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Healthcare Reform 2012


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Healthcare Reform 2012

  1. 1. Benefits: Health Care Reform Health Care Reform What It Means to My Business Presented by: eESI Ken Barge Shannon Schumacher
  2. 2. • 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
  3. 3. 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
  4. 4. • 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
  5. 5. Where Are We Now? Benefits: Health Care Reform • 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
  6. 6. Where Are We Now? Benefits: Health Care Reform • 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on how to report, what coverage to include and how to determine the cost of the coverage • 1099 Reporting requirements repealed • Employee Free Choice Voucher Program eliminated • Most of the funding for Cooperative Plans eliminated
  7. 7. 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
  8. 8. • 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
  9. 9. 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
  10. 10. • Pray • Take Action – Education – Wellness – Change in Philosophy What Can I Do? Benefits: Health Care Reform
  11. 11. • 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
  12. 12. • 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
  13. 13. • 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
  14. 14. • Updates – Subject matter experts • Take action – Education – Philosophical changes – Wellness Overview Benefits: Health Care Reform
  15. 15. Questions? Benefits: Health Care Reform
  16. 16. Contact Information Benefits: Health Care Reform Web: Facebook: LinkedIn: Twitter: @eESI_Talk Thank you to the North Chamber, members and guest for the opportunity to participate in the Small Business How 2 Series.