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Healthcare Reform 2011: The Good, the bad and the ugly


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Interpreting these new laws and regulations are complex but their affect on insurers, employers, medical professionals, and patients is even more confusing. Join HOW for a unique look at these changes and their influence on healthcare decisions for the coming years.

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Healthcare Reform 2011: The Good, the bad and the ugly

  1. 1. The good, the bad and the ugly Healthcare Reform in 2011: Presented by Health Options Worldwide
  2. 3. Health Care Reform Current Issues <ul><li>Implementation will occur in three waves </li></ul><ul><ul><li>2010 </li></ul></ul><ul><ul><li>2011-2013 </li></ul></ul><ul><ul><li>2014 + </li></ul></ul><ul><li>Court Cases </li></ul><ul><ul><li>26 states have filed suit </li></ul></ul><ul><ul><li>Equal protection under the law </li></ul></ul><ul><ul><li>Commandeering </li></ul></ul><ul><li>House repeal- What’s it mean </li></ul><ul><ul><li>Ongoing debate </li></ul></ul>
  3. 5. New Changes in Healthcare Reform <ul><li>National Coverage Requirement (2014) </li></ul><ul><ul><li>Pros </li></ul></ul><ul><ul><ul><li>Access to health insurance </li></ul></ul></ul><ul><ul><ul><li>Ability to change jobs </li></ul></ul></ul><ul><ul><ul><li>Open competition and increased transparency </li></ul></ul></ul><ul><ul><li>Cons </li></ul></ul><ul><ul><ul><li>Effects on computer systems </li></ul></ul></ul><ul><ul><ul><li>Federal money disappears (2014) </li></ul></ul></ul><ul><ul><ul><li>Different states, different rules </li></ul></ul></ul><ul><ul><ul><li>Fines and penalties </li></ul></ul></ul><ul><ul><ul><ul><li>Year 1: $95 </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Either $695 or 2.5% of a person’s income </li></ul></ul></ul></ul>
  4. 6. <ul><li>End of preexisting conditions </li></ul><ul><ul><li>Initially only applies to children </li></ul></ul><ul><ul><li>Extended to adults (2014) </li></ul></ul><ul><li>FSAs/HSAs/HRAs </li></ul><ul><ul><li>Over the counter medications </li></ul></ul><ul><ul><li>20% tax penalty </li></ul></ul><ul><ul><li>Maximum contributions of $2,500 to FSA (2013) </li></ul></ul>New Changes in Healthcare Reform (Cont)
  5. 7. 2011-2018: Employers are Going to Feel the Impacts of Healthcare Reform
  6. 8. Implications for Employers <ul><li>Coverage for dependents up to 26 years old </li></ul><ul><li>1099 tax provisions for employers </li></ul><ul><ul><li>Transactions of $600 + </li></ul></ul><ul><ul><li>Why hasn’t this been repealed? </li></ul></ul><ul><ul><li>$17Billion-$19 Billion </li></ul></ul><ul><li>Tax credits for small businesses </li></ul><ul><ul><li>Form 8941 </li></ul></ul><ul><ul><li>Eligibility requirements </li></ul></ul><ul><ul><ul><li>Average annual wages under $50,000 </li></ul></ul></ul><ul><ul><ul><li>Less than 25 full time employees </li></ul></ul></ul><ul><ul><ul><li>Employers must cover at least 50% of the cost </li></ul></ul></ul>
  7. 9. <ul><li>W-2 requirements of value of health benefits </li></ul><ul><ul><li>Cadillac Taxes </li></ul></ul><ul><ul><ul><li>$10,200 per individual or $27,500 for families </li></ul></ul></ul><ul><ul><ul><li>40% excise tax </li></ul></ul></ul><ul><ul><ul><li>Verizon: $255 million per year </li></ul></ul></ul><ul><li>Pay or Play: employers with 50+ employees </li></ul><ul><ul><ul><li>Fines </li></ul></ul></ul><ul><ul><ul><li>Full time employee? </li></ul></ul></ul><ul><ul><ul><li>Affordable? </li></ul></ul></ul><ul><ul><ul><li>Employer must pay 60%+ </li></ul></ul></ul><ul><ul><ul><li>Employees that use exchanges: $250 fine </li></ul></ul></ul>Implications for Employers (Cont)
  8. 10. Implications for Employers (Cont) <ul><li>AT&T </li></ul><ul><ul><li>Savings of $1.8B </li></ul></ul><ul><ul><li>“ 87% think they will continue to offer health care benefits because they are critical to employee recruitment, retention and remaining competitive.” –IFEBP </li></ul></ul><ul><ul><li>“ Nearly 65% of the largest employers strongly disagree that it would be better to pay fines.” – Workforce </li></ul></ul><ul><ul><li>“ 45% would drop coverage or consider options based on other employers’ actions” – Hewitt </li></ul></ul><ul><li>Ongoing Debate and evolution of health coverage during next decade </li></ul>
  9. 11. Question & Answer <ul><li>For additional information: </li></ul><ul><li>Phone: 1-877-234-1345 </li></ul><ul><li>Email: [email_address] </li></ul>