Learn how the Affordable Care Act will impact the future of health care for small businesses! Specifically, this presentation expores the future of insurance market reforms, small business tax credits and state health exchanges. Presentation by: Cindy Gillespie, Senior Managing Director, Washington, McKenna Long & Aldridge Jandel Allen-Davis, MD, Vice President of Government and External Relations, Kaiser Permanente

1. The Future of Health Care
for Small Businesses
Jandel Allen-Davis, MD, Vice President—Government and External Relations

2. McKenna Long & Aldridge LLP
Senior Managing Director
CINDY GILLESPIE

3. Agenda
 2014: What happens for your employees?
 2014: What are your options as a small business?
 The Question: How do you choose among those options?
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4. 2014: Your employees
* Assumes CO opts in to Medicaid expansion
** Tax-filing threshold
*** 138% FPL – Household MAGI
4 **** 400% FPL – Household MAGI

5. 2014: Different options for different size businesses…
Offer affordable insurance
More than 50 FTEs –
Employer Mandate
Don’t offer and pay penalty
Offer insurance
Less than 50 FTEs – “SHOP” for insurance in small employer
No Employer Mandate health options exchange
Don’t offer
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6. Three Key Pieces to the Penalty
 What businesses are subject to the penalty?
– Those with 50 or more FTEs (or equivalents)
 An FTE works 30 or more hours a week
 What kind of insurance must be offered to avoid a penalty?
– Minimum Essential Coverage
– Grandfathered plan
 How much must the employer contribute?
– Must be “affordable” for the employee
 Safe harbor:
– Lowest cost self-only plan is less than 9.5% of employee’s W-2 wage
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7. Option for Employers with Less than 50 FTEs: Shopping
in COHBE’s Small Employer Health Options Program
Registers On-Line or via
Call Center; provides info Determines Level of May Choose Defined
on the group Employee Choice Contribution
Employer
Goes on-line; provides
Comparison shops, SHOP Payroll and
individual info: Age,
Insurer
premium calculator, other HR Services
Residence, Tobacco
selects & enrolls in plan
use
Employees
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8. Key Questions for Employers
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9. Key Questions: Employers with <50 FTEs
9 * There are numerous complexities to be examined

10. Key Dates to Remember
 Election Day 2012
 November 16, 2012: States submit Exchange Blueprints
 January 1, 2013: States receive “go”/ “no go” from federal government
 October 2013: Open Enrollment begins
 January 1, 2014: Exchanges “go live”
Decision time for small businesses is approaching rapidly…
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11. Kaiser Permanente
Vice President of Government and External Relations
JANDEL ALLEN DAVIS, MD

12. Agenda Slide
Thoughts from small businesses
What you should know about care and coverage
2014 and the Colorado Health Exchange
Fourth Agenda
Fifth Agenda
12 September 19, 2012 | © 2011 Kaiser Foundation Health Plan, Inc.

13. What we heard
Thoughts from 300 Colorado small business owners…
 Study conducted with CO small business
Providing to owners with 2 – 50 employees
some employees
 300 phone interviews conducted by an
Not providing independent pollster
insurance
 Conducted May 7 – 31, 2012
Providing insurance  +/-6% at the 95% confidence level
Source: Text is 9pt Arial Narrow
13 September 19, 2012 | © 2011 Kaiser Foundation Health Plan, Inc. .

14. Increasing frustration
 We know, anecdotally, that small business
owners are feeling more and more
frustrated…
– Lack of clear information
14 September 19, 2012 | © 2011 Kaiser Foundation Health Plan, Inc. .

15. What you should know – Care and Coverage
Care Coverage
 Prevention is still key  Guarantee issue for
small businesses
 Quality of care
 Cost transparency and
accountability
15 September 19, 2012 | © 2011 Kaiser Foundation Health Plan, Inc. .

16. The Exchange and your business
Key benefits for you…
 Flexibility and choice
 Easily compare plan offerings
 Four tiers represent percentage of covered benefit paid:
– Platinum = 90%
– Gold = 80%
– Silver = 70%
– Bronze = 60%
16 September 19, 2012 | © 2011 Kaiser Foundation Health Plan, Inc. .

17. Small business tax credit – available now,
but many are unaware of how it works
 Tax credit outline
– Have low-wage workers (less than $50k average annual salary)
– Pay at least 50 percent of employees’ premium
– Employ no more than 25 full-time equivalent employees
– Through 2013, the credit equals 35 percent of the employer contribution
(25 percent for nonprofits).
– Beginning January 1, 2014 the credit rises to 50 percent of the employer
contribution (35 percent for nonprofits).
17 September 19, 2012 | © 2011 Kaiser Foundation Health Plan, Inc.

18. Thank you! Questions?
“Let’s talk about getting people
healthy. That’s something we can
all agree on.”
— Donna Lynne, DrPH, President,
Kaiser Foundation Health Plan of Colorado
18 September 19, 2012