<ul><li>Brian T. Whitlock CPA, JD, LLM </li></ul>How Federal Health Care Changes will Impact Your Organization
<ul><li>Mandates on Providers  </li></ul><ul><li>Mandates on Insurance & Drug Co. </li></ul><ul><li>Mandates on Employers ...
Tax Treatment of Non-Profit Hospitals <ul><li>501(c)(3) Hospitals must meet new 501(r) </li></ul><ul><ul><li>Community Hea...
Mandates on Health Care Providers  <ul><li>2010 Medicare Reimbursement cuts </li></ul><ul><ul><li>$455 Billion reduction i...
Mandates on Suppliers <ul><li>2010 - 10% Excise Tax on Tanning Salons </li></ul><ul><ul><li>States looking to prohibit use...
Mandates on Suppliers <ul><li>Annual Health Insurance Provider Fee </li></ul><ul><ul><li>$8 Billion in 2014 increasing to ...
Mandates on Insurance Companies <ul><li>2018 - Excise Tax on High Cost “Cadillac” Plans </li></ul><ul><ul><li>40% tax asse...
Typical Health Insurance Plans Today <ul><li>Preferred Provider Organization (PPO) </li></ul><ul><ul><li>Individual $558.2...
Health Related Excise Taxes and Fees <ul><li>Elimination of Corporate deduction Medicare Part D Subsidy “donut hole” </li>...
Standardized Benefit Provisions <ul><li>Beginning September 2010 - Plans must provide standardized benefits  </li></ul><ul...
Mandates on Insurance Companies <ul><li>Beginning in 2014 </li></ul><ul><ul><li>State Insurance Exchanges – “Orbitz for In...
Employer Mandates <ul><li>Plans as of March 23, 2010 – Grandfathered  </li></ul><ul><ul><li>Not currently required to meet...
Employer Mandates <ul><li>2014 Employer “Coverage” for Employees </li></ul><ul><ul><li>(“Individual” Coverage not “Family”...
Essential Plan Benefits  <ul><li>Must offer Affordable Coverage </li></ul><ul><ul><li>Individual coverage not family cover...
Employer Mandates <ul><li>2014 Employer - Penalties </li></ul><ul><ul><li>If employer does not offer coverage when require...
Small Business Tax Credit [Code 45R(c) <ul><ul><li>Credit Available for 2010, 2011, 2012 and 2013 </li></ul></ul><ul><ul><...
Employer Mandates <ul><li>Employee average wage calculation </li></ul><ul><ul><li>Excludes ineligible group </li></ul></ul...
Employer Mandates <ul><li>2011 – 4 page employer summary of benefits  </li></ul><ul><li>2012 – Form W-2 Information Report...
Other Health Related Provisions in 2010 <ul><li>Section 1035 - Pension Protection Act of 2006 </li></ul><ul><ul><li>Expand...
Individual Mandates <ul><li>Current Statistics - 310 MM in US </li></ul><ul><li>179 MM covered by Private Insurance  </li>...
Individual Mandates <ul><li>2014 Individuals Required to have Coverage </li></ul><ul><ul><li>All US Citizens and legal res...
Revenue Raisers – Check Please <ul><li>2011 - Expanded 1099 reporting  </li></ul><ul><ul><li>Small Business Jobs Act signe...
Revenue Raisers - Check Please <ul><li>2013 - 0.9% payroll tax on wages over $200,000  </li></ul><ul><li>2013 - Individual...
Revenue Raisers - Check Please <ul><li>2013 - $2,500 limit for contributions to FSA  </li></ul><ul><li>20% penalty on nonq...
Revenue Raisers – Check Please <ul><li>Closing the Tax Gap </li></ul><ul><ul><ul><li>US Tax System is Best among Developed...
Health Care 2014  <ul><li>Legislative Attacks </li></ul><ul><ul><li>Small changes will continue to chip away  </li></ul></...
Actions <ul><li>Evaluate the effect of changes on current group health coverage </li></ul><ul><li>Address cost and complia...
Reasonable Questions to Consider <ul><li>Is getting out of the employee insurance business a reasonable option for you? </...
Questions Brian T. Whitlock JD, CPA, LLM Blackman Kallick, LLP 10 S. Riverside Plaza, Chicago, IL 60606 Phone: (312) 980-2...
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Patient Protection And Affordable Care Act (2011 Update)

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Presented to Community Memorial Foundation May 11th at Ruth Lake CC

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Patient Protection And Affordable Care Act (2011 Update)

  1. 2. <ul><li>Brian T. Whitlock CPA, JD, LLM </li></ul>How Federal Health Care Changes will Impact Your Organization
  2. 3. <ul><li>Mandates on Providers </li></ul><ul><li>Mandates on Insurance & Drug Co. </li></ul><ul><li>Mandates on Employers </li></ul><ul><li>Mandates on Individuals </li></ul>Coverage of Act
  3. 4. Tax Treatment of Non-Profit Hospitals <ul><li>501(c)(3) Hospitals must meet new 501(r) </li></ul><ul><ul><li>Community Health Needs Assessment </li></ul></ul><ul><ul><li>Written Financial Assistance Policy </li></ul></ul><ul><ul><li>Bill Collection Practices </li></ul></ul><ul><ul><li>Limitation on Charges for patients that qualify for financial assistance </li></ul></ul><ul><ul><ul><li>May not use chargemaster rates (gross charges) </li></ul></ul></ul><ul><ul><ul><li>Amounts billed must be based on average of best negotiated rates, or Medicare rates </li></ul></ul></ul>
  4. 5. Mandates on Health Care Providers <ul><li>2010 Medicare Reimbursement cuts </li></ul><ul><ul><li>$455 Billion reduction in reimbursement rates to Medicare Providers over 10 years </li></ul></ul><ul><ul><ul><li>21% cut in Medicare Reimbursements to doctors </li></ul></ul></ul><ul><ul><ul><li>June Pension funding relief act postponed this until November 2010. December Tax act postponed again. </li></ul></ul></ul><ul><ul><ul><li>The Flinch Method </li></ul></ul></ul><ul><ul><li>Impact on all health care providers accepting Medicare </li></ul></ul><ul><ul><li>Providers will shift costs resulting in higher charges to insurers and their participants </li></ul></ul><ul><ul><li>Likely result - higher insurance premiums </li></ul></ul>
  5. 6. Mandates on Suppliers <ul><li>2010 - 10% Excise Tax on Tanning Salons </li></ul><ul><ul><li>States looking to prohibit use under 18 years of age </li></ul></ul><ul><li>2013 - Medical Device Excise Tax of 2.3% </li></ul><ul><ul><li>Direct pay by purchaser </li></ul></ul><ul><ul><li>Prosthetic devices (electric wheelchairs) </li></ul></ul><ul><ul><li>Excludes eyeglasses, hearing aids, retail items </li></ul></ul><ul><ul><li>Sales after December 31, 2012 </li></ul></ul><ul><ul><li>Likely to include – MRI’s, CT, X-Ray, Dialysis Equipment, Diabetes and medical Testing kits (i.e., pregnancy tests, snake bite kits) </li></ul></ul>
  6. 7. Mandates on Suppliers <ul><li>Annual Health Insurance Provider Fee </li></ul><ul><ul><li>$8 Billion in 2014 increasing to $14 Billion in 2018 </li></ul></ul><ul><ul><li>Divided among insurers based on market share </li></ul></ul><ul><ul><li>Cost likely passed on via higher premiums </li></ul></ul><ul><li>Annual Brand Name Drug Company Fee </li></ul><ul><ul><li>$2.5 Billion in 2011 increasing to $4.1 Billion in 2018 </li></ul></ul><ul><ul><li>Allocated by share of prescription drug sales under a specified government program </li></ul></ul><ul><ul><li>Cost likely passed on in higher prices </li></ul></ul>
  7. 8. Mandates on Insurance Companies <ul><li>2018 - Excise Tax on High Cost “Cadillac” Plans </li></ul><ul><ul><li>40% tax assessed on Insurance Companies </li></ul></ul><ul><ul><li>Assessed on employer plan benefits in excess of </li></ul></ul><ul><ul><ul><li>$10,200 a year of individuals </li></ul></ul></ul><ul><ul><ul><li>$27,500 a year for families </li></ul></ul></ul><ul><ul><ul><li>Effective for taxable years beginning after 12/31/2017 </li></ul></ul></ul><ul><ul><ul><li>Would raise $2.5 Trillion over ten years </li></ul></ul></ul><ul><ul><li>Cost likely passed on via higher premiums </li></ul></ul>
  8. 9. Typical Health Insurance Plans Today <ul><li>Preferred Provider Organization (PPO) </li></ul><ul><ul><li>Individual $558.20 /mo ($6,700/yr) 82.8%($5,550/$1,150) </li></ul></ul><ul><ul><li>Family $1,800 /mo($21,600/yr) 60% ($12,960/$8,540) </li></ul></ul><ul><li>Health Maintenance Organization (HMO) </li></ul><ul><ul><li>Individual $366/mo($4,400/yr) 87.5% ($3,850/$550) </li></ul></ul><ul><ul><li>Family $1,100/mo ($13,200/yr) 59.7% ($7,880/$5,320) </li></ul></ul><ul><li>High Deductible Health Care (HDHC) </li></ul><ul><ul><li>Individual 355 /mo ($4,260/yr) 92.7% ($3,950/$310) </li></ul></ul><ul><ul><li>Family $1,137/mo($13,650/yr) 61.9% ($8,450 + 600/$5,200 +$4,500) </li></ul></ul>
  9. 10. Health Related Excise Taxes and Fees <ul><li>Elimination of Corporate deduction Medicare Part D Subsidy “donut hole” </li></ul><ul><ul><li>Medicare will begin to close the hole on its own </li></ul></ul><ul><li>$500,000 income tax deduction limit on executive compensation of health insurance executives </li></ul><ul><li>Beginning for tax years beginning after 12/31/2012 </li></ul>
  10. 11. Standardized Benefit Provisions <ul><li>Beginning September 2010 - Plans must provide standardized benefits </li></ul><ul><ul><li>Minimum standardized benefits </li></ul></ul><ul><ul><ul><li>Coverage for all dependents to age 26 </li></ul></ul></ul><ul><ul><ul><li>All emergency care must be covered as “in Network” </li></ul></ul></ul><ul><ul><ul><li>No Cost Sharing on preventative services </li></ul></ul></ul><ul><ul><ul><li>Restrictions on annual limits </li></ul></ul></ul><ul><ul><ul><li>No lifetime limits </li></ul></ul></ul><ul><ul><ul><li>Insurance Company must cover pre-existing conditions on children under 19 </li></ul></ul></ul><ul><ul><li>Insurance Companies will only be able rescind policies for fraud of applicant </li></ul></ul>
  11. 12. Mandates on Insurance Companies <ul><li>Beginning in 2014 </li></ul><ul><ul><li>State Insurance Exchanges – “Orbitz for Insurance” </li></ul></ul><ul><ul><li>Insurance companies required to offer policies </li></ul></ul><ul><ul><li>Guaranteed issue, no limit on pre-existing condition </li></ul></ul><ul><ul><li>Premiums become community rated </li></ul></ul><ul><ul><ul><li>Geography no longer allowed as variable </li></ul></ul></ul><ul><ul><ul><li>Family no longer allowed as variable </li></ul></ul></ul><ul><ul><li>Age and Tobacco use are only variables </li></ul></ul><ul><ul><li>Age 3:1 ratio; Tobacco 1.5:1 ratio </li></ul></ul><ul><ul><li>Essential Plan Benefits required </li></ul></ul><ul><ul><ul><li>Undefined currently </li></ul></ul></ul><ul><ul><li>Result: Insurance Company margins squeezed </li></ul></ul>
  12. 13. Employer Mandates <ul><li>Plans as of March 23, 2010 – Grandfathered </li></ul><ul><ul><li>Not currently required to meet employer mandates </li></ul></ul><ul><ul><li>In 2014 – “Essential Plan Benefits” will be required </li></ul></ul><ul><li>Beginning September 2010 All other Plans </li></ul><ul><ul><li>Section 105(h) discrimination rules apply to all plans; previously only self insured plans </li></ul></ul><ul><ul><ul><li>70% of employees must be eligible for coverage </li></ul></ul></ul><ul><ul><ul><li>Highly compensated taxed on “benefits” of self-insured plan </li></ul></ul></ul><ul><ul><ul><li>NEW FOR GROUP PLANS - $100 per day per individual discriminated against for group plans (Notice 2010-63) </li></ul></ul></ul><ul><ul><li>Maintaining discriminatory plans may be costly </li></ul></ul>
  13. 14. Employer Mandates <ul><li>2014 Employer “Coverage” for Employees </li></ul><ul><ul><li>(“Individual” Coverage not “Family” Coverage) </li></ul></ul><ul><ul><li>FIRST TEST: Number of FTEs (Full-Time Equivalent) </li></ul></ul><ul><ul><ul><li># of FTEs = total employee hours / 2,080 </li></ul></ul></ul><ul><ul><li>Employers with >50 FTE’s </li></ul></ul><ul><ul><ul><li>Must Cover “Full-Time” employee (avg. 30 hours/ week) </li></ul></ul></ul><ul><ul><ul><li>Must offer “affordable” coverage </li></ul></ul></ul><ul><ul><ul><li>Must contribute to cost of Insurance </li></ul></ul></ul><ul><ul><ul><li>Employer Penalties for non-compliance </li></ul></ul></ul><ul><ul><li>Employers with <50 FTE’s </li></ul></ul><ul><ul><li>Employers with <25 FTE’s may be eligible for credits if they voluntarily choose to offer coverage </li></ul></ul>
  14. 15. Essential Plan Benefits <ul><li>Must offer Affordable Coverage </li></ul><ul><ul><li>Individual coverage not family coverage </li></ul></ul><ul><ul><ul><li>Definition to be developed in Regulations </li></ul></ul></ul><ul><ul><ul><li>Must meet actuarial guidelines </li></ul></ul></ul><ul><ul><li>Individuals portion of Insurance Premium must meet % of Income tests </li></ul></ul><ul><ul><ul><li>Generally, 8-10% of Household income </li></ul></ul></ul><ul><ul><li>Base = 400% of FPL (Federal Poverty Level) </li></ul></ul><ul><ul><ul><li>$43,320 for an individual in 2009 </li></ul></ul></ul><ul><ul><ul><li>$88,200 for family of four in 2009 </li></ul></ul></ul>
  15. 16. Employer Mandates <ul><li>2014 Employer - Penalties </li></ul><ul><ul><li>If employer does not offer coverage when required </li></ul></ul><ul><ul><ul><li>If one employee claims premium credit then employer subject to penalty of $2,000 per Full-time employees (30+ hours) </li></ul></ul></ul><ul><ul><li>If employer offers unaffordable coverage </li></ul></ul><ul><ul><ul><li>If one employee claims the credit, then employer will be subject to a penalty equal to lesser of $3,000 per employee claiming credit or $2,000 per all Full-time employees (30+ hours) </li></ul></ul></ul><ul><ul><li>If employer offers affordable coverage </li></ul></ul><ul><ul><ul><li>Employer must offer Free Choice Vouchers if employee contribution is 8-9.5% of income (Congress Flinched and removed by 2011 Appropriations Act – April 15 th ) </li></ul></ul></ul>
  16. 17. Small Business Tax Credit [Code 45R(c) <ul><ul><li>Credit Available for 2010, 2011, 2012 and 2013 </li></ul></ul><ul><ul><li>Full credit where 10 or fewer FTEs and avg. wages of $25,000 </li></ul></ul><ul><ul><ul><li>Credit = 35% of Premiums paid </li></ul></ul></ul><ul><ul><ul><li>Credit = 25% of Premiums for small tax exempts </li></ul></ul></ul><ul><ul><ul><li>Beginning in 2014 and 2015 </li></ul></ul></ul><ul><ul><ul><ul><li>Credit = 50% of Premiums paid </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Credit = 35% of Premium for small exempts </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Insurance Exchange option required </li></ul></ul></ul></ul><ul><ul><li>Reduced credit </li></ul></ul><ul><ul><ul><li>Between 10 and 25 FTEs </li></ul></ul></ul><ul><ul><ul><li>Average wages between $25,000 and $50,000 </li></ul></ul></ul><ul><ul><li>Limitations </li></ul></ul><ul><ul><ul><li>No credit available for premiums paid for self-employed or family members; >2% owner of S; >5% owner of C </li></ul></ul></ul><ul><ul><ul><li>Must pay 50% or more of Premium for single coverage </li></ul></ul></ul>
  17. 18. Employer Mandates <ul><li>Employee average wage calculation </li></ul><ul><ul><li>Excludes ineligible group </li></ul></ul><ul><ul><ul><li>Self-employed and family members; >2% owner of S; >5% owner of C </li></ul></ul></ul><ul><ul><li>Includes leased employee </li></ul></ul><ul><ul><li>Includes affiliated service groups – 415(m) and (o) </li></ul></ul><ul><ul><li>Excludes Seasonal Workers </li></ul></ul><ul><ul><ul><li>Less than 120 days </li></ul></ul></ul>
  18. 19. Employer Mandates <ul><li>2011 – 4 page employer summary of benefits </li></ul><ul><li>2012 – Form W-2 Information Reporting </li></ul><ul><ul><li>Optional for 2011 (IRS Notice 2010-69, 10/13/10) </li></ul></ul><ul><ul><li>Cost of Coverage to be list (not taxed) </li></ul></ul><ul><ul><li>Verification of Insurance Coverage </li></ul></ul><ul><li>2012 – Expanded Form 1099 Reporting </li></ul><ul><ul><li>PPA removed exception for Goods and Services </li></ul></ul><ul><ul><li>Small Business Act treated landlords as “Trade or Business” (Congress Flinched and removed both in 2011 HR4 on April 14 th ) </li></ul></ul>
  19. 20. Other Health Related Provisions in 2010 <ul><li>Section 1035 - Pension Protection Act of 2006 </li></ul><ul><ul><li>Expanded opportunity to exchange annuities and life policies for policies that contain Long-term Care Ins. </li></ul></ul><ul><ul><li>Effective for exchanges after 12/31/2009 </li></ul></ul><ul><ul><ul><li>Hancock – Life Care </li></ul></ul></ul><ul><ul><ul><li>United of Omaha – Living Care Benefits </li></ul></ul></ul>
  20. 21. Individual Mandates <ul><li>Current Statistics - 310 MM in US </li></ul><ul><li>179 MM covered by Private Insurance </li></ul><ul><ul><ul><li>132 M in Large Group Plans </li></ul></ul></ul><ul><ul><ul><li>29 M in Small Group Plans </li></ul></ul></ul><ul><ul><ul><li>18 M in individual Plans </li></ul></ul></ul><ul><li>100 MM covered by Government Programs </li></ul><ul><ul><ul><li>44 M in Medicare </li></ul></ul></ul><ul><ul><ul><li>44M in Medicaid </li></ul></ul></ul><ul><ul><ul><li>12M in VA and Dept of Defense </li></ul></ul></ul><ul><li>41 MM Uninsured </li></ul><ul><ul><ul><li>12 MM estimated Illegal Aliens (no impact) </li></ul></ul></ul><ul><ul><ul><li>29 MM people potential new insureds </li></ul></ul></ul>
  21. 22. Individual Mandates <ul><li>2014 Individuals Required to have Coverage </li></ul><ul><ul><li>All US Citizens and legal residents must have qualifying coverage or pay a penalty </li></ul></ul><ul><ul><ul><li>1% of household income in 2014 </li></ul></ul></ul><ul><ul><ul><li>2% in 2015 </li></ul></ul></ul><ul><ul><ul><li>2.5% in 2016 </li></ul></ul></ul><ul><ul><li>Exemption for financial hardship, religious objections, or if lowest cost plan is greater than 8% of income. </li></ul></ul><ul><ul><li>Premium credits payable to exchange to reduce cost of coverage for low income beginning 2014 </li></ul></ul><ul><ul><ul><li>Tax Evasion(?) No, offset refunds and tax credits </li></ul></ul></ul><ul><ul><ul><li>Education Jobs Act eliminates advance refund of EIC (flinch?) </li></ul></ul></ul><ul><ul><ul><li>2011 HR4 Requires credit repayment if income > 400% of FPL (Flinch) </li></ul></ul></ul>
  22. 23. Revenue Raisers – Check Please <ul><li>2011 - Expanded 1099 reporting </li></ul><ul><ul><li>Small Business Jobs Act signed September 27, 2010 (Congress Flinched and removed first part in 2011) </li></ul></ul><ul><ul><ul><li>Effective for years beginning after 12/31/2010 </li></ul></ul></ul><ul><ul><ul><li>Expanded the “trade or business” definition </li></ul></ul></ul><ul><ul><ul><ul><li>“ a person receiving rental income from real estate shall be considered to be engaged in a trade or business” </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Exception rental of principal residence </li></ul></ul></ul></ul><ul><ul><ul><li>Raised the Section 6721 Penalty from $50 to $100 for failure to file “correct information returns” </li></ul></ul></ul><ul><ul><ul><ul><li>Reduced penalty if corrected in 30 days increased from $15 to $30 </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Reduced penalty if corrected by August 1st days increased from $30 to $60 </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Intentional disregard increased from $100 to $250 </li></ul></ul></ul></ul>
  23. 24. Revenue Raisers - Check Please <ul><li>2013 - 0.9% payroll tax on wages over $200,000 </li></ul><ul><li>2013 - Individuals, trusts and estates pay 3.8% tax </li></ul><ul><ul><li>Net investment income (interest, dividends, capital gains, and rental income) </li></ul></ul><ul><ul><li>Modified AGI over $200,000 single/$250,000 MFJ </li></ul></ul><ul><ul><li>Top fiduciary bracket – trusts and estates >$11,200 </li></ul></ul><ul><ul><li>No indexing of brackets </li></ul></ul><ul><li>2013 - Itemized deduction threshold increased from 7.5% of AGI to 10% of AGI </li></ul>
  24. 25. Revenue Raisers - Check Please <ul><li>2013 - $2,500 limit for contributions to FSA </li></ul><ul><li>20% penalty on nonqualified distributions from HSA & MSA </li></ul><ul><li>Over the counter drugs prescribed by physician excluded from HSA, FSA, MSA reimbursements – Announcement issued September 2010 </li></ul>
  25. 26. Revenue Raisers – Check Please <ul><li>Closing the Tax Gap </li></ul><ul><ul><ul><li>US Tax System is Best among Developed Countries </li></ul></ul></ul><ul><ul><ul><li>Gap estimated at $465 Billion per year </li></ul></ul></ul><ul><ul><ul><ul><li>Cash economy </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Lack of Tax Withholding at the source </li></ul></ul></ul></ul><ul><li>What will “Tax Reform” Look like </li></ul><ul><ul><li>Some version of Expanded Form 1099 Reporting? </li></ul></ul><ul><ul><li>President Commission Report </li></ul></ul><ul><ul><ul><li>Lower rates and broaden base </li></ul></ul></ul><ul><ul><li>American Bar Association – Simplification </li></ul></ul><ul><ul><li>International Tax Reform </li></ul></ul><ul><ul><ul><li>Value Added Tax (only US, Iran, Somalia(?) lack VAT) </li></ul></ul></ul><ul><ul><ul><li>Internet or National Sales Tax </li></ul></ul></ul>
  26. 27. Health Care 2014 <ul><li>Legislative Attacks </li></ul><ul><ul><li>Small changes will continue to chip away </li></ul></ul><ul><ul><li>Massive “defunding” not likely </li></ul></ul><ul><ul><ul><li>Majority of Effective dates not until 2014 </li></ul></ul></ul><ul><ul><ul><li>Value of having a Political Issue </li></ul></ul></ul><ul><ul><ul><ul><li>2012 Presidential Election </li></ul></ul></ul></ul><ul><ul><ul><ul><li>2014 Mid-Term Election </li></ul></ul></ul></ul><ul><li>Executive - Presidential Veto </li></ul><ul><li>Judicial Challenges to Constitutionality of Mandates </li></ul><ul><ul><li>Florida v US ( “unconstitutional” ) </li></ul></ul><ul><ul><ul><li>Appellate argument set for June 8 th in Florida </li></ul></ul></ul><ul><ul><li>Virginia v Sebelius ( struck down parts of Act ) </li></ul></ul><ul><ul><ul><li>US Sup Ct denied request to bypass Ct of Appeals – April 25 th </li></ul></ul></ul><ul><ul><ul><li>Appellate argument set for May 10 th in Richmond, Virginia </li></ul></ul></ul>
  27. 28. Actions <ul><li>Evaluate the effect of changes on current group health coverage </li></ul><ul><li>Address cost and compliance issues </li></ul><ul><li>Consider keeping grandfathered plans </li></ul>
  28. 29. Reasonable Questions to Consider <ul><li>Is getting out of the employee insurance business a reasonable option for you? </li></ul><ul><ul><li>Cheaper to get out completely(?) </li></ul></ul><ul><ul><li>Impact on current employees? </li></ul></ul><ul><ul><li>Ability to attract future employees? </li></ul></ul><ul><li>Pay penalty allow employees to self insure? </li></ul><ul><li>Remember Section 105(h) discrimination rule </li></ul><ul><ul><ul><li>Not just White collar v. Blue collar (70%) </li></ul></ul></ul><ul><li>Look at employer self insuring a larger portion </li></ul>
  29. 30. Questions Brian T. Whitlock JD, CPA, LLM Blackman Kallick, LLP 10 S. Riverside Plaza, Chicago, IL 60606 Phone: (312) 980-2941 Website: www.blackmankallick.com Email: [email_address] Linked-in Blog www.untaxinglyyours.com

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