San Antonio North Chamber: How 2 Series


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eESI would like to thank the San Antonio North Chamber for being a part of the How 2 Series on May 30th, 2011. We hope our dialogue in regards to Healthcare Reform was beneficial to all.

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San Antonio North Chamber: How 2 Series

  1. 1. Benefits: Health Care Reform Health Care Reform What It Means to My Business Presented by: eESI Ken Barge Shannon Schumacher
  2. 2. <ul><li>What is Health Care Reform? </li></ul><ul><li>Why was Health Care Reform passed? </li></ul><ul><li>Where are we now? </li></ul><ul><li>What’s up next? </li></ul><ul><li>Questions for my business? </li></ul><ul><li>What can I do? </li></ul>Benefits: Health Care Reform
  3. 3. What is Health Care Reform? <ul><li>Patient Protection and Affordable Care Act (PPACA) </li></ul><ul><ul><li>Signed by President Obama March 23, 2010 </li></ul></ul><ul><li>Health Care and Education Reconciliation Act of 2010 </li></ul><ul><ul><li>Signed by President Obama March 30, 2010 </li></ul></ul><ul><ul><li>Amends PPACA provision and adds new provisions </li></ul></ul>Benefits: Health Care Reform
  4. 4. <ul><li>Provide Broader Coverage for Americans </li></ul><ul><ul><li>Implementing a health exchange program </li></ul></ul><ul><ul><li>Implement employer and individual mandates </li></ul></ul><ul><li>Increase Level of Care </li></ul><ul><ul><li>Removing annual and lifetime limitations </li></ul></ul><ul><ul><li>Removing pre-existing limitations </li></ul></ul><ul><li>Control Costs </li></ul><ul><ul><li>Minimum loss ratios </li></ul></ul><ul><ul><li>Provide new regulations and policies </li></ul></ul><ul><ul><li>Was Reform a Necessity or Political? </li></ul></ul>Why was Health Care Reform passed? Benefits: Health Care Reform
  5. 5. Where Are We Now? <ul><li>Expansion of preventative services </li></ul><ul><li>Dependants coverage up to age 26 </li></ul><ul><li>No pre–existing conditions for children under the age of 19 </li></ul><ul><li>Changes to lifetime maximum benefits and annual limits </li></ul><ul><li>Expansion of non-discrimination requirements </li></ul><ul><li>Annual rebates on fully insured plans </li></ul><ul><li>Elimination of FSA reimbursements for over-the-counter drugs </li></ul><ul><li>Small employer tax credits </li></ul><ul><li>Waiting periods no longer than 90 days </li></ul><ul><li>Coverage appeals </li></ul><ul><li>Grandfather plans </li></ul><ul><li>High risk pools </li></ul>Benefits: Health Care Reform
  6. 6. Where Are We Now? <ul><li>Enforcement delayed on 105 (h) non-discrimination rules for all fully insured non-grandfathered plans </li></ul><ul><ul><li>IRS solicited comments in March </li></ul></ul><ul><ul><li>Guidance expected later this year </li></ul></ul><ul><li>W2 Reporting made optional for 2011 </li></ul><ul><ul><li>New guidance issued March 29 for 2012 </li></ul></ul><ul><ul><li>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) </li></ul></ul><ul><ul><li>For larger employers - includes information on how to report, what coverage to include and how to determine the cost of the coverage </li></ul></ul><ul><li>1099 Reporting requirements repealed </li></ul><ul><li>Employee Free Choice Voucher Program eliminated </li></ul><ul><li>Most of the funding for Cooperative Plans eliminated </li></ul>Benefits: Health Care Reform
  7. 7. What Up Next? <ul><li>2012 </li></ul><ul><ul><li>Form W-2 reporting </li></ul></ul><ul><li>Uniform summary of benefits </li></ul><ul><li>2013 </li></ul><ul><ul><li>Increase in medical deduction </li></ul></ul><ul><ul><li>Medicare tax on High Income earners/Self Employed/Unearned income </li></ul></ul><ul><ul><li>Premium Tax-Research </li></ul></ul><ul><ul><li>Flexible spending arrangement maximum imposed ($2500) </li></ul></ul><ul><ul><li>Notice of insurance exchanges due to employees </li></ul></ul>Benefits: Health Care Reform
  8. 8. <ul><li>The Big 2014 </li></ul><ul><ul><li>Individual health insurance mandate fine 1% </li></ul></ul><ul><ul><li>Employer Mandate 50+(less than 50 exempted) </li></ul></ul><ul><ul><li>Small employer tax credit increased to 50% (less than 25) </li></ul></ul><ul><ul><li>Auto enrollment for companies with 200+ employees </li></ul></ul><ul><ul><li>Waiting period greater than 90 days eliminated </li></ul></ul><ul><ul><li>Pre existing conditions eliminated </li></ul></ul><ul><ul><li>Premium assistance credit </li></ul></ul><ul><ul><li>Insurance exchanges begin </li></ul></ul><ul><ul><li>Penalties and vouchers for unaffordable insurance </li></ul></ul><ul><li>2015-2017 </li></ul><ul><ul><li>Large employers now eligible for health insurance exchanges </li></ul></ul><ul><ul><li>Increase on medical deduction threshold for tax payers 65+ </li></ul></ul>What Up Next? Benefits: Health Care Reform
  9. 9. Questions For My Business <ul><li>Can I anticipate health care costs to increase at a smaller percentage? </li></ul><ul><li>Should I prepare for government health care system? </li></ul><ul><li>Should I offer health insurance in the future? </li></ul><ul><li>How will the exchanges work? </li></ul><ul><li>Why and How do I need to pay attention? </li></ul>Benefits: Health Care Reform
  10. 10. <ul><li>Pray </li></ul><ul><li>Take Action </li></ul><ul><ul><li>Education </li></ul></ul><ul><ul><li>Wellness </li></ul></ul><ul><ul><li>Change in Philosophy </li></ul></ul>What Can I Do? Benefits: Health Care Reform
  11. 11. <ul><li>Education </li></ul><ul><ul><li>Review key components of the Act </li></ul></ul><ul><ul><ul><li>Keep up-to-date </li></ul></ul></ul><ul><ul><li>Work with subject matter experts </li></ul></ul><ul><ul><li>Health Insurance Exchanges </li></ul></ul><ul><ul><ul><li>How do you manage risks </li></ul></ul></ul><ul><ul><ul><li>Rates may look attractive </li></ul></ul></ul><ul><ul><ul><li>Will this work for my Company? </li></ul></ul></ul>What Can I Do? Benefits: Health Care Reform
  12. 12. <ul><li>Wellness </li></ul><ul><ul><li>Government tried but fell a little short </li></ul></ul><ul><ul><li>Health Conditions </li></ul></ul><ul><ul><ul><li>According to BCBS of TX 5 most expensive medical conditions </li></ul></ul></ul><ul><ul><ul><ul><li>Heart Disease, Ortho-Back, Renal Failure, Hypertension, Diabetes </li></ul></ul></ul></ul><ul><ul><ul><li>Among minority groups two major health concerns </li></ul></ul></ul><ul><ul><ul><ul><li>Hypertension & Diabetes </li></ul></ul></ul></ul><ul><ul><ul><li>For every pound of weight that you lose, it removes 3 pounds of pressure off your knees and back. </li></ul></ul></ul><ul><ul><li>Benefits of Wellness </li></ul></ul><ul><ul><ul><li>Increase productivity </li></ul></ul></ul><ul><ul><ul><li>Reduce absenteeism </li></ul></ul></ul><ul><ul><ul><li>Reduce health insurance rates </li></ul></ul></ul>What Can I Do? Benefits: Health Care Reform
  13. 13. <ul><li>Change in Philosophy </li></ul><ul><ul><li>Understand </li></ul></ul><ul><ul><ul><li>Consumer Driven Health Plans </li></ul></ul></ul><ul><ul><ul><li>Employees have skin in the game </li></ul></ul></ul><ul><ul><ul><li>Work with subject matter experts </li></ul></ul></ul><ul><ul><ul><ul><li>Understand how your plan works </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Deductibles, Out of pocket maximums, HSA’s Gap Products, Supplemental Insurance Products </li></ul></ul></ul></ul><ul><ul><li>Pay Penalty vs. Offering Health insurance? </li></ul></ul><ul><ul><ul><li>30% of companies are considering canceling insurance plans </li></ul></ul></ul><ul><ul><ul><li>Penalties less than the offering health Insurance </li></ul></ul></ul><ul><ul><ul><ul><li>AT&T – 2.4 billion to offer insurance vs. 600 million penalty. </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Chance employees will leave to other companies </li></ul></ul></ul></ul>What Can I Do? Benefits: Health Care Reform
  14. 14. <ul><li>Updates </li></ul><ul><ul><li>Subject matter experts </li></ul></ul><ul><li>Take action </li></ul><ul><ul><li>Education </li></ul></ul><ul><ul><li>Philosophical changes </li></ul></ul><ul><ul><li>Wellness </li></ul></ul>Overview Benefits: Health Care Reform
  15. 15. Questions? Benefits: Health Care Reform
  16. 16. Contact Information Benefits: Health Care Reform <ul><li>Web: </li></ul><ul><li>Facebook: </li></ul><ul><li>LinkedIn: </li></ul><ul><li>Twitter: @eESI_Talk </li></ul>Thank you to the North Chamber, members and guest for the opportunity to participate in the Small Business How 2 Series.