The medicalinsuranceexchange.com Obamacare Update 11,05,13

326 views
205 views

Published on

Tired of political soundbites and opinions masquerading as news? Would you like to know What's REALLY going on in Texas about Obamacare. Would you like information that you can actually use to help you, your employees and your family decide what you should do, and when you should do it? Then you need to watch this presentation and call me, Michael Chapman, at (888)398-6246, or email me mtchapman@endeavorgroup.net, and let me help you make the best decision you can make and take action. I am a licensed, experienced and certified broker who will help you now and throughout the year with expert advice and support, and at no cost.

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

  • Be the first to like this

No Downloads
Views
Total views
326
On SlideShare
0
From Embeds
0
Number of Embeds
68
Actions
Shares
0
Downloads
4
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

The medicalinsuranceexchange.com Obamacare Update 11,05,13

  1. 1. ACA: The Great Equalizer for Small to Mid-Size Businesses (SMBs) New Strategies On How to Use ACA to: • Benefit your Business • Benefit Your Employees • Disadvantage Your (Bigger) Competitors. • And how to keep more of what you make! …Stuff your benefits consultant or broker doesn’t know or doesn’t want you to know!
  2. 2. ACA: The Great Equalizer for Small to Mid-Size Businesses (SMBs) Find some ACA “Easter” Eggs for your biz! …Stuff your benefits consultant or broker doesn’t know or doesn’t want you to know!
  3. 3. US History Lesson 1935: 1965: 1985: 2003: 2010: Social Security and Disability Created Medicare Created COBRA Created Medicare Prescription Drug “Part D” Created ACA (Obamacare) Created Each of Above was Controversial Each Required Education and Adjustment by Americans Each Bas Been Modified Through Legislation None Has Ever Been Repealed Each Quickly Became a “Right of Citizenship” 2014: ACA “Guaranteed Issue” Health Plans – History Repeats Itself!
  4. 4. “The Good Ship „Guaranteed Issue‟ Has Sailed” • ACA can’t be defunded without Senate vote to change ACA from a Mandatory to Discretionary Spending budget item. • Future changes likely, but “Guaranteed Issue” is here to stay
  5. 5. ACA Individual Plans: “Better” than Group Plans • Comprehensive, Essential Health Benefits in all ACA Plans: • Preventative, Wellness • Maternity, Child Dental, Vision • Serious mental, emotional, drug/alcohol abuse, tobacco cessation, obesity counseling.
  6. 6. Under Healthcare Reform, Are Benefits Still Beneficial? Why many employees will seek jobs that do NOT offer group health insurance starting in 2014, and how SMBs can benefit…
  7. 7. Under Healthcare Reform, Are Benefits Still Beneficial? Under ACA, Bigger ≠ Better • 2015 Employer Tax Penalties • More Compliance • More Legal, Administrative In Fact, Being Smaller May Be Better, More Profitable!
  8. 8. Under Healthcare Reform, Are Benefits Still Beneficial? “Benefit” of Getting Bigger: • Self-Insure = Lower Cost under ACA • • • Less Mandates, Taxes No Community Rating More Control Over Employee Health • 100+ (Healthy) Employees
  9. 9. A:
  10. 10. Why are they called “Benefits”? Because They Benefit the Employee. Four ways: 1. Employer Contribution – Nobody else is going to pay for their health insurance 2. Tax Free – Receive benefits tax free, pay their portion of premium tax free through 125 plan 3. Guaranteed Issue – Employees and dependents cannot be denied coverage or charged more due to medical conditions (big deal in Texas) 4. Mandated Benefits – Group plans cover services not covered by individual plans (i.e. maternity – although these benefits do drive up the costs)
  11. 11. Most of the “Benefits” are Gone The “Benefits” of a Group Health Plan Are Gone in 2014. 1. Employer Contribution – This now penalizes most employees (More about this later) 2. Tax Free – Receive benefits tax free, pay their portion of premiums tax free through 125 Cafeteria plan. 3. Guaranteed issue – Employees and dependents can no longer be denied coverage or charged more due to medical conditions with individual ACA plans 4. Mandated Benefits – Group plans cover services now covered by individual plans (i.e. maternity).
  12. 12. Factors will be: 1. 2. 3. Size of Business (# of Employees) Average Income of Employees Costs – Group Premium Vs. Penalty etc…
  13. 13. WHAT ARE BIG EMPLOYERS DOING ABOUT ACA? Reducing workforce Reducing hours to <30hrs/week Dropping coverage
  14. 14. WHAT ARE BIG EMPLOYERS DOING ABOUT ACA? Cutbacks = not a place you want to work Part-time/revolving door = mistakes & lost productivity Cost increases passed on to customers
  15. 15. Who Wants to Work at a BIG Company? Losing Advantage of Size and Scale Employer of Last Resort + No loyalty Lower profits, Customer satisfaction.
  16. 16. ACA advantages to SMBs SMBs can become an employer of choice Stable, personal SMB = customer, employee loyalty Lower employee cost, lower turnover, more talent
  17. 17. ACA Plan Rates: • • • • • • • • ACA Plan N. TX Premiums: Lowest cost PPO (Bronze) Plan for 40/50/60 yo: • $239.70/$354.22/$539.68 Lowest cost PPO (Silver) Plan for 40/50/60 yo: $341.04/$488.51/$736.04 Lowest cost PPO (Gold) Plan for 40/50/60 yo: $412.26/$590.52/$889.75 Lowest Cost HMO (Bronze) Plan for 40/50/60 yo: $189.72/$271.82/$409.46
  18. 18. How Dropping Group Health Benefits Helps “Most” Employees under ACA IRS Tax Subsidies are SMBs New Best Friend. (& Employees‟ New Best Friend.)
  19. 19. Household Size ~ Household Income ~ Annual Subsidy Here’s The Link to Subsidy Calculator: http://themedicalinsuranceexchange.com/oba macare-subsidy-calculator/
  20. 20. Dropping Group Health Benefits Helps “Most” Employees under ACA For “Most” Employees, An Employer Health Plan is NOT a Benefit under ACA! One Example: • Median for HH Family of 4: $60,000 – Employer Pays 50% of Employee Only Premium, $250 per month, $3,000/yr. – Est. Cost to Insure Family = $11,500/yr. – IRS Premium Tax Credit: $6,700
  21. 21. Big ACA “GOTCHA”: • If Either Spouse‟s Employer Offers a Group Health Plan for Employees… • Then Entire Household is Disqualified from IRS Premium Tax Credit!
  22. 22. Big ACA “GOTCHA”: • The $ from the IRS Premium Subsidy Likely More than What Employer Contributes for Health Insurance!
  23. 23. No Tax Subsidies if a Group Health Plan Available This Is Why Unions Are So Mad!
  24. 24. Your Company Key Employees “Experienced” Employees • Big Companies with Big, Self-Insured Health Plans Will Continue to Shed Older, Wiser Employees • BIG OPPORTUNITY FOR SMBs to pick up valuable talent without risk of medical claims hurting company‟s benefits.
  25. 25. What about your #1, And Most Valuable Employee?
  26. 26. What about your #1, Most Valuable Employee? YOU! Founder/CEO • If Dropping Group Health Insurance Saves Your Employees $$ and gives them better coverage options… • …What could dropping Group Health do to Benefit Your Business and Benefit YOU?
  27. 27. What about your #1, Most Valuable Employee? YOU! Founder/CEO How Dropping Group Health Ins. Can Benefit Your Business: • Reduces administrative time + red tape. • Eliminates your company’s biggest budget inflation item. • Frees up $$ for other uses in the business.
  28. 28. What about your #1, Most Valuable Employee? YOU! Founder/CEO How Dropping Group Health Ins. Can Benefit YOU: • Increase profitability & business valuation. • Fund a Max. Retirement /Profit Sharing Contribution • Fund ESOP to get your equity out of business.
  29. 29. Do the Math: Employer • SMB with 40 employees spends minimum of $120,000/yr. on group health insurance premiums • IF SMB makes 5% after tax profit, it takes $2,400,000 in extra sales just to pay for group health insurance.
  30. 30. Do the Math: Employee • SMB pays $3,000 towards per employee with avg. annual wages of $50,000. • Est. IRS Premium Subsidy of $6,500 for employee with family of 4. • The $3,500 extra from premium subsidy is an extra six weeks wages.
  31. 31. Do the Math: Self-Employed • Deductions reduce how much you pay in IRS Taxes. • Deductions could also increase your IRS Insurance Subsidy. • Premiums are deductible if selfemployed. • By opting to pay full premiums, you increase deductions, and increase IRS Tax Credit Alternative (Silver Plan or Better)
  32. 32. If Group Health Insurance Is No Longer a Benefit, Then What is?? Other Ways to Attract & Retain Employees: • Taxable Benefits: – Pay Increase – Bonuses • Tax-Favored Benefits: – – – – Profit Sharing Plan 401K Contribution Dental, vision, other ins. ESOP
  33. 33. My Value Proposition Here‟s How I Help Your SMB: • Adjust Your Employee Benefits to ACA Realities & Opportunities • Educate Your Employees About The New ACA Realities & About Your New Benefits • Enroll Your Employees In New Benefits, Including Individual ACA Health Plans
  34. 34. 3 Simple Steps for Employer: Revise Benefits Plan Employee Group Meeting One on One Enrollment
  35. 35. 3 Simple Steps for Employee: Apply for Subsidy Shop for Health Insurance Employee Pays The Difference
  36. 36. Business Advantages A Private Health Insurance Exchange Helps You Attract and Retain Great Employees Offer flexible and affordable benefit plans that all of your employees qualify for Reduces Benefits Inflation & Admin Cost
  37. 37. How can I learn more about ACA? IMPORTANT: Don‟t Procrastinate! • Get familiar with rates, networks, etc. • Decide on best plan now. • If no subsidy, apply now • If subsidy-eligible, decide now, apply asap Healthcare.gov is fixed.
  38. 38. How can I learn more about ACA? Deadlines: 1. 11/15/13: Last date for “preACA” plan (both individual and Group) for 12/1/13 coverage. • • • Underwritten, no IRS subsidy Rates fixed until 12/1/14 At that point, only (higher cost) ACA plans available
  39. 39. How can I learn more about ACA? Deadlines: 2. 12/15/13: Last date for ACA plan (both individual and Group) for 1/1/14 coverage • • • Guaranteed Issue Higher Cost But May Qualify for IRS Subsidy.
  40. 40. How can I learn more about ACA? Deadlines: 3. 3/31/14: Last date for ACA plan (both individual and Group.) for 5/1/14 coverage • • • Guaranteed Issue Higher Cost But May Qualify for IRS Subsidy.
  41. 41. How can I learn more about ACA? Healthcare.gov Issues No Fix Until 11/30 (maybe) • • • • No Subsidy until fixed Decide on Health Plan Now Narrow Window to apply by 12/15 for 1/1/14 coverage.
  42. 42. How can I learn more about ACA? Seek Professional Advice • • • No cost to work with a broker. Saves Time, Better Decisions, avoid costly mistakes. Help throughout the year with claims, insurance issues.
  43. 43. How can I learn more about ACA? Want an Obamacare Quote? 1. Go to: www.TheMedicalInsurance Exchange.com 2. Click on “Quotes” button on Left Hand Side. 3. Go to Subsidy Calculator for Subsidy Estimate.
  44. 44. How can I learn more about ACA? Call/Email Me to Discuss/Enroll – – mtchapman@endeavorgroup.net (214) 764-6315 • • Put “Obamacare Request” in subject line. Will send documents you need to enroll, along with updates. Will follow up with request for appointment a few days later. •
  45. 45. How can I learn more about ACA? What you‟ll get now: • • 11 page ACA FAQ Guide Subsidy Chart • Pre-enrollment Checklist • TX Rate and Plan Guide • Updates
  46. 46. How You‟ll Benefit What you‟ll get: • Cutting Edge Advice • Expertise in ACA and other insurance/benefits • Keep more of what you earn • Support throughout the year.
  47. 47. A Stress-Free ACA Enrollment • Save you, employees $$ • Pre-education, guidance • Smooth, hassle-free enrollment • Year-round support
  48. 48. Value-Based No Cost Services What this costs you: • Absolutely no additional cost to enroll through a broker. • Costs you $$$ in missed opportunities or extra medical expenses from poor decisions. • Saves valuable time working with an expert, so you can focus on your business.
  49. 49. Value-Based No Cost Services What this costs you: • Absolutely no additional cost to enroll through a broker. • Costs you $$$ in missed opportunities or extra medical expenses from poor decisions. • Saves valuable time working with an expert, so you can focus on your business.
  50. 50. Next Steps • • • • • • Schedule Appointment Formulate Plan Communicate Plan Implement/Enroll >December 15th Quarterly Updates
  51. 51. How can I learn more about ACA? Call/Email Me to Discuss/Enroll – – mtchapman@endeavorgroup.net (214) 764-6315 • • Put “Obamacare Request” in subject line. Will send documents you need to enroll, along with updates. Will follow up with request for appointment a few days later. •

×