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De Pere Area Chamber, Lori Compas, Wisconsin Business Alliance, ACA 9-11-13


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Presentation on the Affordable Care Act given by Lori Compas, Executive Director of the Wisconsin Business Alliance and its sister foundation to De Pere Area Chamber of Commerce on 9/11/13.

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De Pere Area Chamber, Lori Compas, Wisconsin Business Alliance, ACA 9-11-13

  1. 1. How the Affordable Care Act affects your small business
  2. 2. Presentation Overview • Current health care system • ACA changes already in effect • Changes coming with the new exchanges • Making your choice • Employee notification deadline: Oct 1
  3. 3. Current health care system • High cost: Premiums have doubled over the past nine years • Small businesses pay 18% more than big businesses • Insurance costs more for women and older workers • Pre-existing conditions = denied coverage or very expensive coverage • Difficult to compare insurance plans
  4. 4. ACA changes already in effect • No penalties for women and older workers • Children with pre-existing conditions cannot be denied coverage • Plan costs and benefits are standardized and easy to compare • Young adults can stay on their parents’ plans until they’re 26
  5. 5. The new health care exchanges • You don’t have to offer coverage. No penalty if you have fewer than 50 employees. • Health care exchanges are an option, not a requirement • If you want to offer coverage, you can choose to buy coverage on the SHOP marketplace.
  6. 6. SHOP Marketplace • Standard coverage at various levels: Platinum – Gold – Silver – Bronze • Allow you to “compare apples to apples” • ALL SHOP plans fully cover… – Preventive care – Immunizations – Well child check-ups – and more
  7. 7. SHOP Eligibility • Open to employers with 50 or fewer FTEs (full-time-equivalent employees) • If you're self-employed with no employees, you can get coverage through the individual Health Insurance Marketplace, but not through SHOP.
  8. 8. SHOP Features • Compare health plans online • You control the coverage you offer • You decide how much to pay toward employee premiums • All plans offer preventive care, immunizations, well-child check-ups, etc. • You may qualify for a tax credit worth up to 50% of your premium costs
  9. 9. Tax credits • For-profit businesses • < 25 FTEs (and only for employees) • Pay at least 50% of employees’ premiums • Employees’ annual salaries can average no more than $50,000 • Beginning 2014, tax credit is available only for plans purchased through SHOP.
  10. 10. Calculating & claiming your tax credit • Use IRS Form 8941, Credit for Small Employer Health Insurance Premiums • Include the amount as part of the general business credit on your income tax return • Calculator (try different scenarios) /ACA
  11. 11. Deductions Since the amount of the health insurance premium payments is more than the total credit, eligible small businesses can still claim a business expense deduction for the premiums in excess of the credit. That’s both a credit and a deduction for employee premium payments.
  12. 12. Enrollment You can enroll either… • Through a broker, or • Directly through the SHOP exchange
  13. 13. Payments You can choose to… • Collect employee share of premiums through payroll deduction • Make premium contributions to SHOP with pre-tax dollars • Get one monthly bill, make one monthly payment to SHOP
  14. 14. Making your choice • You determine your employees’ deductible, co-pays, and out-of-pocket • In general… Lower premiums  Higher out-of-pocket Higher premiums  Lower out-of-pocket • Platinum plans generally have the highest monthly premiums and lowest out-of-pocket costs. • The plan with the lowest premium may not provide you or your employees with the best overall value.
  15. 15. Employee notification You must notify employees of the new exchanges by October 1, 2013 How to notify? Model forms available from the U.S. Dept. of Labor or
  16. 16. Questions? Have questions about the SHOP Marketplace for businesses with 50 or fewer employees? Call 1-800-706-7893 Monday through Friday, 8-4 central time Or visit