Your SlideShare is downloading. ×
0
BACC Ohio - Healthcare Reform Presentation 2013
BACC Ohio - Healthcare Reform Presentation 2013
BACC Ohio - Healthcare Reform Presentation 2013
BACC Ohio - Healthcare Reform Presentation 2013
BACC Ohio - Healthcare Reform Presentation 2013
BACC Ohio - Healthcare Reform Presentation 2013
BACC Ohio - Healthcare Reform Presentation 2013
BACC Ohio - Healthcare Reform Presentation 2013
BACC Ohio - Healthcare Reform Presentation 2013
BACC Ohio - Healthcare Reform Presentation 2013
BACC Ohio - Healthcare Reform Presentation 2013
BACC Ohio - Healthcare Reform Presentation 2013
BACC Ohio - Healthcare Reform Presentation 2013
BACC Ohio - Healthcare Reform Presentation 2013
BACC Ohio - Healthcare Reform Presentation 2013
BACC Ohio - Healthcare Reform Presentation 2013
BACC Ohio - Healthcare Reform Presentation 2013
BACC Ohio - Healthcare Reform Presentation 2013
BACC Ohio - Healthcare Reform Presentation 2013
BACC Ohio - Healthcare Reform Presentation 2013
BACC Ohio - Healthcare Reform Presentation 2013
BACC Ohio - Healthcare Reform Presentation 2013
BACC Ohio - Healthcare Reform Presentation 2013
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×
Saving this for later? Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime – even offline.
Text the download link to your phone
Standard text messaging rates apply

BACC Ohio - Healthcare Reform Presentation 2013

183

Published on

A presentation by the insurance brokerage of Brooker Insurance Agency on the Affordable Care Act 2010 and its effects and implementation, given to the British American Chamber of Commerce Ohio in …

A presentation by the insurance brokerage of Brooker Insurance Agency on the Affordable Care Act 2010 and its effects and implementation, given to the British American Chamber of Commerce Ohio in October 2013.

Reproduced and published by kind permission of Brooker Insurance Agency

For more information, please visit www.baccohio.org

Published in: Business, Economy & Finance
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total Views
183
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
0
Comments
0
Likes
0
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide

Transcript

  • 1. The Hitchhiker’s Guide to Obamacare Jamie Debenham October 25, 2013
  • 2. AGENDA • Individuals • Small Employers EE’s < 50 • Large Employers EE’s > 50 • Q & A Jamie Debenham October 25, 2013
  • 3. INDIVIDUALS Federal Mandate: All Citizens and Legal Residents must purchase health insurance by January 1, 2014 or be subject to a fine. Jamie Debenham October 25, 2013
  • 4. INDIVIDUALS Consequences for Non Compliance • If individual health insurance NOT purchased by January 1, 2014, fine imposed: • 2014: $95 per adult/$47.50 per child, up to $285 for a family or 1% of family income, whichever is greater. • 2015: $325 per adult/$162.50 per child, up to $975 for a family or 2% of family income, whichever is greater. • 2016 and beyond: $695 per adult/$347.50 per child up to $2,085 for a family or 2.5% of family income. Jamie Debenham October 25, 2013
  • 5. INDIVIDUALS Public Exchange (“Marketplace”) •Subsidy • available to those who qualify Family with income between 133%-400% of FPL (Federal Poverty Level), will qualify for subsidy on a sliding scale basis. Private Exchange • Offered through private insurance companies • • More choices and coverage options available than public exchange Subsidy not available through private exchange Jamie Debenham October 25, 2013
  • 6. INDIVIDUALS Important Dates: October 1, 2013 – Open Enrollment Starts January 1, 2014 – Individual Mandate Effective March 31, 2014 – Open Enrollment Closes Jamie Debenham October 25, 2013
  • 7. SMALL EMPLOYERS Under 50 FTE’s Full-time Equivalents (FTE’s) – All full-time employees and all part-time employees (including seasonal employees) who are not full-time employees are included in the calculation. Jamie Debenham October 25, 2013
  • 8. SMALL EMPLOYERS •Subject to “Community Rating” Beginning with Renewals after January 2014 •Cost Control Strategy Early Renewal prior to January 2014 Jamie Debenham October 25, 2013
  • 9. SMALL EMPLOYERS Purchasing Options for Small Group Health Insurance Access to SHOP (Small Business Health Options Program) • • Full implementation of SHOP delayed until 2015 SHOP opens October 1st with limited offerings (for January 2014 Renewals) Direct Purchase through Carriers • Subject to “Community Rating” with renewals after January 2014 Jamie Debenham October 25, 2013
  • 10. SMALL EMPLOYERS Dependent Coverage Available Until Age 28 •Age 26 – Federal Mandate •Age 28- State (Ohio) Mandate * Note – coverage for dependents between ages 26 and 28 (Ohio mandate) will be different than for dependents ages up to 26 (Federal Mandate) Jamie Debenham October 25, 2013
  • 11. SMALL EMPLOYERS New Fees Associated with Health Insurance Premiums • PCORI Fee (Patient Centered Outcomes Research Institute) 2013 • 2018 $2.00 x Avg. Number of Employees 2013 2016 $63 Annual Fee Per Employee ($5.25 per Month per Employee) Re-Insurance Fee Market Share Fee Based on Market Share of Insurer Jamie Debenham October 25, 2013
  • 12. SMALL EMPLOYERS Preventative Services Covered at 100% * * Excludes “grandfathered” plans until January 2014 Jamie Debenham October 25, 2013
  • 13. SMALL EMPLOYERS Small Business Health Care Tax Credit is Available to Certain Qualifying Businesses • Employer with < or = 25 Employees • Employer with < $50,000 average Employee wage Jamie Debenham October 25, 2013
  • 14. SMALL EMPLOYERS SBC (Summary of Benefits Coverage) •Must be given to each eligible Employee within 30 days of renewal or date of hire Exchange Notice •Must be given to every Employee by October 1, 2013 or within 14 days of hire Jamie Debenham October 25, 2013
  • 15. SMALL EMPLOYERS Consequences of Non-Compliance • Individual Employees must seek coverage elsewhere or pay penalty under Federal Individual Mandate • Currently no financial consequences at this time for Employer who chooses to not offer health benefits to employees (but may suffer retention consequences and lose good employees) Jamie Debenham October 25, 2013
  • 16. LARGE EMPLOYERS Large Group = 50+ FTE’s What is an FTE? Full Time Equivalent – all full time Employees plus all part-time employees (including seasonal employees) are included in the calculation. Jamie Debenham October 25, 2013
  • 17. LARGE EMPLOYERS Federal Mandate: (Delayed Until 1/2015) Large Group Plan offering: • Must Provide “Minimum Essential Coverage” • • Minimum of 60% actuarial value Must Be “Affordable” • Cannot charge more than 9.5% of Family Income for Single Coverage Health Insurance • Safe Harbor - No more than 9.5% of Employee’s W-2 income must go toward cost of single coverage Health Insurance Jamie Debenham October 25, 2013
  • 18. LARGE EMPLOYERS W-2 Reporting Requirement Beginning with the Calendar Year 2012 W-2 Forms, Employers with more than 250 W-2 Filings for proceeding year must report cost of the benefits provided on each Employee’s W-2 Jamie Debenham October 25, 2013
  • 19. LARGE EMPLOYERS Consequences of Non Compliance If Employer Does Not Offer Health Insurance: • If Employee goes to Public Exchange and qualifies for federal subsidy, a $2,000 fine per FTE is assessed (minus the first 30 FTE’s) • Example: Company ABC with 100 FTE’s does not offer health insurance. Employee X goes to Public Exchange and qualifies for subsidy on health insurance purchased. Fine levied is: $2,000 x (100-30) = $140,000 Jamie Debenham October 25, 2013
  • 20. LARGE EMPLOYERS Consequences of Non Compliance If Employer offers Health Insurance but Plan does not comply with mandate standards of “Minimum Essential Coverage” or “Affordable”: • If Employee goes to Public Exchange and qualifies for federal subsidy, a $3,000 fine per FTE is assessed • Example: Company ABC with 100 FTE’s offers non-qualifying health insurance. Ten Employees go to Public Exchange and qualifies for Subsidies on health insurance purchased. Fine levied is: $3,000 x (10) = $30,000 Jamie Debenham October 25, 2013
  • 21. LARGE EMPLOYERS Important Dates January 1, 2012 Employer must provide a SBC (Summary of Benefits Coverage) to all Employees at renewal. October 1, 2013 Employer must provide all Employees (and new hires) with an electronic or printed copy of Marketplace Notice. Jamie Debenham October 25, 2013
  • 22. Questions? Jamie Debenham October 25, 2013
  • 23. Thank you! Jamie Debenham October 25, 2013

×