choice…
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The Value of Choice
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Case Study #3 –
56 Employee Hair Care Franchise
Fact Pattern:• Currently don't provide any form of a health benefit
• Would like to, but can't afford it
• Facing the employer mandate penalty for not offering a group plan
and can’t afford the penalty
Solution:• Offer a MEC plan – Minimum Essential Coverage to reduce penalties
• Offer key employees a defined contribution
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Case Study #3 –
56 Employee Hair Care Franchise
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A New Option – the SEHRA
Defined Contribution Individual market plan
Taxable or Tax friendly Employer dollars
Two options for providing employees with $$$:
1. Supplemental Wage – Taxable – Subsidies – Discriminate
2. Small Employer Health Reimbursement Arrangement
SEHRA - Tax Friendly - No Subsidies - Limited Discrimination
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21st Century Cures Act & Small Employer
HRA Passed into Law – December 13, 2016
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Beginning on January 1st 2017, a company with fewer than the
equivalent of 50 full-time employees can reimburse employees
for purchasing individual health insurance as if it were directly
paying the premiums on a group health policy: the employee
won’t have to pay taxes on the company’s premium
contribution, and the company won’t owe payroll taxes on it
either.
Qualified Small Employer Health Reimbursement
Arrangement
New Law Eases Small Business
Health Care Burden Forbes Dec 14, 2016
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QSEHRA - Qualified Small Employer Health
Reimbursement Arrangement 1-1-2017
• A new type of HRA that provides tax free benefits to Small Employers
<50 and does not offer a group plan
• To get the tax advantage, an employee must have an individual
market plan funded solely by the employer and they can be FT or PT
• No ERISA or Cobra requirements
• The contribution can vary by Family status or age and the 2017 Max
amounts are –
Single - $4950 annual or $412.50 monthly
Family - $10,000 annually or $833 .33 Monthly
• If the employer wants to provide dollar in excess of the limits, they
can – it is just taxable as normal income
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• 37,800 employers moved workers to an exchange
• 2.8 million employees signed up for benefits through one
of the online marketplaces
• 5.6 million people covered by benefit plans sold through
the sites
PBE Index enters 2017 with impressive numbers
Employee Benefit News February 2017
The Growth and Acceptance of the
Private Benefit Exchange
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What is GRAVIE?Provides next generation health plans combining
3 key ingredients:
1) A Private Marketplace for Health Plans
– Smart Technology
2) A New World Third Party Administrator
– A Complete Scope of Services
3) Human Involvement using GravieCare Member Advisors
and Account Managers
– Advocacy, support, guidance
Launched in November 2013
Founders also established
leading companies like
Bloom Health, RedBrick Health
and Definity Health
Over 1000 employers
representing 50,000+ employees
have registered on Gravie as their
health benefit.
Featured in:
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WHO IS GRAVIE?
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HOW IT WORKS.
You choose the dollar
amount to give each
employee
We check if your employees
are eligible for government
tax credits (and help them
apply if they are)
We help employees choose a
plan in the individual market
We provide year-round
service and health insurance
advice to all your employees
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How does Gravie Help Employers?
1. Control Spend – Defined Contribution
Next Generation Health Plan
2. Eliminate Hassles – New World Third Party
Administrator
3. Provide More Choice – Private Marketplace
(Exchange) for all Individual Health Plans
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THANK YOU!
Questions or comments?
Michael Haffey
317-714-8495