The document discusses key provisions of the Affordable Care Act including the employer mandate, individual mandate, premium tax credits, metallic levels, deductible and out-of-pocket limits, medical loss ratio, guaranteed issue, adjusted community rating, essential health benefits, and employer options. It provides an overview of the timeline for implementation of various ACA provisions from 2010 to 2018. The presentation is for the GA Chapter of the American Rental Association to explain health care reform and what employers can do.
ISCEBS 2014 Presentation: Health Care Reform’s Impact on Disability ManagementSpring Consulting Group
Recently, Spring Consultants Karen English and Kimberly Mashburn presented at the annual ISCEBS conference. They explore how Disability Management has been impacted by recent US health care changes brought on by the implementation of the Affordable Care Act (ACA)
This session focuses on Ed Health, a medical stop loss group captive consisting of 11 Boston-area colleges that Spring assisted in the development of. It details Ed Health’s success to date and lessons learned through the development and ongoing management of a medical stop loss group captive.
Pediatric Dental Benefits Under the ACA - What Employers (and dentists) Need ...Spring Consulting Group
With the ACA requiring health plans to cover pediatric dental plans, a number of questions have arisen from both employers and dentists. Here are a few of the basics that both groups need to know. Please note, that this information is specific to the State of Massachusetts, and some details may change from state to state.
Across the United States, a legislative movement to mandate paid sick leave time for all employees has picked up significant momentum over the past couple of years. With a number of states, municipalities and even the President advocating for these new mandates, it is important that employers know how these changes impact them.
At a recent Disability Management Employer Coalition event, Spring partner Teri Weber gave the presentation below on paid sick leave laws with fellow industry experts Geoffrey Simpson from Presagia and Mike Soltis from jackson lewis.
We hope you find this deck helpful and please don’t hesitate to reach out to Teri using the form below with any questions about paid sick leave laws or anything related to leave management.
ISCEBS 2014 Presentation: Health Care Reform’s Impact on Disability ManagementSpring Consulting Group
Recently, Spring Consultants Karen English and Kimberly Mashburn presented at the annual ISCEBS conference. They explore how Disability Management has been impacted by recent US health care changes brought on by the implementation of the Affordable Care Act (ACA)
This session focuses on Ed Health, a medical stop loss group captive consisting of 11 Boston-area colleges that Spring assisted in the development of. It details Ed Health’s success to date and lessons learned through the development and ongoing management of a medical stop loss group captive.
Pediatric Dental Benefits Under the ACA - What Employers (and dentists) Need ...Spring Consulting Group
With the ACA requiring health plans to cover pediatric dental plans, a number of questions have arisen from both employers and dentists. Here are a few of the basics that both groups need to know. Please note, that this information is specific to the State of Massachusetts, and some details may change from state to state.
Across the United States, a legislative movement to mandate paid sick leave time for all employees has picked up significant momentum over the past couple of years. With a number of states, municipalities and even the President advocating for these new mandates, it is important that employers know how these changes impact them.
At a recent Disability Management Employer Coalition event, Spring partner Teri Weber gave the presentation below on paid sick leave laws with fellow industry experts Geoffrey Simpson from Presagia and Mike Soltis from jackson lewis.
We hope you find this deck helpful and please don’t hesitate to reach out to Teri using the form below with any questions about paid sick leave laws or anything related to leave management.
In less than one year, major provisions of the Patient Protection and Affordable Care Act are taking effect at state and federal levels, and many of those new provisions will directly impact businesses around the country. At this event, we’ll present fact-based, non-partisan information that’s important to Colorado business leaders: the timeline of the law and important dates.
The Institute of Medicine's report, Unequal Treatment: Confronting Racial/Ethnic Disparities in Health Care, cited more than 175 studies documenting diagnostic and treatment disparities of various conditions among racial/ethnic populations, even when confounding factors (e.g., insurance and socioeconomic status, comorbidities, age, healthcare venue, stage of diseases) were controlled for in analyses.Specific examples include higher rates of hypertension, diabetes, breast cancer, cervical cancer, colon cancer, and cardiovascular diseases in African Americans; diabetes in Native Americans, Alaskan Natives, and Latino populations; and heart disease mortality in certain Asian American, Latino or Hispanic, and Native American groups.Lower rates of immunization and higher rates of infant mortality have been reported in African American, Hispanic, and Native American populations.
The recently enacted federal healthcare legislation will affect virtually everyone and will mean significant changes for patients, insurers, employers, hospitals and physicians. This is one of the largest changes to the tax laws in the past 30 years. Are you interested in finding out how the Reform will affect you or your business? We want to help. We are offering presentations to businesses and groups to provide information on how the Reform may impact you.
For more information visit our website at www.kl-cpa.com.
Health Care Reform Strategies for Small Employers:
• Health Care Tax Credits and Penalties
• The Recently Delayed Pay or Play Mandate
• Health Insurance Exchanges
• SHOPs
• Other Cost-Savings Opportunities
• Strategic Decision Making for Large and Small Employers
• And more!
In less than one year, major provisions of the Patient Protection and Affordable Care Act are taking effect at state and federal levels, and many of those new provisions will directly impact businesses around the country. At this event, we’ll present fact-based, non-partisan information that’s important to Colorado business leaders: the timeline of the law and important dates.
The Institute of Medicine's report, Unequal Treatment: Confronting Racial/Ethnic Disparities in Health Care, cited more than 175 studies documenting diagnostic and treatment disparities of various conditions among racial/ethnic populations, even when confounding factors (e.g., insurance and socioeconomic status, comorbidities, age, healthcare venue, stage of diseases) were controlled for in analyses.Specific examples include higher rates of hypertension, diabetes, breast cancer, cervical cancer, colon cancer, and cardiovascular diseases in African Americans; diabetes in Native Americans, Alaskan Natives, and Latino populations; and heart disease mortality in certain Asian American, Latino or Hispanic, and Native American groups.Lower rates of immunization and higher rates of infant mortality have been reported in African American, Hispanic, and Native American populations.
The recently enacted federal healthcare legislation will affect virtually everyone and will mean significant changes for patients, insurers, employers, hospitals and physicians. This is one of the largest changes to the tax laws in the past 30 years. Are you interested in finding out how the Reform will affect you or your business? We want to help. We are offering presentations to businesses and groups to provide information on how the Reform may impact you.
For more information visit our website at www.kl-cpa.com.
Health Care Reform Strategies for Small Employers:
• Health Care Tax Credits and Penalties
• The Recently Delayed Pay or Play Mandate
• Health Insurance Exchanges
• SHOPs
• Other Cost-Savings Opportunities
• Strategic Decision Making for Large and Small Employers
• And more!
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.
With the recent delay in the employer coverage mandate until 2015, employers should continue to plan their compliance strategy and remain vigilant as regulations continue to change. Hosted by Aon’s health and benefits expert, Richard Kaufman, this webinar will update employers on the ongoing changes and provide reminders of what remains, deadlines and other helpful information in understanding the complexities of the mandate.
Presented by Richard S. Kaufman, Aon Consulting VP, Health and Benefits
Employee Benefits in the Obamacare World & How to Maximize Its ImpactJoseph Appelbaum
Are you struggling to understand Obamacare and how it impacts your company? Do you want to learn about how to use employee benefits as a recruitment and retention tool?
This presentation will provide valuable insight into employee benefits in the Obamacare world and how to maximize its impact. Under Obamacare, employers are offered the option to "pay or play." But, for most companies there is no choice—they must “play” in order to recruit and retain employees. This not only includes offering health insurance but also life, disability, and the whole spectrum of employee benefits.
Here you'll learn about the impact of Obamacare on the employee benefits mix and employer decision-making process, along with understanding the importance of insurance benefits as a mandatory piece of the total compensation puzzle.
Craig Cordola, CEO of Memorial Hermann Hospital -Texas Medical Center in Houston, joins McCombs Finance Professor Jay Hartzell, Keith W. Maxwell of Spark Energy, and Greg Peters of Zillant to take a look ahead at not just the national economy as a whole, but also at the state of Texas.
Under the Affordable Care Act, managed care patients will migrate to the insurance exchanges, and become unprofitable patients, Cordola said.
We believe in the rewards of employee health. By listening, understanding and by partnering with you, we can deliver more than just a group benefits plan. Together we can deliver innovative benefits solutions for today and tomorrow. #SUNADVANTAGE is a solution for small business to help them reap the rewards of a healthier workforce.
Latino Buying Power - May 2024 Presentation for Latino CaucusDanay Escanaverino
Unlock the potential of Latino Buying Power with this in-depth SlideShare presentation. Explore how the Latino consumer market is transforming the American economy, driven by their significant buying power, entrepreneurial contributions, and growing influence across various sectors.
**Key Sections Covered:**
1. **Economic Impact:** Understand the profound economic impact of Latino consumers on the U.S. economy. Discover how their increasing purchasing power is fueling growth in key industries and contributing to national economic prosperity.
2. **Buying Power:** Dive into detailed analyses of Latino buying power, including its growth trends, key drivers, and projections for the future. Learn how this influential group’s spending habits are shaping market dynamics and creating opportunities for businesses.
3. **Entrepreneurial Contributions:** Explore the entrepreneurial spirit within the Latino community. Examine how Latino-owned businesses are thriving and contributing to job creation, innovation, and economic diversification.
4. **Workforce Statistics:** Gain insights into the role of Latino workers in the American labor market. Review statistics on employment rates, occupational distribution, and the economic contributions of Latino professionals across various industries.
5. **Media Consumption:** Understand the media consumption habits of Latino audiences. Discover their preferences for digital platforms, television, radio, and social media. Learn how these consumption patterns are influencing advertising strategies and media content.
6. **Education:** Examine the educational achievements and challenges within the Latino community. Review statistics on enrollment, graduation rates, and fields of study. Understand the implications of education on economic mobility and workforce readiness.
7. **Home Ownership:** Explore trends in Latino home ownership. Understand the factors driving home buying decisions, the challenges faced by Latino homeowners, and the impact of home ownership on community stability and economic growth.
This SlideShare provides valuable insights for marketers, business owners, policymakers, and anyone interested in the economic influence of the Latino community. By understanding the various facets of Latino buying power, you can effectively engage with this dynamic and growing market segment.
Equip yourself with the knowledge to leverage Latino buying power, tap into their entrepreneurial spirit, and connect with their unique cultural and consumer preferences. Drive your business success by embracing the economic potential of Latino consumers.
**Keywords:** Latino buying power, economic impact, entrepreneurial contributions, workforce statistics, media consumption, education, home ownership, Latino market, Hispanic buying power, Latino purchasing power.
Introduction to Indian Financial System ()Avanish Goel
The financial system of a country is an important tool for economic development of the country, as it helps in creation of wealth by linking savings with investments.
It facilitates the flow of funds form the households (savers) to business firms (investors) to aid in wealth creation and development of both the parties
If you are looking for a pi coin investor. Then look no further because I have the right one he is a pi vendor (he buy and resell to whales in China). I met him on a crypto conference and ever since I and my friends have sold more than 10k pi coins to him And he bought all and still want more. I will drop his telegram handle below just send him a message.
@Pi_vendor_247
how can I sell my pi coins for cash in a pi APPDOT TECH
You can't sell your pi coins in the pi network app. because it is not listed yet on any exchange.
The only way you can sell is by trading your pi coins with an investor (a person looking forward to hold massive amounts of pi coins before mainnet launch) .
You don't need to meet the investor directly all the trades are done with a pi vendor/merchant (a person that buys the pi coins from miners and resell it to investors)
I Will leave The telegram contact of my personal pi vendor, if you are finding a legitimate one.
@Pi_vendor_247
#pi network
#pi coins
#money
The European Unemployment Puzzle: implications from population agingGRAPE
We study the link between the evolving age structure of the working population and unemployment. We build a large new Keynesian OLG model with a realistic age structure, labor market frictions, sticky prices, and aggregate shocks. Once calibrated to the European economy, we quantify the extent to which demographic changes over the last three decades have contributed to the decline of the unemployment rate. Our findings yield important implications for the future evolution of unemployment given the anticipated further aging of the working population in Europe. We also quantify the implications for optimal monetary policy: lowering inflation volatility becomes less costly in terms of GDP and unemployment volatility, which hints that optimal monetary policy may be more hawkish in an aging society. Finally, our results also propose a partial reversal of the European-US unemployment puzzle due to the fact that the share of young workers is expected to remain robust in the US.
when will pi network coin be available on crypto exchange.DOT TECH
There is no set date for when Pi coins will enter the market.
However, the developers are working hard to get them released as soon as possible.
Once they are available, users will be able to exchange other cryptocurrencies for Pi coins on designated exchanges.
But for now the only way to sell your pi coins is through verified pi vendor.
Here is the telegram contact of my personal pi vendor
@Pi_vendor_247
Poonawalla Fincorp and IndusInd Bank Introduce New Co-Branded Credit Cardnickysharmasucks
The unveiling of the IndusInd Bank Poonawalla Fincorp eLITE RuPay Platinum Credit Card marks a notable milestone in the Indian financial landscape, showcasing a successful partnership between two leading institutions, Poonawalla Fincorp and IndusInd Bank. This co-branded credit card not only offers users a plethora of benefits but also reflects a commitment to innovation and adaptation. With a focus on providing value-driven and customer-centric solutions, this launch represents more than just a new product—it signifies a step towards redefining the banking experience for millions. Promising convenience, rewards, and a touch of luxury in everyday financial transactions, this collaboration aims to cater to the evolving needs of customers and set new standards in the industry.
What price will pi network be listed on exchangesDOT TECH
The rate at which pi will be listed is practically unknown. But due to speculations surrounding it the predicted rate is tends to be from 30$ — 50$.
So if you are interested in selling your pi network coins at a high rate tho. Or you can't wait till the mainnet launch in 2026. You can easily trade your pi coins with a merchant.
A merchant is someone who buys pi coins from miners and resell them to Investors looking forward to hold massive quantities till mainnet launch.
I will leave the telegram contact of my personal pi vendor to trade with.
@Pi_vendor_247
Resume
• Real GDP growth slowed down due to problems with access to electricity caused by the destruction of manoeuvrable electricity generation by Russian drones and missiles.
• Exports and imports continued growing due to better logistics through the Ukrainian sea corridor and road. Polish farmers and drivers stopped blocking borders at the end of April.
• In April, both the Tax and Customs Services over-executed the revenue plan. Moreover, the NBU transferred twice the planned profit to the budget.
• The European side approved the Ukraine Plan, which the government adopted to determine indicators for the Ukraine Facility. That approval will allow Ukraine to receive a EUR 1.9 bn loan from the EU in May. At the same time, the EU provided Ukraine with a EUR 1.5 bn loan in April, as the government fulfilled five indicators under the Ukraine Plan.
• The USA has finally approved an aid package for Ukraine, which includes USD 7.8 bn of budget support; however, the conditions and timing of the assistance are still unknown.
• As in March, annual consumer inflation amounted to 3.2% yoy in April.
• At the April monetary policy meeting, the NBU again reduced the key policy rate from 14.5% to 13.5% per annum.
• Over the past four weeks, the hryvnia exchange rate has stabilized in the UAH 39-40 per USD range.
Falcon stands out as a top-tier P2P Invoice Discounting platform in India, bridging esteemed blue-chip companies and eager investors. Our goal is to transform the investment landscape in India by establishing a comprehensive destination for borrowers and investors with diverse profiles and needs, all while minimizing risk. What sets Falcon apart is the elimination of intermediaries such as commercial banks and depository institutions, allowing investors to enjoy higher yields.
how to swap pi coins to foreign currency withdrawable.DOT TECH
As of my last update, Pi is still in the testing phase and is not tradable on any exchanges.
However, Pi Network has announced plans to launch its Testnet and Mainnet in the future, which may include listing Pi on exchanges.
The current method for selling pi coins involves exchanging them with a pi vendor who purchases pi coins for investment reasons.
If you want to sell your pi coins, reach out to a pi vendor and sell them to anyone looking to sell pi coins from any country around the globe.
Below is the contact information for my personal pi vendor.
Telegram: @Pi_vendor_247
how to sell pi coins in South Korea profitably.DOT TECH
Yes. You can sell your pi network coins in South Korea or any other country, by finding a verified pi merchant
What is a verified pi merchant?
Since pi network is not launched yet on any exchange, the only way you can sell pi coins is by selling to a verified pi merchant, and this is because pi network is not launched yet on any exchange and no pre-sale or ico offerings Is done on pi.
Since there is no pre-sale, the only way exchanges can get pi is by buying from miners. So a pi merchant facilitates these transactions by acting as a bridge for both transactions.
How can i find a pi vendor/merchant?
Well for those who haven't traded with a pi merchant or who don't already have one. I will leave the telegram id of my personal pi merchant who i trade pi with.
Tele gram: @Pi_vendor_247
#pi #sell #nigeria #pinetwork #picoins #sellpi #Nigerian #tradepi #pinetworkcoins #sellmypi
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Core hcr presentation rental association wo video
1. What can you do?
Employer Mandate and Responsibility
Cost Care Reform
Long-Term Care
HealthContainment
Provisions
Health Care Reform:
What comes next?
Presentation for
GA Chapter, American Rental Association
CORE Benefit Solutions, LLC
Lisa Owen, President, RHU
lowen@corebenefitsga.com
Jennifer Gregory, Account Executive
jgregory@corebenefitsga.com
2. What can you do?
Employer Mandate and Responsibility
Cost Containment
Long-Term Solutions
Care
CORE Benefit
Provisions
Tailored employee benefit
programs:
CORE PRODUCTS
- Medical/Rx/Dental/Vision/Life/AD&D
- Disability
- Long Term Care
- Group Health
- Wellness Programs
- Self Insured Health Plans
- Individual/Personal Health
- Voluntary Benefits
- Employee Assistance Programs (EAP)
- Benefits Administration
- International Plans
- Human Resource Solutions - FSA, HSA, HRA
OTHER PRODUCTS
- Property & Casualty
- EZ Enroll Kits
- Worker's Compensation
- General Liability
- Benefits Administration
- Retirement
3. What can you do?
Employer Mandate and Responsibility
CostHCR Quiz
Long-Term Care
Containment
Provisions
What does the Individual
mandate require of all US
citizens?
What are employers with 49
or fewer employees required
to provide employees under
the ACA?
Can any individual obtain a
federal subsidy to help pay
for health insurance?
• A. Must purchase minimum essential coverage
• B. Must purchase dental and vision coverage
• C. Must purchase “Platinum, Gold, Silver, or Bronze
Plan”
• D. All of the above
• A. Provide affordable and minimum value coverage or be
penalized
• B. Provide financial contribution to help employees
purchase coverage
• C. Provide Marketplace Notice to existing and new hire
employees & Summary of Benefits & Coverage (SBC), if
employer offers group medical plan
• A. Only if employer doesn’t offer coverage
• B. Only if income is between 100-400% FPL and employer
does not offer affordable minimum essential coverage
• C. Only if income is between 100-400% FPL
• D. As long as individual is below the age of 30
4. What can you do?
Employer Mandate and Responsibility
Cost Containment
Long-TermOverview
Care
HCR Timeline
Provisions
2010
Dependent coverage for adult children up to age 26
Elimination of pre-existing conditions for children under 19
Preventive services covered at 100% *
Patient Protection provisions * (PCP, Emergency Room)
Elimination of lifetime limits, restricted annual limits on essential heath benefits
Disclosure notices (Grandfathered/Non-Grandfathered, Patient Protections)
Non-discrimination provisions * (enforcement delayed)
Small employer tax credit
Federal pre-existing condition plan available
2011
FSAs, HSAs, HRAs Changes (OTC, non-qualified H.S.A. 20% excise tax)
Medical Loss Ratio
New long-term care program (not funded)
2012
Expanded Women’s Preventive Care *
Summary of Benefits and Coverage
* Does not apply to grandfathered plans
5. What can you do?
Employer Mandate and Responsibility
Cost Containment
Long-TermOverview
Care
HCR Timeline
Provisions
2013
Medical FSA Limit of $2,500
W-2 Reporting (250+ W-2s in 2012)
Taxes and Fees (CERF, Reinsurance, Medicare, etc.)
Written notice of Exchanges (new hires included)
2014
Employer Mandate: Pay or Play (50+) (Delayed until 2015)
Individual Mandate
State/Federal Marketplace/Exchange (1-50=2014 & 1-100=2016)
Adjusted Community Rating * (1-50, 2014 & 1-100, 2016)
Guaranteed issued/Guaranteed renewability * (1-50=2014 & 1-100=2016)
No Pre-Existing Conditions
Must cover Essential Health Benefits (EHB) * (1-50=2014 & 1-100=2016)
Deductible Limits* (2-50=2014 & 2-100=2016)
Out of Pocket Expenses Limits *
Health plans may not establish Annual Limits on EHB *
90 Day Limit on Waiting Periods
* Does not apply to grandfathered plans
6. What can you do?
Employer Mandate and Responsibility
Cost Containment
Long-TermOverview
Care
HCR Timeline
Provisions
2014 Continued
Automatic Enrollment (200+)
Increased Wellness Program Incentives
2016
Employer Size Redefined
- (Small group = 2-100 & Large group = >100)
Community Rating (1-100)
2017
Exchange for Large Employers (>100)
2018
Cadillac Tax
* Does not apply to grandfathered plans
7. Individual Mandate
2017 and beyond:
Annual adjustments
2016
Greater of $695 per person (cap of $2,085
per family) or 2.5% of household income
2015
Greater of $325 per person (cap of $975 per
family) or 2% of household income
2014
Greater of $95 per person (cap of $285 per family)
or 1% of household income
Source: BCBS Exchange Webinar
8. What can you do?
Employer Mandate and Responsibility
Cost Containment
Long-Term Care
Employer Mandate
Provisions
“Applicable Large Employers”
•
Employers with 50 Full-Time Equivalents (FTEs) on average
•
Measured by looking at entire controlled group over prior calendar year
Controlled Group:
1.
2.
•
Parent-child= business owns, directly or indirectly, at least 80% of another business.
Brother-sister= 5 or fewer owners own at least 80% of 2 or more business & combined identical
ownership of the common owners in each entity is more than 50%.
Transition relief in 2013: employer can measure full-time equivalents for any
continuous 6-month period in 2013 to determine 2014 large employer
status; remove seasonal employees working less than120 days per year
What is an FTE?
•
•
•
•
Common law EE who, during the applicable calendar month, was employed
on average at least 30 hours of service per week
Number of FTEs = all part-time EE hours (up to 120 hours per EE)
for the applicable calendar month divided by 120
Only count U.S. hours
Leased EE rules do not apply
Source: United Health Care
9. What can you do?
Employer Mandate and Responsibility
Cost Containment
Long-Term Care
Medical Loss Ratio
Provisions
Source: BCBS Exchange Webinar
($0.05)
- MLR for small groups / individual
plans = 80%
- MLR for large groups = 85%
- Carriers provide rebates by
August 1 every year
- Carriers rebate individuals
directly for individual plans
- Carriers rebate employer directly
for group plans
- Employer must follow certain
rebate distribution rules
Commissions
Taxes ($0.024)
Profits ($0.036)
($0.10)
Claims ($0.80)
Administrative Expense
The health care reform components include new
minimum loss ratios (MLR):
10. What can you do?
Employer Mandate and Responsibility
Cost Containment
Long-Term Care
Underwriting Changes
Provisions
For Small Group and Individual markets:
Guaranteed
Issue
No health
status rating
(also known as
adjusted
community
rating)
3:1 age
rating bands
CURRENT: Guarantee Issue only required in the small group market
(2-50) today. For all size markets, pre-existing condition exclusions
may apply for members without creditable coverage for 63+ days.
Sources: National Association of Health Underwriters (NAHU), BCBS Exchange Webinar
11. What can you do?
Employer Mandate and Responsibility
Cost Containment
Long-Term of Pocket
Deductible/Out Care
Provisions
Deductible/Out-of-Pocket Limits
Deductible Limit
- Applies to 2-50 market
- $2,000 single/$4,000 family, increased by employer
contribution to FSA
Out of Pocket Limit
- Applies to all markets (individual, small group, large group,
and self-insured)
- Copays apply to out of pocket limit
- $6,350 individual/$12,700 family (no more than H.S.A. limits)
Sources: BCBS Exchange Webinar
12. Metallic Levels
Product Tier Requirements in Marketplace/Exchange:
Platinum
90%
actuarial value
Gold
80%
actuarial value
All will include
Essential
Health Benefits
Silver
70%
actuarial value
* Catastrophic plan
for those under 30
and those over 30
whose premium
would cost more than
8% of their income
Bronze
60%
actuarial value
Actuarial Value = Total Expected Payments by Health Plans for
EHBs / Total Costs of EHBs for the Standard Population
Source: BCBS Exchange Webinar
13. What can you do?
Employer Mandate and Responsibility
Cost Containment QHP
Long-Term Care
Individual Premiums for
Provisions
Average premium across all Affordable Care Act plans offered in
Georgia, effective January 1, 2014
Metallic
Levels
Age 27
Age 50
FAM
Single
FAM
Couple
Child
Only
Bronze
$231
$394
$782
$531
$565
$140
Silver
$276
$472
$935
$635
$675
$168
Gold
$335
$568
$1,127
$765
$813
$202
Platinum
$272
$463
$919
$624
$663
$165
Catastrophic
$168
$285
$566
$384
$408
$101
Source: healthcare.gov
14. What can you do?
Employer Mandate and Responsibility
Cost Containment
Long-Term Care
AffordableProvisions Coverage
Group
Unaffordable group coverage = Employee share of premium for
single coverage greater than 9.5% of the employee’s W-2 income
(lowest cost plan offered)
9.5% of Salary: The Amount Employee Contributions Cannot Exceed
For Single Coverage in Lowest Cost Medical Plan
W-2 Salary
Annual
Monthly
$20,000
$1,900
$158.33
$30,000
$2,850
$237.50
$40,000
$3,800
$316.67
$50,000
$4,750
$395.83
$60,000
$5,700
$475.00
Source: CIGNA
15. What can you do?
Employer Mandate and Responsibility
Cost Containment
Long-Term Care
Income Eligibility
Provisions
Premium Tax Credit Eligibility
-
Employees with household income between 100% and 400% of
the Federal Poverty Level (non Medicaid Eligible)
Household
Size
1
2
3
4
Medicaid Eligible
Eligible for
Premium Tax Credit
100%
400%
$11,490
$15,510
$19,530
$23,550
$45,960
$62,040
$78,120
$94,200
Source: Calculations by Families USA based on data from the U.S. Department of Health and
Human Services
16. What can you do?
Employer Mandate and Responsibility
Cost Containment
Long-Term Care
Amount of Premium Tax Credit
Provisions
If eligible for premium tax credit, the amount of premium you pay
(and your corresponding premium tax credit) is based on your FPL
household income.
Household Income Level
Premium as Percent of
Income
100% FPL
2% of Income
150% FPL
4% of Income
200% FPL
6.3% of Income
250% FPL
8.05% of Income
300% -400%FPL
9.5% of Income
Source: CIGNA
17. What can you do?
Employer Mandate and Responsibility
Long-Term Care
Silver Cost Containment
Plan Provisions Scenarios
Pricing
ANNUAL COSTS / ADVANCED PREMIUM TAX CREDIT (Subsidy)
26 year old single person (man or woman):
1) Income: $12K (just above FPL) - individual pays $240; receives $3,000
subsidy
2) Income: $35K - no subsidy; cost of silver plan is 9.5% of income
Husband is 32, wife is 30, 1 year old daughter
1) Income: $20K (just above FPL) – family pays $400; receives $8,800 subsidy
2) Income: $60K (300% FPL) – family pays $5,700; receives $3,500 subsidy
Husband is 47, wife is 42, kids are 25, 20, and 16
1) Income: $28K (at FPL) - family pays $560; receives $15,500 subsidy
2) Income: $84K (300% FPL) – family pays $8,000; receives $8,000 subsidy
Husband is 62, wife is 62
1) Income: $16K (at FPL) – husband/wife pay $320; receive
$17,600 subsidy
2) Income: $47K (300% FPL) – husband/wife pay $4,500;
receive $13,500 subsidy
Source: Atlanta Journal Constitution
18. What can you do?
Employer Mandate and Responsibility
Cost Containment
Long-Term Care
Employer Group Plan
Provisions
2013 Early Renewal Option
Option for Non-grandfathered Small Group / Individual
Plans:
-
Delay higher rates of Adjusted Community Rating and other health
care reform plan design requirements (deductibles, out of pocket
limits, etc.)
-
Keep current plan design for 11 months of 2014
-
Renew December 1, 2013 with a significantly lower increase than you
would otherwise see at your 2014 renewal
-
Early renewal option may not benefit every group or individual
and your health benefits broker should be reviewing these
options with you now
19. What can you do?
Employer Mandate and Responsibility
Cost Containment
SmallLong-Term Care
Employer Tax Credit
Provisions
25 or fewer employees + average wage
less than $50,000:
- Tax credit for employers with 25 or less employees and
average wages than $50K
- Starting in 2014, available on the Small Employer Health
Options Plan (SHOP) Exchange/Marketplace only for first
two years
- Credit up to 50% of employer cost
- Credits decrease on a sliding scale as avg. compensation
increases
*tax credit started for 2010 tax year (for employers with 25
or fewer employers) and currently offers a credit up to 35%
Source: BCBS Exchange Webinar
20. What can you do?
Employer Mandate and Responsibility
Cost Containment
Long-Term Care
Employer Options
Provisions
21. What can you do?
Employer Mandate and Responsibility
Cost Containment
Long-Term Care
Individual Mandate
Provisions
22. Health Care Reform
Importance of your Trusted Advisors
• Benefits
Broker
• Accountant
• Attorney
• Financial
Advisor
Lean on your trusted advisors to understand
upcoming changes!
23. What can you do?
Employer Mandate and Responsibility
Cost Containment
Long-Term Care
Questions?
Provisions
24. What can you do?
Employer Mandate and Responsibility
Cost Containment
Long-Term Care
Thank you for your time.
Provisions
Lisa Owen, President, RHU
CORE Benefit Solutions, LLC
404-478-2304
lowen@corebenefitsga.com
Jennifer Gregory, Account Executive
CORE Benefit Solutions, LLC
404-478-2305
jgregory@corebenefitsga.com