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Healthcare Reform 2012

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  • Good Morning. And Thank you for starting your day with Me to discuss this rather hot topic Health Care Reform. I would imagine that many of you have heard quite a bit about HCR It is all over the news. There are quite a few articles written in regards to this topic. Before we get started. I want to let you know what I hope to accomplish during the meeting. I hope this discussion encourages you to think proactively rather than reactively. I hope that this discussion provides you with insight to a few points that in my eyes have not been thoroughly addressed. And lastly I hope that you walk away more knowledgeable than when you walked in. If we can accomplish this in 20 or so minutes then I believe that this would be a success. Let me introduce a few individuals in the audience First I would like to introduce our CEO Terry Hookstra. Also in attendance Marketing Director Corey Hookstra, Shannon Schumacher Benefits manager, and Myself Ken Barge
  • Lets discuss what we will discuss in detail today
  • Health Care Reform law is broken up into two parts On March 23, 2010, President Obama signed H.R. 3590, the Patient Protection and Affordable Care Act and on March 30, 2010, H.R. 4872, the Health Care and Education Affordability Reconciliation Act of 2010 , a companion package of "fixes" to H.R. 3590, was signed into law. Taken together, the two measures make the most profound changes to our country's private-market health care system in 50 years. Makes significant statutory changes affecting the regulation of and payment for many types of private health insurance – many insurance market reforms Will require almost all private sector employers to evaluate the health benefits they currently offer and consider whether they are compliant For those without access to employer coverage, new individual mandate to purchase and maintain minimum coverage Focuses on insurance market reforms and subsidies – does not really address the true cost of health care Bulk of the reforms take effect in 2014, but there are still many aspects of the law employers need to be cognizant of between now and then
  • Grandfathered Plans Take Effect Small Business Tax Credits Federal High Risk Pool Federal Retirement Reinsurance Program Federal Premium Rate Oversight Sept. 23 rd Reforms for All Plans-- Dependent Coverage to Age 26, No Preexisting Condition Limitations for Children, Rescission Restrictions, Annual and Lifetime Limit Restrictions Sept. 23 rd Reforms for Non-Grandfathered Plans--Preventive Care, 105h Nondiscrimination ( enforcement delayed) , New coverage appeals process requirements FSAs/HRAs/HSAs — OTC drugs not allowed without Rx HSA distribution tax increases Simple cafeteria plan rules Medical Loss Ratio requirements begin. Small business wellness grants should be made available, but have not been yet
  • Grandfathered Plans Take Effect Small Business Tax Credits Federal High Risk Pool Federal Retirement Reinsurance Program Federal Premium Rate Oversight Sept. 23 rd Reforms for All Plans-- Dependent Coverage to Age 26, No Preexisting Condition Limitations for Children, Rescission Restrictions, Annual and Lifetime Limit Restrictions Sept. 23 rd Reforms for Non-Grandfathered Plans--Preventive Care, 105h Nondiscrimination ( enforcement delayed) , New coverage appeals process requirements FSAs/HRAs/HSAs — OTC drugs not allowed without Rx HSA distribution tax increases Simple cafeteria plan rules Medical Loss Ratio requirements begin. Small business wellness grants should be made available, but have not been yet
  • New longer Summary Plan Description requirements (60 day notice of material change) New quality reporting requirements (to HHS and beneficiaries) for all employer plans and all individual and group carriers Delayed W2 Reporting begins (requirement is optional for employers who issue less than 250 W2s until further notice) CLASS Act options for the new national long-term care program should be announced by HHS. Participating employers must auto-enroll employees Employers whose carrier did not meet MLR standards may receive a rebate. Carriers responsible for ensuring that any rebate is shared with employees based on employer-contribution standards. New Medicare Taxes on unearned income and higher income employees and self-employed FSA contributions capped at $2,500 New federal premium tax on fully insured and self-insured group health plans to fund comparative effectiveness research program begins. It imposes an annual fee on private insurance plans equal to two dollars for each individual covered. Exchange notification requirements for employers
  • Let me discuss
  • Health Care Costs are Increasing According to a recent survey done by the Lockton Group Since
  • Yes please pray for our nation and our leaders. That they will make wise decisions. Whether you like them or not we have people in power who truly need our prayer for this topic and many others But also we need to take action Through Education, Wellness and Change in Philosophy
  • Know time lines There are many websites that will offer timelines if you send me an email I should have one I can send to you. Or better yet work with Subject matter experts. These individuals will provide the understanding that you need to naviagate through all of the regulation On topic I want to discuss briefly are the exchanged. Many are concerned about the exchanges and how they will work. Well I wlll tell you that I have seem mixed reports however in a nut shell. Individuals, small employerrs and some larger employers in 2017 will be eligible to enter into an insurance pool set up by the state. Now Some have said that the rates hawill increase where as other say that the rates will decrease. Most importantly how will we manage the losses. Again the rates wildo nothing but increase if you have no remedy to manage your risks, how can you maitian the costs. It is nearly impossible. In our industry you find the successful companies are able to manage their costs better typically can survive. In this instance how can we manager our costs.? That’s this issue I believe one area we are truly missing in this whole equation is
  • Govt tried by implementing preventative measures but fell a little short In my opinion instead of placing a bandaid over a injury, one needs to treat it. For example if you look at the screen 5 most expensive health conditions Now some of these have to deal with the issues
  • Defined narrowly, consumer driven health care (CDHC) refers to third tier health insurance plans that allow members to use personal Health Savings Accounts (HSAs), Health Reimbursement Arrangements (HRAs), or similar medical payment products to pay routine health care expenses directly, while a high-deductible health insurance policy protects them from catastrophic medical expenses. High-deductible policies cost less, but the user pays routine medical claims using a pre-funded spending account, often with a special debit card provided by a bank or insurance plan. If the balance on this account runs out, the user then pays claims just like under a regular deductible Employees have skin in the Game Insurance low deductibles was the key Employers paid 100% of the premium Should insurance costs increase er’s need to have ee’e aclamated to rising costs Subject matter experts Agents- typically may be reducing moving to a fee structure Hr Consultants PEO’s companies like ours work to not only formulate, educate comply with regulation Pay penalty vs Offering Health insurance Studies show that nearly 30% o companies are considering canceling their plans why, less expensive Infact companies such as ATT, John Deere and Verizon considered would save quite a bit ATT pays 2.4 offer 600 million to pay penaltys Not positive, as not good messaging to send to employees employees may move to other companies
  • Provide overview
  • Thank you again for listening. Should you have any additional questions, please feel free to contact me with any questions

Healthcare Reform 2012 Healthcare Reform 2012 Presentation Transcript

  • Benefits: Health Care Reform Health Care Reform What It Means to My Business Presented by: eESI Ken Barge Shannon 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?
    • 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
    Benefits: Health Care Reform
  • Where Are We Now?
    • 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
    Benefits: Health Care Reform
  • 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 Facebook: www.facebook.com/eEmployersSolutions LinkedIn: www.linkedin.com/company/eesi---eemployers-solutions-inc Twitter: @eESI_Talk Thank you to the North Chamber, members and guest for the opportunity to participate in the Small Business How 2 Series.