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Understanding 
PPACA: A Dose of 
Accounting Medicine 
February 13, 2014 Jay Hutto, CPA/ABV/CFF, CVA 
Partner
Health Care Update 
• Business reporting and penalties have been 
delayed until January 1, 2015 for employers 
with 100 or more full-time equivalent (FTE) 
employees that offer insurance to 70 percent 
of workers for 2015 and 95 percent thereafter 
• Under new rules, employers with 50 to 99 FTE 
employees will be given until 2016 to offer 
health care coverage before being subject to 
shared-responsibility payments 
• Employers with fewer than 50 FTE employees 
do not have to offer coverage but will need to 
report on workers and health care insurance 
coverage in 2015
Health Care Overview 
• Transition relief offered if employer doesn’t 
reduce the size of its workforce or the 
overall hours of service of its employees 
unless the reductions are for a bona fide 
business reason 
• The individual mandate penalty was 
effective as of January 1, 2014 via the Form 
1040 
• For the Health Care Marketplace 
(Exchanges), there are new storefronts, 
kiosks, call centers, and navigators assisting 
individuals with obtaining coverage
Health Care Review 
• Florida is one of the majority of states 
that do not have a separate exchange so 
individuals and small businesses will go to 
www.healthcare.gov for information 
• Medicare Part D - Subsidy is reduced for 
those with incomes above $170,000 
(couples)/ $85,000 (single) 
• Medical device manufacturers and 
importers must pay a 2.3% tax imposed 
on the sale of any medical device
Status Of Reform 
• Florida has not participated in 
Medicaid expansion 
• Medical malpractice reform has not 
been addressed 
• Medical Loss Ratio (MLR) Insurance 
Rebates are paid if the health 
insurance issuer does not spend at 
least 80% or 85% (large plans) of 
premium dollars on medical care 
starting back in 2012
Fees 
• PCORI fees for self-insured and health reimbursement accounts (HRAs) are 
paid on Form 720 and will be included in health insurance premiums for 
policies with policy years ending after September 30, 2012. 
– The fee is $1 per covered person ($2 for plan years after September 30, 
2013). 
• Health Insurance Industry fee – fund premium subsidies and cost-sharing 
reductions for exchange participants (2% to 2.5% of premium) 
• Reinsurance fee – stabilize premiums in exchange due to high cost claimants 
($63 per member per year) 
• Risk Adjustment fee – spread the financial risk in the exchange 
• Marketplace User fee – fund a self-sustaining exchange going forward 
(equates to 3.5% of premiums)
Summary Of PPACA – 2010 And 2011 
• Small business tax credit since 2010 
• Dependent coverage up to 26 and no discrimination for pre-existing 
conditions 
• Over-the-counter drugs (OTCD) are no longer treated as allowable for 
FSA, HSA, HRA and MSA 
• Increased tax on non-qualifying HSA and MSA distributions to 20%
Small Business Health Care Credit 
• Available for certain businesses offering health coverage 
• For uniform non-elective contributions if business has no more than 25 full-time 
employees (FTE) with an average annual wage of no more than $50,000 
• The maximum credit is the lesser of: 
– Actual insurance paid by the employer, or 
– What the employer would have paid had the employee enrolled in 
coverage with a small business benchmark premium (Rev. Rul. 2010-13) 
• Multiplied by the percentages below: 
– 2010 - 2013: 35% 
– 2014 and beyond: 50% (SHOP and 2 yr max) 
• The credit is refundable for nonprofits but subject 
to the sequestration reduction
Small Business Health Care Credit 
• Credit phase-out is the sum of: 
– The credit x (# of FTE – 10)/15, and 
– The credit x (average annual wage – 
$25,000)/$25,000 
• Employer contribution must be at least 
50% of the premiums paid for employee 
only coverage 
• Tax-exempt employers can qualify 
• Any unused credit is carried forward 
• Qualified premiums are those paid in a 
uniform percentage for all employees
Summary Of 2012 
• Reporting of cost of employer-sponsored 
health coverage 
(250 or more W-2s) 
• Summary of Benefits and 
Coverage must be provided 
• Medical loss rebates 
• Electronic medical records 
(EMR)
How will I be affected in 2013? 
What does this mean for taxpayers? 
• Additional Medicare Tax: 
– For single taxpayer employees earning 
over $200,000 (married taxpayers filing 
jointly $250,000) 
– Pay an additional 0.9% Medicare tax over 
the 1.45% tax currently applicable 
• Tax applies to wages and self-employment 
income in excess of threshold 
• Thresholds not affected by inflation 
• Penalty for being married 
• No employer match on 0.9% tax
Tax on Earnings - Example 
John 
• Single taxpayer 
• Self-employed 
• $500,000 
Excess of Earnings Threshold 
$500,000 
- $200,000 
$300,000 
0.9% surtax would 
apply to $300,000 
= 
$2,700 Additional Tax
Medicare Surtax 
3.8% of the lesser of 1. Net Investment Income OR 
2. The excess (if any) of: 
- “Modified Adjusted Gross 
Income” (MAGI) 
- “Threshold Amount” 
($200,000 single, $250,000 
married)
Net Investment Income 
• Net Investment Income Categories: 
1. Passive Income 
2. Net Gain from Dispositions of Entity 
Interest 
3. Investment Income 
• Trust threshold for 3.8% tax is $11,000 
• Investment fees can reduce net 
investment income
3.8% Medicare Surtax – Example 1 
John 
• Single taxpayer 
• $100,000 of salary 
• $50,000 net investment 
income 
• 3.8% surtax would NOT 
apply 
• MAGI is less than 
threshold 
MAGI 
$150,000
3.8% Medicare Surtax – Example 2 
Tom & Sandy 
• Married, filing jointly 
• $400,000 salary income 
• $50,000 net investment 
income 
Excess of Earnings Threshold 
$400,000 
- $250,000 
$150,000 
• 3.8% surtax would apply to 
$50,000 = 
$1,900 Additional Tax 
AND 
• 0.9% surtax would 
apply to $150,000 = 
$1,350 Additional Tax
Summary Of 2013 
• Medicare payroll tax 
• Unearned income surtax 
• Medical expense deduction – exceeds 
10% of AGI 
• New FSA contribution limits of $2,500 
per year 
• Medical device manufacturer excise tax 
• Notice regarding exchange was delayed 
from March 1, 2013 to October 1, 2013
Impact For 2014 And After 
• Health insurance exchanges 
• Penalties if no health insurance post 2013 for 
individual mandates 
• Penalties if large employer and no health 
insurance for full-time workers post 2014 for 
employer mandates 
• Reporting requirements post 2014 also for 
employers 
• Pay or Play penalty for 2015: 
- Depends on whether coverage is offered 
- Penalty as high as $2,000 - $3,000 per employee
Impact For 2014 And After 
• Waiting period – 90 days 
• Increase access to Medicaid in 
certain states based on % of 
poverty level 
• Pre-existing coverage 
conditions and no limits 
• Cadillac Health Plan 
– 40% Excise Tax (2018)
Group Health Plans for 2014 
• Plans through 2013 – Old rules allowed for a company health 
insurance plan to provide reimbursement to the employee for 
health insurance as long as it was under an accountable plan 
and not discriminatory. Otherwise, the reimbursement must 
be included in wages. 
• Plans for 2014 and future years – There is no pre-tax 
reimbursement for individual insurance plan under the ACA. 
Employers must have a group health insurance in place to be 
tax-free to the employee.
Integrated Health Plan 
• An HRA is an arrangement that is funded solely by an employer and that 
reimburses an employee for medical care expenses incurred by the 
employee, or his spouse, dependents, and any children who, as of the 
end of the taxable year, have not attained age 27, up to a maximum dollar 
amount for a coverage period. 
• The ACA provides that an employer-sponsored HRA cannot be integrated 
with individual market coverage. 
• A group health plan used to purchase coverage on the individual market is 
not integrated and will fail to comply with the annual dollar limit prohibition 
because an employer payment plan is considered to impose an annual limit 
up to the cost of the individual market coverage purchased through the 
arrangement and an employer payment plan cannot be integrated with any 
individual health insurance policy purchased under the arrangement.
Integrated Health Plan (continued) 
An HRA is integrated with another group health plan for purposes of the annual dollar limit 
prohibition and the preventive services requirements if (1) the employer offers a group 
health plan (other than the HRA) to the employee that does not consist solely of excepted 
benefits; (2) the employee receiving the HRA is actually enrolled in a group health plan (other 
than the HRA) that does not consist solely of excepted benefits, regardless of whether the 
employer sponsors the plan (non-HRA group coverage); (3) the HRA is available only to 
employees who are enrolled in non-HRA group coverage, regardless of whether the employer 
sponsors the non-HRA group coverage (for example, the HRA may be offered only to 
employees who do not enroll in the employer’s group health plan but are enrolled in other 
non-HRA group coverage, such as a plan maintained by the employer of the employee’s 
spouse); (4) the HRA is limited to reimbursement of one or more of the following—co-payments, 
co-insurance, deductibles, and premiums under the non-HRA group coverage, as 
well as medical care that does not constitute essential health benefits; and (5) under the 
terms of the HRA, an employee (or former employee) is permitted to permanently opt out of 
and waive future reimbursements from the HRA at least annually and, upon termination of 
employment, either the remaining amounts in the HRA are forfeited or the employee is 
permitted to permanently opt out of and waive future reimbursements from the HRA. This 
opt-out feature is required because the benefits provided by the HRA generally will constitute 
minimum essential coverage and will therefore preclude the individual from claiming a 
premium tax credit. If minimum value is required, item (4) above is not required.
Year Provision 
2013 • Flexible spending arrangement the maximum drops to $2,500 per plan 
year 
• New “HI” (hospital insurance tax) on high-income taxpayers (.9% tax 
on wages in excess of threshold amount) 
• New 3.8% Medicare tax on investment income 
• Medical care itemized deduction threshold increases to 10% of AGI 
starting in 2013 but remains at 7.5% for those age 65 and older until 
2016 
• Notification to employees by October 1, 2013 
2014 
2015 
• States will be required to provide federally approved insurance plans 
or default to federal marketplace 
• Premium assistance credit 
• Excise tax on uninsured individuals on Form 1040 
• Excise tax on applicable large employers 
• Insurer reporting requirements 
2017 • Increase in medical deduction threshold for taxpayers age 65 and over 
2018 • Excise tax on high-cost employer plans
Individual Health Insurance Plans 
The insurance price is determined by only 
four criteria: 
1. Age – Older people will not pay more than 
three times the amount younger people 
pay 
2. Premium Rating Area – High cost areas will 
have more expensive insurance 
3. Number of family members covered 
4. Tobacco Use Observation – Young adults 
and men may see an increase in premiums
Essential Health Benefits 
Generally, the following ten benefits must be 
provided with no annual or lifetime limits: 
1. Ambulatory services 
2. Emergency services 
3. Hospitalization 
4. Maternity and Newborn care 
5. Mental Health and substance abuse 
6. Prescription drugs 
7. Rehabilitative services 
8. Laboratory services 
9. Pediatric services including oral and vision care 
10. Preventative and wellness services and chronic disease management
Individual Mandate 
• The requirements 
• The penalty 
• Premium Assistance Credit 
• Note: Not like a normal 
credit. The money goes 
directly to the insurance 
company. 
• Exceptions to the penalty 
• Define Minimum Essential 
Coverage
Individual Mandate (continued) 
• Small Business Health Options Program 
(SHOP) Marketplace for small 
businesses with up to 100 employees 
• Must purchase insurance through the 
SHOP Marketplace to be eligible for 
small business health care tax credit for 
tax years 2014 and beyond 
• Online SHOP Marketplace has been 
delayed by one year requiring an agent, 
broker or insurance company to get 
coverage
Penalty For Remaining Uninsured 
• Minimum essential coverage is 
required to avoid the penalty 
• Insurance bought through an 
exchange will meet the minimum 
essential requirements 
• The penalty imposed on the 
uninsured under 18 is one-half of that 
imposed on adults 
• A taxpayer is responsible for providing 
coverage if they are able to claim a 
personal exemption for the person
Penalty For Remaining Uninsured (continued) 
• Exemptions from penalties 
• The penalty is the greater of a Percentage of the Taxpayer’s Income 
or a Flat Dollar Amount. The per adult annual penalty is phased in: 
2014: Greater of 1% of applicable income* or $95 
2015: Greater of 2% of applicable income or $325 
2016: Greater of 2.5% of applicable income or $695 
2017 and beyond: Indexed for inflation from $695 
* Applicable Income is the excess of household income over the 
threshold filing amount.
Penalty Cap 
• The Flat Dollar amount is capped at 300% 
of the adult penalty (without regard to 
dependents) 
• For 2016, the cap is 2.5% of household 
income or $2,085 (3 x $695) 
• The penalty cannot exceed the cost of a 
bronze level plan 
• The penalty applies to any period essential 
coverage is not maintained (monthly) 
• The penalty is to be assessed through the 
IRC (no liens or levies allowed)
Premium Assistance Credit 
• Tax credit available for those with incomes up to 400% of the federal 
poverty level — currently: $46,680 (single), $95,400 (family of four) 
• Not eligible for Medicaid or affordable employer insurance 
• These people will have to obtain insurance through an exchange
Premium Assistance Credit 
• Based on income level estimated before the 
enrollment period 
• Eligibility is determined month-by-month 
• Cannot be eligible to be claimed as a 
dependent 
• The taxpayer is only eligible for the credit if 
the employer coverage is unaffordable 
• The employer plan is unaffordable if the 
employee must pay (self-coverage only) 
premiums that exceed 9.5% of household 
income
Substantiation of Income in the Marketplace 
• Include taxpayer, spouse, children who live with you, unmarried 
partner, any dependent, and anyone else under 21 who you take care 
of and lives with you 
• Estimate your income for 2014 including wages, net income from self-employment 
or business, unemployment, Social Security, alimony and 
other items included in household income 
• Household income is MAGI plus any tax-exempt Social Security, tax-exempt 
interest and tax-exempt foreign income 
• Any adjustment necessary based on actual income will be reflected on 
tax return
Premium Assistance Credit Household Income 
• Household Income is AGI plus: 
– Tax exempt income, foreign 
earned income and housing 
excluded under Section 911, 
and excluded social security 
benefits 
• Also include the AGI of 
dependents who are required 
to file a return
Premium Assistance Credit Household Income 
• Taxpayer buys insurance at the exchange and the exchange makes advance 
payments on behalf of taxpayer after the exchange determines eligibility. 
At tax time, taxpayer reconciles the actual credit for the tax year computed 
on his 1040 with the amount of advance payments made on his behalf. If 
the credit exceeds the amount of advance payments, he gets a refund or 
the excess amount is applied to other taxes owed. If the advance payments 
exceed the credit, he owes but the amount owed is limited. 
• Repayment of excess - The limitation is between $600 - $2,500 ($300 - 
$1,250 single) 
• The credit is the lesser of the premiums for the month or a calculation 
based on your household income (Excess of “adjusted monthly premium” 
for a “benchmark plan” (silver plan) over 1/12 of the product of household 
income and the “applicable percentage”)
Premium Assistance Credit 
Applicable Percentage 
Household Income as % of Percentage of 
Federal Poverty Level (FPL) Household Income 
Less than 133% 2.0 – 2.0% 
133% to 150% 3.0 – 4.0% 
150% to 200% 4.0 – 6.3% 
200% to 250% 6.3 – 8.05% 
250% to 300% 8.05 – 9.50% 
300% to 400% 9.50 – 9.50% 
Over 400% N/A 
Credit is benchmark plan premium over percentage.
Cost Sharing Reduction Subsidy 
• The Cost Sharing Reduction Subsidy is available to those that 
qualify with income not exceeding 250% of the FPL 
• This subsidy allows for a reduction in the amount of out-of-pocket 
expense they could incur 
• Applies to deductibles and co-pays 
• Must buy insurance through an Exchange to qualify
Exemption From Individual Mandate Penalty 
1. Religious reasons 
2. Member of health care sharing ministry 
3. Indian tribes 
4. No tax return filing requirement 
5. Short coverage gap (went without coverage for less than three 
consecutive months). The coverage gap only applies to the first gap. 
6. Unaffordable coverage options – Minimum amount you must pay for 
premiums is more than 8% of your adjusted household income. 
7. Incarceration 
8. Not a U.S. citizen, a U.S. national nor an alien lawfully present in the U.S.
Exemption From Penalty – 8% Rule 
• If premiums exceed 8% of Adjusted 
Household Income, the taxpayer is 
exempted from penalties 
• Adjusted Household Income is AGI plus: 
– Tax exempt income, foreign earned 
income and housing excluded under 
Section 911 
• Subtotal is called Household Income 
• Add back premiums paid through a salary 
reduction plan (e.g. Cafeteria plan) 
• Total is Adjusted Household Income
Exemption From Penalty – 8% Rule (continued) 
• Also include the AGI of dependents 
who are required to file a return 
• Do not add in non-taxed Social 
Security benefits as we do with the 
Premium Assistance Credit 
• If an individual can only buy through 
an Exchange the cost is based on 
Bronze level premiums
Employer Mandate 
• Effective Date - Effective January 1, 2015 for large 
employers with 100 or more full-time equivalent 
(FTE) employees and effective January 1, 2016 for 
employers with 50 to 99 FTE employees 
• Large Employer Play or Pay – A large employer is 
one that had at least 50 FTE (average at least 30 
hours per week or 130 hours per month) during 
the previous calendar year 
• Part-time workers – In determining whether a 
company is a large employer the employer will 
take the aggregate number of hours of part-time 
employees ÷ 120 and add this to the number of 
FTEs
Employer Mandate 
• Large Employer (100+ FTE) – Business reporting and penalties delayed 
until January 1, 2015. No penalties if offer insurance to 70 percent of 
workers for 2015 and 95 percent of workers in 2016 and future years. 
• Large Employer (50-99 FTE) – Shared-responsibility payments delayed 
until January 1, 2016 
• All Employers – Beginning in 2015, must report on workers and health 
care insurance coverage. 
• Transition Relief – Available only if employer doesn’t reduce the size of its 
workforce or the overall hours of service of its employees unless the 
reductions are for a bona fide business reason. 
• Reimbursement of Individual Policies – Not available in 2014 unless part 
of an integrated Health Reimbursement Arrangement (HRA)
Employer Mandate (continued) 
• An exemption applies where the 
workforce exceeds 50 FTE for no more 
than 120 days, and the employees in 
excess of 50 were seasonal 
• Include all hours which the employee 
is paid including holidays, vacation, 
sick pay, etc. 
• Coverage must begin within 90 days 
of employment for full-time 
employees
Employer Mandate Periods 
• If an employee works at least 30 hours per week during the 
measurement period, then they are treated as full-time during the 
stability period regardless of how many hours they actually work. 
• Standard Measurement Period - A three to six month period where an 
employer can look back. The employer can choose the length of time. 
The length of time needs to be consistent with employees in the 
following categories: salaried and hourly employees, employees of 
different entities, employees in different states, and collectively 
bargained and non-collectively bargained employees.
Employer Mandate Periods 
• Stability period - A period of time where 
employees determined to be full-time in the 
measurement period must be offered insurance. 
• Must be for at least six consecutive calendar 
months and no shorter than the measurement 
period. 
• Initial measurement period can be used by an 
employer that is between three to twelve months. 
• An administrative period is available for new 
employees in addition to the initial measurement 
period of up to 90 days before the stability period 
starts.
Employer Mandate Potential Penalties 
1. “No coverage penalty” - An employer does not offer minimum essential 
insurance to at least 95% (70% for 2015) of its full-time employees (in 
2015 this includes dependents) and at least one employee qualifies for the 
Premium Assistance Credit or Cost Sharing Reduction. The penalty is 
calculated on a monthly basis and there is a 30 FTE threshold before the 
penalty is applied. 
2. “Lacking Minimum Value or Unaffordable Penalty” - An employer does 
offer minimum essential coverage to at least 95% (70% for 2015) of the 
full-time, but at least one employee qualifies for the Premium Assistance 
Credit or Cost Sharing Reduction. The penalty is assessed monthly with a 
maximum of the above penalty.
Affordable Coverage 
• Affordable coverage is determined to exist 
if an employee’s share of the premium for 
employer provided coverage would cost 
the employee no more than 9.5% of that 
employee’s annual household income 
• If an employer offers multiple healthcare 
coverage options, the affordability test 
applies to the lowest-cost option available 
to the employee that also meets the 
minimum value requirement
Affordable Coverage 
Employers can take advantage of one of the following safe harbors to 
determine if the coverage is affordable: 
a. Form W-2 Determination Method - Self-Only coverage does not exceed 
9.5% of the W-2 as reported in Box 1. This is determined at the end of 
the year on an employee-by-employee basis. The employee’s required 
contribution must remain consistent throughout the year. 
b. Federal Poverty Line Method - The cost does not exceed 9.5% of the 
Federal Poverty Line. 
c. Rate of Pay Method - The cost does not exceed 9.5% of 130 hours x 
employee’s rate of pay as of the first day of the coverage period. Use 
monthly salary for salaried employees.
Minimum Value 
Methods for an employer to determine 
whether the coverage it offers provides 
minimum value: 
a. A minimum value calculator will be made 
available by the IRS and the Department 
of Health and Human Services (HHS). 
Employers can input information and 
determine if the plan provides minimum 
value by covering at least 60% of the 
expected costs. 
b. Ask the insurance agent or company.
Employer Mandate Issues 
• Testing Periods - The employer can use any consecutive six month period 
in the prior year to measure the number of employees for the applicable 
year. 
• Aggregation rules - Controlled and Affiliated group rules apply so you 
can’t bypass with multiple companies. 
• Benefits provided through an association - The determination of large 
employer status is made at the employer level. 
• The IRS will send a notice and demand for payment of the Employer 
Shared Responsibility payment due and it is not deductible.
Employer Mandate Tax Planning 
• Measurement Period 
• Keep Employees Below 30 
Hours Per Week 
• Use Independent Contractors 
• Health Insurance Coverages 
• Thomson Reuters EBIA Health 
Care Reform Tool for 
independent information
Cadillac Plans Excise Tax 
• 40% tax imposed on high cost employer-sponsored 
and self-insured plans beginning 
in 2018 
• The tax is levied on insurance companies and 
plan administrators 
• It is applied to annual insurance premiums 
for those under 55 that exceed $10,200 for 
individuals/$27,500 for families 
• For ages 55 and above, the threshold is 
$11,850 for individuals/$30,950 for families 
• There are age, gender and other 
adjustments
Obamacare Strategy Steps 
• Notice to Employees required on October 1, 2013 
(http://www.dol.gov/ebsa/faqs/faq-noticeofcoverageoptions.html) 
• Get an accurate head count to determine if the employer mandate is applicable 
• Consider whether you will offer coverage 
• Decide where to shop for health insurance (SHOP, Private, Marketplace, Direct, 
or Agents) 
• Explore a Self-Funded Plan (avoid community ratings) 
• Consider Skinny Plan Strategy (doesn’t meet ACA minimum value test) to limit 
the penalty to $3,000 per-employee only for employees who actually claims a 
subsidy on exchange. The benefit to the employee is that they may qualify for 
subsidy and avoid individual mandate penalty. 
• Claim your Tax Credit if you have 25 or fewer FTEs and pay average wages 
below $50,000 and pay at least half the cost of employee only health insurance 
(SHOP and 2 year limitation for 2014 and future years).
American Tax Relief Act (ATRA) 
• Agreement on legislation to address 
the “fiscal cliff” 
• 2012: Ordinary-income rates 
permanent, ranging from 10% to 35% 
• 2013: Taxable income exceeding the 
following amounts are subject to the 
top marginal tax rate of 39.6%: 
– $400,000 (Single) 
– $425,000 (Heads of Household) 
– $450,000 (Married Filing Jointly)
American Taxpayer Relief Act 
• Individual Tax Rates – Joint 2013 Taxable Income 2012 2013 
0 10% 10% 
17,850 15% 15% 
72,500 25% 25% 
146,400 28% 28% 
223,050 33% 33% 
398,350 35% 35% 
450,000 39.6% 
• Capital gains - max 15% 20% 
• Qualified dividends - max 15% 20% 
• Estate/Gift tax rate 35% 40%
American Tax Relief Act (ATRA) 
• 2013: Return of limits on certain itemized 
deductions. Thresholds at: 
– $250,000 (Single) 
– $275,000 (Heads of Household) 
– $300,000 (Married Filing Jointly) 
• Long-term capital gains 
– 2012 rates of 0% and 15% 
• Taxable income exceeding thresholds face 
long-term gains rate of 20%. Thresholds at: 
– $400,000 (Single) 
– $425,000 (Heads of Household) 
– $450,000 (Married Filing Jointly)
Return Of Phase-Outs – Exemptions 
• Phase out of personal exemptions starting after 2012 
• Reduced 2% for each $2,500 or part thereof Adjusted Gross 
Income in excess of new thresholds: 
Joint $300,000 
Head of Household $275,000 
Single $250,000 
Married filing separate $150,000 
• Can be completely phased out 
• Adjusted for inflation after 2013
Return Of Phase-Outs – Itemized Deductions 
• Limitation of itemized deductions starting after 2012 
• 3% of excess of adjusted gross income in excess of new thresholds: 
Joint $300,000 
Head of Household $275,000 
Single $250,000 
Married filing separate $150,000 
• Adjusted for inflation after 2013 
• Reduction not to exceed 80% of Schedule A amount 
• Medical, investment interest, casualty and gambling losses not 
reduced by limitation
American Tax Relief Act (ATRA) 
• Alternative Minimum Tax (AMT) relief 
retroactive to January 1, 2012 
• Tax break extensions: 
– Deduction for state and local sales tax in 
lieu of state and local income tax 
– Child- and education-related credits and 
deductions 
– Taxpayers age 70 ½ or older can make 
direct tax-free rollover from an IRA to 
charity 
– Certain home and energy-related breaks
American Tax Relief Act (ATRA) (cont.) 
• Estate Taxes 
– Top estate tax rate, 40% 
– “Portability” election permanent 
– Exemption annually inflated, 
adjusted $5 million
How To Prepare?
Questions 
Jay Hutto, CPA/ABV/CFF, CVA 
Partner 
James Moore, CPAs 
www.jmco.com 
Jay.Hutto@jmco.com 
Ph: 352.378.1331 
http://www.linkedin.com/pub/ 
jay-hutto-cpa/5/7a7/52a

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Understanding Health Care Reform: A Dose of Accounting Medecine

  • 1. Understanding PPACA: A Dose of Accounting Medicine February 13, 2014 Jay Hutto, CPA/ABV/CFF, CVA Partner
  • 2. Health Care Update • Business reporting and penalties have been delayed until January 1, 2015 for employers with 100 or more full-time equivalent (FTE) employees that offer insurance to 70 percent of workers for 2015 and 95 percent thereafter • Under new rules, employers with 50 to 99 FTE employees will be given until 2016 to offer health care coverage before being subject to shared-responsibility payments • Employers with fewer than 50 FTE employees do not have to offer coverage but will need to report on workers and health care insurance coverage in 2015
  • 3. Health Care Overview • Transition relief offered if employer doesn’t reduce the size of its workforce or the overall hours of service of its employees unless the reductions are for a bona fide business reason • The individual mandate penalty was effective as of January 1, 2014 via the Form 1040 • For the Health Care Marketplace (Exchanges), there are new storefronts, kiosks, call centers, and navigators assisting individuals with obtaining coverage
  • 4. Health Care Review • Florida is one of the majority of states that do not have a separate exchange so individuals and small businesses will go to www.healthcare.gov for information • Medicare Part D - Subsidy is reduced for those with incomes above $170,000 (couples)/ $85,000 (single) • Medical device manufacturers and importers must pay a 2.3% tax imposed on the sale of any medical device
  • 5. Status Of Reform • Florida has not participated in Medicaid expansion • Medical malpractice reform has not been addressed • Medical Loss Ratio (MLR) Insurance Rebates are paid if the health insurance issuer does not spend at least 80% or 85% (large plans) of premium dollars on medical care starting back in 2012
  • 6. Fees • PCORI fees for self-insured and health reimbursement accounts (HRAs) are paid on Form 720 and will be included in health insurance premiums for policies with policy years ending after September 30, 2012. – The fee is $1 per covered person ($2 for plan years after September 30, 2013). • Health Insurance Industry fee – fund premium subsidies and cost-sharing reductions for exchange participants (2% to 2.5% of premium) • Reinsurance fee – stabilize premiums in exchange due to high cost claimants ($63 per member per year) • Risk Adjustment fee – spread the financial risk in the exchange • Marketplace User fee – fund a self-sustaining exchange going forward (equates to 3.5% of premiums)
  • 7. Summary Of PPACA – 2010 And 2011 • Small business tax credit since 2010 • Dependent coverage up to 26 and no discrimination for pre-existing conditions • Over-the-counter drugs (OTCD) are no longer treated as allowable for FSA, HSA, HRA and MSA • Increased tax on non-qualifying HSA and MSA distributions to 20%
  • 8. Small Business Health Care Credit • Available for certain businesses offering health coverage • For uniform non-elective contributions if business has no more than 25 full-time employees (FTE) with an average annual wage of no more than $50,000 • The maximum credit is the lesser of: – Actual insurance paid by the employer, or – What the employer would have paid had the employee enrolled in coverage with a small business benchmark premium (Rev. Rul. 2010-13) • Multiplied by the percentages below: – 2010 - 2013: 35% – 2014 and beyond: 50% (SHOP and 2 yr max) • The credit is refundable for nonprofits but subject to the sequestration reduction
  • 9. Small Business Health Care Credit • Credit phase-out is the sum of: – The credit x (# of FTE – 10)/15, and – The credit x (average annual wage – $25,000)/$25,000 • Employer contribution must be at least 50% of the premiums paid for employee only coverage • Tax-exempt employers can qualify • Any unused credit is carried forward • Qualified premiums are those paid in a uniform percentage for all employees
  • 10. Summary Of 2012 • Reporting of cost of employer-sponsored health coverage (250 or more W-2s) • Summary of Benefits and Coverage must be provided • Medical loss rebates • Electronic medical records (EMR)
  • 11. How will I be affected in 2013? What does this mean for taxpayers? • Additional Medicare Tax: – For single taxpayer employees earning over $200,000 (married taxpayers filing jointly $250,000) – Pay an additional 0.9% Medicare tax over the 1.45% tax currently applicable • Tax applies to wages and self-employment income in excess of threshold • Thresholds not affected by inflation • Penalty for being married • No employer match on 0.9% tax
  • 12. Tax on Earnings - Example John • Single taxpayer • Self-employed • $500,000 Excess of Earnings Threshold $500,000 - $200,000 $300,000 0.9% surtax would apply to $300,000 = $2,700 Additional Tax
  • 13. Medicare Surtax 3.8% of the lesser of 1. Net Investment Income OR 2. The excess (if any) of: - “Modified Adjusted Gross Income” (MAGI) - “Threshold Amount” ($200,000 single, $250,000 married)
  • 14. Net Investment Income • Net Investment Income Categories: 1. Passive Income 2. Net Gain from Dispositions of Entity Interest 3. Investment Income • Trust threshold for 3.8% tax is $11,000 • Investment fees can reduce net investment income
  • 15. 3.8% Medicare Surtax – Example 1 John • Single taxpayer • $100,000 of salary • $50,000 net investment income • 3.8% surtax would NOT apply • MAGI is less than threshold MAGI $150,000
  • 16. 3.8% Medicare Surtax – Example 2 Tom & Sandy • Married, filing jointly • $400,000 salary income • $50,000 net investment income Excess of Earnings Threshold $400,000 - $250,000 $150,000 • 3.8% surtax would apply to $50,000 = $1,900 Additional Tax AND • 0.9% surtax would apply to $150,000 = $1,350 Additional Tax
  • 17. Summary Of 2013 • Medicare payroll tax • Unearned income surtax • Medical expense deduction – exceeds 10% of AGI • New FSA contribution limits of $2,500 per year • Medical device manufacturer excise tax • Notice regarding exchange was delayed from March 1, 2013 to October 1, 2013
  • 18. Impact For 2014 And After • Health insurance exchanges • Penalties if no health insurance post 2013 for individual mandates • Penalties if large employer and no health insurance for full-time workers post 2014 for employer mandates • Reporting requirements post 2014 also for employers • Pay or Play penalty for 2015: - Depends on whether coverage is offered - Penalty as high as $2,000 - $3,000 per employee
  • 19. Impact For 2014 And After • Waiting period – 90 days • Increase access to Medicaid in certain states based on % of poverty level • Pre-existing coverage conditions and no limits • Cadillac Health Plan – 40% Excise Tax (2018)
  • 20. Group Health Plans for 2014 • Plans through 2013 – Old rules allowed for a company health insurance plan to provide reimbursement to the employee for health insurance as long as it was under an accountable plan and not discriminatory. Otherwise, the reimbursement must be included in wages. • Plans for 2014 and future years – There is no pre-tax reimbursement for individual insurance plan under the ACA. Employers must have a group health insurance in place to be tax-free to the employee.
  • 21. Integrated Health Plan • An HRA is an arrangement that is funded solely by an employer and that reimburses an employee for medical care expenses incurred by the employee, or his spouse, dependents, and any children who, as of the end of the taxable year, have not attained age 27, up to a maximum dollar amount for a coverage period. • The ACA provides that an employer-sponsored HRA cannot be integrated with individual market coverage. • A group health plan used to purchase coverage on the individual market is not integrated and will fail to comply with the annual dollar limit prohibition because an employer payment plan is considered to impose an annual limit up to the cost of the individual market coverage purchased through the arrangement and an employer payment plan cannot be integrated with any individual health insurance policy purchased under the arrangement.
  • 22. Integrated Health Plan (continued) An HRA is integrated with another group health plan for purposes of the annual dollar limit prohibition and the preventive services requirements if (1) the employer offers a group health plan (other than the HRA) to the employee that does not consist solely of excepted benefits; (2) the employee receiving the HRA is actually enrolled in a group health plan (other than the HRA) that does not consist solely of excepted benefits, regardless of whether the employer sponsors the plan (non-HRA group coverage); (3) the HRA is available only to employees who are enrolled in non-HRA group coverage, regardless of whether the employer sponsors the non-HRA group coverage (for example, the HRA may be offered only to employees who do not enroll in the employer’s group health plan but are enrolled in other non-HRA group coverage, such as a plan maintained by the employer of the employee’s spouse); (4) the HRA is limited to reimbursement of one or more of the following—co-payments, co-insurance, deductibles, and premiums under the non-HRA group coverage, as well as medical care that does not constitute essential health benefits; and (5) under the terms of the HRA, an employee (or former employee) is permitted to permanently opt out of and waive future reimbursements from the HRA at least annually and, upon termination of employment, either the remaining amounts in the HRA are forfeited or the employee is permitted to permanently opt out of and waive future reimbursements from the HRA. This opt-out feature is required because the benefits provided by the HRA generally will constitute minimum essential coverage and will therefore preclude the individual from claiming a premium tax credit. If minimum value is required, item (4) above is not required.
  • 23. Year Provision 2013 • Flexible spending arrangement the maximum drops to $2,500 per plan year • New “HI” (hospital insurance tax) on high-income taxpayers (.9% tax on wages in excess of threshold amount) • New 3.8% Medicare tax on investment income • Medical care itemized deduction threshold increases to 10% of AGI starting in 2013 but remains at 7.5% for those age 65 and older until 2016 • Notification to employees by October 1, 2013 2014 2015 • States will be required to provide federally approved insurance plans or default to federal marketplace • Premium assistance credit • Excise tax on uninsured individuals on Form 1040 • Excise tax on applicable large employers • Insurer reporting requirements 2017 • Increase in medical deduction threshold for taxpayers age 65 and over 2018 • Excise tax on high-cost employer plans
  • 24. Individual Health Insurance Plans The insurance price is determined by only four criteria: 1. Age – Older people will not pay more than three times the amount younger people pay 2. Premium Rating Area – High cost areas will have more expensive insurance 3. Number of family members covered 4. Tobacco Use Observation – Young adults and men may see an increase in premiums
  • 25. Essential Health Benefits Generally, the following ten benefits must be provided with no annual or lifetime limits: 1. Ambulatory services 2. Emergency services 3. Hospitalization 4. Maternity and Newborn care 5. Mental Health and substance abuse 6. Prescription drugs 7. Rehabilitative services 8. Laboratory services 9. Pediatric services including oral and vision care 10. Preventative and wellness services and chronic disease management
  • 26. Individual Mandate • The requirements • The penalty • Premium Assistance Credit • Note: Not like a normal credit. The money goes directly to the insurance company. • Exceptions to the penalty • Define Minimum Essential Coverage
  • 27. Individual Mandate (continued) • Small Business Health Options Program (SHOP) Marketplace for small businesses with up to 100 employees • Must purchase insurance through the SHOP Marketplace to be eligible for small business health care tax credit for tax years 2014 and beyond • Online SHOP Marketplace has been delayed by one year requiring an agent, broker or insurance company to get coverage
  • 28. Penalty For Remaining Uninsured • Minimum essential coverage is required to avoid the penalty • Insurance bought through an exchange will meet the minimum essential requirements • The penalty imposed on the uninsured under 18 is one-half of that imposed on adults • A taxpayer is responsible for providing coverage if they are able to claim a personal exemption for the person
  • 29. Penalty For Remaining Uninsured (continued) • Exemptions from penalties • The penalty is the greater of a Percentage of the Taxpayer’s Income or a Flat Dollar Amount. The per adult annual penalty is phased in: 2014: Greater of 1% of applicable income* or $95 2015: Greater of 2% of applicable income or $325 2016: Greater of 2.5% of applicable income or $695 2017 and beyond: Indexed for inflation from $695 * Applicable Income is the excess of household income over the threshold filing amount.
  • 30. Penalty Cap • The Flat Dollar amount is capped at 300% of the adult penalty (without regard to dependents) • For 2016, the cap is 2.5% of household income or $2,085 (3 x $695) • The penalty cannot exceed the cost of a bronze level plan • The penalty applies to any period essential coverage is not maintained (monthly) • The penalty is to be assessed through the IRC (no liens or levies allowed)
  • 31. Premium Assistance Credit • Tax credit available for those with incomes up to 400% of the federal poverty level — currently: $46,680 (single), $95,400 (family of four) • Not eligible for Medicaid or affordable employer insurance • These people will have to obtain insurance through an exchange
  • 32. Premium Assistance Credit • Based on income level estimated before the enrollment period • Eligibility is determined month-by-month • Cannot be eligible to be claimed as a dependent • The taxpayer is only eligible for the credit if the employer coverage is unaffordable • The employer plan is unaffordable if the employee must pay (self-coverage only) premiums that exceed 9.5% of household income
  • 33. Substantiation of Income in the Marketplace • Include taxpayer, spouse, children who live with you, unmarried partner, any dependent, and anyone else under 21 who you take care of and lives with you • Estimate your income for 2014 including wages, net income from self-employment or business, unemployment, Social Security, alimony and other items included in household income • Household income is MAGI plus any tax-exempt Social Security, tax-exempt interest and tax-exempt foreign income • Any adjustment necessary based on actual income will be reflected on tax return
  • 34. Premium Assistance Credit Household Income • Household Income is AGI plus: – Tax exempt income, foreign earned income and housing excluded under Section 911, and excluded social security benefits • Also include the AGI of dependents who are required to file a return
  • 35. Premium Assistance Credit Household Income • Taxpayer buys insurance at the exchange and the exchange makes advance payments on behalf of taxpayer after the exchange determines eligibility. At tax time, taxpayer reconciles the actual credit for the tax year computed on his 1040 with the amount of advance payments made on his behalf. If the credit exceeds the amount of advance payments, he gets a refund or the excess amount is applied to other taxes owed. If the advance payments exceed the credit, he owes but the amount owed is limited. • Repayment of excess - The limitation is between $600 - $2,500 ($300 - $1,250 single) • The credit is the lesser of the premiums for the month or a calculation based on your household income (Excess of “adjusted monthly premium” for a “benchmark plan” (silver plan) over 1/12 of the product of household income and the “applicable percentage”)
  • 36. Premium Assistance Credit Applicable Percentage Household Income as % of Percentage of Federal Poverty Level (FPL) Household Income Less than 133% 2.0 – 2.0% 133% to 150% 3.0 – 4.0% 150% to 200% 4.0 – 6.3% 200% to 250% 6.3 – 8.05% 250% to 300% 8.05 – 9.50% 300% to 400% 9.50 – 9.50% Over 400% N/A Credit is benchmark plan premium over percentage.
  • 37. Cost Sharing Reduction Subsidy • The Cost Sharing Reduction Subsidy is available to those that qualify with income not exceeding 250% of the FPL • This subsidy allows for a reduction in the amount of out-of-pocket expense they could incur • Applies to deductibles and co-pays • Must buy insurance through an Exchange to qualify
  • 38. Exemption From Individual Mandate Penalty 1. Religious reasons 2. Member of health care sharing ministry 3. Indian tribes 4. No tax return filing requirement 5. Short coverage gap (went without coverage for less than three consecutive months). The coverage gap only applies to the first gap. 6. Unaffordable coverage options – Minimum amount you must pay for premiums is more than 8% of your adjusted household income. 7. Incarceration 8. Not a U.S. citizen, a U.S. national nor an alien lawfully present in the U.S.
  • 39. Exemption From Penalty – 8% Rule • If premiums exceed 8% of Adjusted Household Income, the taxpayer is exempted from penalties • Adjusted Household Income is AGI plus: – Tax exempt income, foreign earned income and housing excluded under Section 911 • Subtotal is called Household Income • Add back premiums paid through a salary reduction plan (e.g. Cafeteria plan) • Total is Adjusted Household Income
  • 40. Exemption From Penalty – 8% Rule (continued) • Also include the AGI of dependents who are required to file a return • Do not add in non-taxed Social Security benefits as we do with the Premium Assistance Credit • If an individual can only buy through an Exchange the cost is based on Bronze level premiums
  • 41. Employer Mandate • Effective Date - Effective January 1, 2015 for large employers with 100 or more full-time equivalent (FTE) employees and effective January 1, 2016 for employers with 50 to 99 FTE employees • Large Employer Play or Pay – A large employer is one that had at least 50 FTE (average at least 30 hours per week or 130 hours per month) during the previous calendar year • Part-time workers – In determining whether a company is a large employer the employer will take the aggregate number of hours of part-time employees ÷ 120 and add this to the number of FTEs
  • 42. Employer Mandate • Large Employer (100+ FTE) – Business reporting and penalties delayed until January 1, 2015. No penalties if offer insurance to 70 percent of workers for 2015 and 95 percent of workers in 2016 and future years. • Large Employer (50-99 FTE) – Shared-responsibility payments delayed until January 1, 2016 • All Employers – Beginning in 2015, must report on workers and health care insurance coverage. • Transition Relief – Available only if employer doesn’t reduce the size of its workforce or the overall hours of service of its employees unless the reductions are for a bona fide business reason. • Reimbursement of Individual Policies – Not available in 2014 unless part of an integrated Health Reimbursement Arrangement (HRA)
  • 43. Employer Mandate (continued) • An exemption applies where the workforce exceeds 50 FTE for no more than 120 days, and the employees in excess of 50 were seasonal • Include all hours which the employee is paid including holidays, vacation, sick pay, etc. • Coverage must begin within 90 days of employment for full-time employees
  • 44. Employer Mandate Periods • If an employee works at least 30 hours per week during the measurement period, then they are treated as full-time during the stability period regardless of how many hours they actually work. • Standard Measurement Period - A three to six month period where an employer can look back. The employer can choose the length of time. The length of time needs to be consistent with employees in the following categories: salaried and hourly employees, employees of different entities, employees in different states, and collectively bargained and non-collectively bargained employees.
  • 45. Employer Mandate Periods • Stability period - A period of time where employees determined to be full-time in the measurement period must be offered insurance. • Must be for at least six consecutive calendar months and no shorter than the measurement period. • Initial measurement period can be used by an employer that is between three to twelve months. • An administrative period is available for new employees in addition to the initial measurement period of up to 90 days before the stability period starts.
  • 46. Employer Mandate Potential Penalties 1. “No coverage penalty” - An employer does not offer minimum essential insurance to at least 95% (70% for 2015) of its full-time employees (in 2015 this includes dependents) and at least one employee qualifies for the Premium Assistance Credit or Cost Sharing Reduction. The penalty is calculated on a monthly basis and there is a 30 FTE threshold before the penalty is applied. 2. “Lacking Minimum Value or Unaffordable Penalty” - An employer does offer minimum essential coverage to at least 95% (70% for 2015) of the full-time, but at least one employee qualifies for the Premium Assistance Credit or Cost Sharing Reduction. The penalty is assessed monthly with a maximum of the above penalty.
  • 47. Affordable Coverage • Affordable coverage is determined to exist if an employee’s share of the premium for employer provided coverage would cost the employee no more than 9.5% of that employee’s annual household income • If an employer offers multiple healthcare coverage options, the affordability test applies to the lowest-cost option available to the employee that also meets the minimum value requirement
  • 48. Affordable Coverage Employers can take advantage of one of the following safe harbors to determine if the coverage is affordable: a. Form W-2 Determination Method - Self-Only coverage does not exceed 9.5% of the W-2 as reported in Box 1. This is determined at the end of the year on an employee-by-employee basis. The employee’s required contribution must remain consistent throughout the year. b. Federal Poverty Line Method - The cost does not exceed 9.5% of the Federal Poverty Line. c. Rate of Pay Method - The cost does not exceed 9.5% of 130 hours x employee’s rate of pay as of the first day of the coverage period. Use monthly salary for salaried employees.
  • 49. Minimum Value Methods for an employer to determine whether the coverage it offers provides minimum value: a. A minimum value calculator will be made available by the IRS and the Department of Health and Human Services (HHS). Employers can input information and determine if the plan provides minimum value by covering at least 60% of the expected costs. b. Ask the insurance agent or company.
  • 50. Employer Mandate Issues • Testing Periods - The employer can use any consecutive six month period in the prior year to measure the number of employees for the applicable year. • Aggregation rules - Controlled and Affiliated group rules apply so you can’t bypass with multiple companies. • Benefits provided through an association - The determination of large employer status is made at the employer level. • The IRS will send a notice and demand for payment of the Employer Shared Responsibility payment due and it is not deductible.
  • 51. Employer Mandate Tax Planning • Measurement Period • Keep Employees Below 30 Hours Per Week • Use Independent Contractors • Health Insurance Coverages • Thomson Reuters EBIA Health Care Reform Tool for independent information
  • 52. Cadillac Plans Excise Tax • 40% tax imposed on high cost employer-sponsored and self-insured plans beginning in 2018 • The tax is levied on insurance companies and plan administrators • It is applied to annual insurance premiums for those under 55 that exceed $10,200 for individuals/$27,500 for families • For ages 55 and above, the threshold is $11,850 for individuals/$30,950 for families • There are age, gender and other adjustments
  • 53. Obamacare Strategy Steps • Notice to Employees required on October 1, 2013 (http://www.dol.gov/ebsa/faqs/faq-noticeofcoverageoptions.html) • Get an accurate head count to determine if the employer mandate is applicable • Consider whether you will offer coverage • Decide where to shop for health insurance (SHOP, Private, Marketplace, Direct, or Agents) • Explore a Self-Funded Plan (avoid community ratings) • Consider Skinny Plan Strategy (doesn’t meet ACA minimum value test) to limit the penalty to $3,000 per-employee only for employees who actually claims a subsidy on exchange. The benefit to the employee is that they may qualify for subsidy and avoid individual mandate penalty. • Claim your Tax Credit if you have 25 or fewer FTEs and pay average wages below $50,000 and pay at least half the cost of employee only health insurance (SHOP and 2 year limitation for 2014 and future years).
  • 54. American Tax Relief Act (ATRA) • Agreement on legislation to address the “fiscal cliff” • 2012: Ordinary-income rates permanent, ranging from 10% to 35% • 2013: Taxable income exceeding the following amounts are subject to the top marginal tax rate of 39.6%: – $400,000 (Single) – $425,000 (Heads of Household) – $450,000 (Married Filing Jointly)
  • 55. American Taxpayer Relief Act • Individual Tax Rates – Joint 2013 Taxable Income 2012 2013 0 10% 10% 17,850 15% 15% 72,500 25% 25% 146,400 28% 28% 223,050 33% 33% 398,350 35% 35% 450,000 39.6% • Capital gains - max 15% 20% • Qualified dividends - max 15% 20% • Estate/Gift tax rate 35% 40%
  • 56. American Tax Relief Act (ATRA) • 2013: Return of limits on certain itemized deductions. Thresholds at: – $250,000 (Single) – $275,000 (Heads of Household) – $300,000 (Married Filing Jointly) • Long-term capital gains – 2012 rates of 0% and 15% • Taxable income exceeding thresholds face long-term gains rate of 20%. Thresholds at: – $400,000 (Single) – $425,000 (Heads of Household) – $450,000 (Married Filing Jointly)
  • 57. Return Of Phase-Outs – Exemptions • Phase out of personal exemptions starting after 2012 • Reduced 2% for each $2,500 or part thereof Adjusted Gross Income in excess of new thresholds: Joint $300,000 Head of Household $275,000 Single $250,000 Married filing separate $150,000 • Can be completely phased out • Adjusted for inflation after 2013
  • 58. Return Of Phase-Outs – Itemized Deductions • Limitation of itemized deductions starting after 2012 • 3% of excess of adjusted gross income in excess of new thresholds: Joint $300,000 Head of Household $275,000 Single $250,000 Married filing separate $150,000 • Adjusted for inflation after 2013 • Reduction not to exceed 80% of Schedule A amount • Medical, investment interest, casualty and gambling losses not reduced by limitation
  • 59. American Tax Relief Act (ATRA) • Alternative Minimum Tax (AMT) relief retroactive to January 1, 2012 • Tax break extensions: – Deduction for state and local sales tax in lieu of state and local income tax – Child- and education-related credits and deductions – Taxpayers age 70 ½ or older can make direct tax-free rollover from an IRA to charity – Certain home and energy-related breaks
  • 60. American Tax Relief Act (ATRA) (cont.) • Estate Taxes – Top estate tax rate, 40% – “Portability” election permanent – Exemption annually inflated, adjusted $5 million
  • 62. Questions Jay Hutto, CPA/ABV/CFF, CVA Partner James Moore, CPAs www.jmco.com Jay.Hutto@jmco.com Ph: 352.378.1331 http://www.linkedin.com/pub/ jay-hutto-cpa/5/7a7/52a