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"Should I provide health insurance for my employees?" The process for determining the cost of providing health care benefits and the impact of health benefits an retaining and attracting ...

"Should I provide health insurance for my employees?" The process for determining the cost of providing health care benefits and the impact of health benefits an retaining and attracting best-in-class employees.

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Pay or Play? Pay or Play? Presentation Transcript

  • E D U C A T I O N S E R I E S
    Pay or Play?
    Date: August 10, 2010
    Presented by:
    Dominic Franchini
    Vice President Market Development, HORAN
    William Freedman
    Attorney, Dinsmore & Shohl
    Marty Howard, CPA
    Cassedy Schiller
  • Agenda - Pay or Play
    Define the regulation, employers affected and timeline
    Review the moving parts
    Model options and costs
    Identify tax consequences
    Discuss employer notification requirements
    Share other key points to consider
  • Regulation Highlights
    Beginning in 2014, individuals must maintain “minimum essential coverage” or pay a penalty
    Applicable large employers with 50 FTE’s may owe penalties
    Failure to offer “minimum essential” health coverage
    Offering “minimum essential” health coverage that is not affordable
    Full time employee = 30 hours or more per week
    Full time employees may be eligible to purchase coverage through exchange
    Full time employee may qualify for premium credit
  • Who is affected
    Businesses with 49 employees or less
    Exempt from pay or play mandates
    Businesses with 25 employees or less
    Exempt from pay or play mandates
    Eligible for tax incentives IF currently offering group health benefits
    Businesses with 50 or more employees
    Required to comply with pay or play mandates
  • Timelines
    Insurance as “usual” until 2014
    New discrimination rules
    New underwriting requirements
    W-2 reporting of 2011 benefits
    Small business tax credit 2010 - 2013
    Exchanges established by January 1, 2014
    Pay or Play begins January 1, 2014
  • Things to Consider
    How much does insurance cost my company today?
    How much would I pay in penalties?
    Is my benefit plan design compliant? Cost to change benefit design?
    Do I have employees a 100% to 400% federal poverty guideline?
    Is my contribution affordable for those employees?
    How much would penalty be for employees receiving assistance?
    How would employees purchase insurance outside employer? Cost?
  • For Example
  • 8
    Employer Notification
    Required notifications to employees (Not later than March 1, 2013)
    Existence of an Exchange, description of services, how to get assistance
    Employer plan’s share of total allowed cost is less than 60%, eligibility for premium tax credit
    Purchase of health plan through exchange, outside free choice voucher, may forfeit employer contribution and tax deduction
    Required notifications to Secretary of Treasury
    Name / Address / TIN # / months enrolled for all FTE
    Waiting period
    Months during year coverage is available
    Monthly premium for lowest cost option
    Employer’s share of total allowed cost
  • Common Considerations
    Divisions / Common ownership
    Cafeteria plan
    1099 employees
    Contributions defined as % income