Guidelines for the Colorado Health Benefit Exchange and our Federal Exchange are still up in the air. What do these various funding, administration, and oversight issues mean for employers and how will plan pricing, availability, and benefits be addressed? This presentation is designed for the Colorado business leader who needs to understand the current state of the exchanges. In this session, we’ll go over the very latest developments and how they could impact local businesses, discuss how you can create a proactive multi-year benefits strategy, and introduce resources to help you stay on top of this constantly changing landscape.
These slides were from a recent SBA webinar presented by Small Business Majority. It focused on both federal and state provisions to help local small business owners understand how the law will affect them. Topics being discussed included:
Small business tax credits (available to businesses and tax-exempt non-profits)— who’s eligible for them and how to claim them, Marketplace updates, Shared responsibility,Cost containment, Tools and resources available for small businesses interested in learning more about the law.
About Small Business Majority
Small Business Majority is a national nonprofit advocacy organization focused on solving the biggest problems facing America's 28 million small businesses. We conduct extensive opinion and economic research and work with small business owners, policy experts, and elected officials nationwide to bring nonpartisan small business voices to the public policy table.
Affordable Care Act 101: What the New Healthcare Law Means for Your Small Bus...Small Business Majority
August 15, 2013. Hosted by the U.S. Small Business Administration and Small Business Majority. This webinar focused on what the new healthcare law, the Affordable Care Act, means for small businesses. It focused on both federal and state provisions to help local small business owners understand how the law will affect them.
Affordable Care Act 101: What the Healthcare Law Means for Small BusinessSmall Business Majority
August 8, 2013. Hosted by the U.S. Small Business Administration and Small Business Majority. This webinar focused on what the new healthcare law, the Affordable Care Act, means for small businesses. It focused on both federal and state provisions to help local small business owners understand how the law will affect them.
This webinar focused on what the new healthcare law, the Affordable Care Act, means for small businesses. It focused on both federal and state provisions to help local small business owners understand how the law will affect them.
McKonly & Asbury Webinar - The Patient Protection and Affordable Care ActMcKonly & Asbury, LLP
We continued our Celebrating 40 Years of Excellence! Fall Webinar Series with a webinar focusing on the impact of The Patient Protection and Affordable Care Act and next steps for employees, hosted by Suzanne Sentman (Human Resource Director with McKonly & Asbury) with featured guest Kent Evans (Vice President / Human Capital Consultant with Willis of Delaware, Inc).
Check out our Upcoming Events page for news and updates on our future seminars and webinars at http://www.macpas.com/events/.
View a full recap of this webinar at http://www.macpas.com/register-today-for-mckonly-asburys-free-the-patient-protection-and-affordable-care-act-webinar/.
On Thursday July 19th, 2012, the Taylor-Wilks Group held a free Health Care Symposium to provide resources and answer questions regarding the Affordable Care Act. This is some content from the event.
These slides were from a recent SBA webinar presented by Small Business Majority. It focused on both federal and state provisions to help local small business owners understand how the law will affect them. Topics being discussed included:
Small business tax credits (available to businesses and tax-exempt non-profits)— who’s eligible for them and how to claim them, Marketplace updates, Shared responsibility,Cost containment, Tools and resources available for small businesses interested in learning more about the law.
About Small Business Majority
Small Business Majority is a national nonprofit advocacy organization focused on solving the biggest problems facing America's 28 million small businesses. We conduct extensive opinion and economic research and work with small business owners, policy experts, and elected officials nationwide to bring nonpartisan small business voices to the public policy table.
Affordable Care Act 101: What the New Healthcare Law Means for Your Small Bus...Small Business Majority
August 15, 2013. Hosted by the U.S. Small Business Administration and Small Business Majority. This webinar focused on what the new healthcare law, the Affordable Care Act, means for small businesses. It focused on both federal and state provisions to help local small business owners understand how the law will affect them.
Affordable Care Act 101: What the Healthcare Law Means for Small BusinessSmall Business Majority
August 8, 2013. Hosted by the U.S. Small Business Administration and Small Business Majority. This webinar focused on what the new healthcare law, the Affordable Care Act, means for small businesses. It focused on both federal and state provisions to help local small business owners understand how the law will affect them.
This webinar focused on what the new healthcare law, the Affordable Care Act, means for small businesses. It focused on both federal and state provisions to help local small business owners understand how the law will affect them.
McKonly & Asbury Webinar - The Patient Protection and Affordable Care ActMcKonly & Asbury, LLP
We continued our Celebrating 40 Years of Excellence! Fall Webinar Series with a webinar focusing on the impact of The Patient Protection and Affordable Care Act and next steps for employees, hosted by Suzanne Sentman (Human Resource Director with McKonly & Asbury) with featured guest Kent Evans (Vice President / Human Capital Consultant with Willis of Delaware, Inc).
Check out our Upcoming Events page for news and updates on our future seminars and webinars at http://www.macpas.com/events/.
View a full recap of this webinar at http://www.macpas.com/register-today-for-mckonly-asburys-free-the-patient-protection-and-affordable-care-act-webinar/.
On Thursday July 19th, 2012, the Taylor-Wilks Group held a free Health Care Symposium to provide resources and answer questions regarding the Affordable Care Act. This is some content from the event.
Navigating Health Insurance in the Health Care Reform Era lkennon
A presentation for large employers, small employers and individuals without employer-based insurance. The slides present the current state of health insurance for each group and the impending changes of Health Care Reform and their potential effects.
Your Bottom Line: What the Affordable Care Act Means For Your Nebraska Small ...Small Business Majority
Hosted by the United States Department of Health and Human Services and Small Business Majority. This webinar focused on what the new healthcare law, the Affordable Care Act, means for Nebraska small businesses. It focused on both federal and state provisions to help local small business owners understand how the law will affect them.
Hosted by the United States Department of Health and Human Services and Small Business Majority. This webinar focused on what the new healthcare law, the Affordable Care Act, means for Kentucky small businesses. It focused on both federal and state provisions to help local small business owners understand how the law will affect them.
Hosted by the United States Department of Health and Human Services and Small Business Majority. This webinar focused on what the new healthcare law, the Affordable Care Act, means for Alabama small businesses. It focused on both federal and state provisions to help local small business owners understand how the law will affect them.
Understanding Health Care Reform: A Dose of Accounting MedecineJames Moore & Co
The affordable Care Act was signed into law on March 23, 2010 and upheld by the Supreme Court in June 2012. These reform measures will have wide-spread impacts to most businesses and individuals. In this presentation, we discuss the tax consequences, small business health care credits, fees, and provide a summary of the Affordable Care Act and the status of reform.
How does the Affordable Care Act affect your employee group? Get the basics here! Contact Erin Hart for more specific questions about your group.
ph: 412-657-3028
Understanding the ObamaCare North Carolina Health Insurance Plans
As a result of the Affordable Care Act (a.k.a. ObamaCare) the following provisions are now in place for health insurance policies with an effective date January 1, 2014 or after:Individuals cannot be declined for health insurance or charged more due to their health status or gender.
Insurance premiums are based on age, your zip code and tobacco usage.
Coverage limitations or exclusions based on pre-existing conditions are not allowed.
Elimination of annual and lifetime coverage limits.
Prohibition of declining an individual for coverage based on their participation in an approved clinical trial.
Maternity and mental health are included on all policies.
Preventative dental is covered with a $25 copay for members up to age 19. There is also some vision coverage for this age group.
Whether or not your children are students they can stay on your policy until age 26.
Introduction of the Medical Loss Ratio (MLR) which ensures that 80% of the premium dollars paid to the health insurance issuer are spend on providing health care. An insurance company that does not do this must provide rebates to their policyholders
http://www.hisonc.com/obamacare-north-carolina
How Does Obamacare Impact Your Business Planning?Tilson
The Supreme Court has upheld the PPACA and its implementation is full steam ahead. Now is the time to begin preparing for the impact on your business and your employees. Many have forgotten the complexity, decisions, and regulatory requirements of this legislation. As we all know, the devil is in the details.
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.
Navigating Health Insurance in the Health Care Reform Era lkennon
A presentation for large employers, small employers and individuals without employer-based insurance. The slides present the current state of health insurance for each group and the impending changes of Health Care Reform and their potential effects.
Your Bottom Line: What the Affordable Care Act Means For Your Nebraska Small ...Small Business Majority
Hosted by the United States Department of Health and Human Services and Small Business Majority. This webinar focused on what the new healthcare law, the Affordable Care Act, means for Nebraska small businesses. It focused on both federal and state provisions to help local small business owners understand how the law will affect them.
Hosted by the United States Department of Health and Human Services and Small Business Majority. This webinar focused on what the new healthcare law, the Affordable Care Act, means for Kentucky small businesses. It focused on both federal and state provisions to help local small business owners understand how the law will affect them.
Hosted by the United States Department of Health and Human Services and Small Business Majority. This webinar focused on what the new healthcare law, the Affordable Care Act, means for Alabama small businesses. It focused on both federal and state provisions to help local small business owners understand how the law will affect them.
Understanding Health Care Reform: A Dose of Accounting MedecineJames Moore & Co
The affordable Care Act was signed into law on March 23, 2010 and upheld by the Supreme Court in June 2012. These reform measures will have wide-spread impacts to most businesses and individuals. In this presentation, we discuss the tax consequences, small business health care credits, fees, and provide a summary of the Affordable Care Act and the status of reform.
How does the Affordable Care Act affect your employee group? Get the basics here! Contact Erin Hart for more specific questions about your group.
ph: 412-657-3028
Understanding the ObamaCare North Carolina Health Insurance Plans
As a result of the Affordable Care Act (a.k.a. ObamaCare) the following provisions are now in place for health insurance policies with an effective date January 1, 2014 or after:Individuals cannot be declined for health insurance or charged more due to their health status or gender.
Insurance premiums are based on age, your zip code and tobacco usage.
Coverage limitations or exclusions based on pre-existing conditions are not allowed.
Elimination of annual and lifetime coverage limits.
Prohibition of declining an individual for coverage based on their participation in an approved clinical trial.
Maternity and mental health are included on all policies.
Preventative dental is covered with a $25 copay for members up to age 19. There is also some vision coverage for this age group.
Whether or not your children are students they can stay on your policy until age 26.
Introduction of the Medical Loss Ratio (MLR) which ensures that 80% of the premium dollars paid to the health insurance issuer are spend on providing health care. An insurance company that does not do this must provide rebates to their policyholders
http://www.hisonc.com/obamacare-north-carolina
How Does Obamacare Impact Your Business Planning?Tilson
The Supreme Court has upheld the PPACA and its implementation is full steam ahead. Now is the time to begin preparing for the impact on your business and your employees. Many have forgotten the complexity, decisions, and regulatory requirements of this legislation. As we all know, the devil is in the details.
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.
As we close out our last Health Care Reform Preparedness event in the series, hear the latest
legislative updates and discuss strategies in preparing for the changes with your fellow business
leaders. This interactive session will leave you with actionable, easy-to-implement approaches for
setting your business up for success as we head into the changing landscape of health care.
The Election is over. Health care Reform is here to stay, and Colorado is also moving forward on a number of health care issues independently of the federal government. Conversely, employers in the state have to make huge employee benefit decisions based on changing and sometimes limited information.
Are you interested in contracting with the Colorado Department of Transportation (CDOT)? This seminar is an excellent primer for firms just getting started and wanting to learn how to do business with CDOT. You will find out what they buy, how they let contracts for goods and services and where to find contract opportunities. This workshop will include a discussion of CDOT's small business programs and how they can help you become more competitive in bidding and teaming on CDOT projects.
Connect for Colorado's Lindy Hinman's 2013 SLC presentation on health insurance marketplaces and what the Connect for Colorado organization has done to get their state insurance marketplace up and running.
The SBA spoke at the WDCEP's Entrepreneur Road Map's Business Insurance seminar held at Venable (7/16/14). The topic of the presentation was focused on the Affordable Care Act.
What the New Healthcare Law Means for Your South Carolina Small BusinessSmall Business Majority
Hosted by the United States Department of Health and Human Services and Small Business Majority. This webinar focused on what the new healthcare law, the Affordable Care Act, means for South Carolina small businesses. It focused on both federal and state provisions to help local small business owners understand how the law will affect them.
What the New Healthcare Law Means for Your Mississippi Small BusinessSmall Business Majority
Hosted by the United States Department of Health and Human Services and Small Business Majority. This webinar focused on what the new healthcare law, the Affordable Care Act, means for Mississippi small businesses. It focused on both federal and state provisions to help local small business owners understand how the law will affect them.
Hosted by the United States Department of Health and Human Services and Small Business Majority. This webinar focused on what the new healthcare law, the Affordable Care Act, means for Georgia small businesses. It focused on both federal and state provisions to help local small business owners understand how the law will affect them.
What the New Healthcare Law Means for Your North Carolina Small BusinessSmall Business Majority
Hosted by the United States Department of Health and Human Services and Small Business Majority. This webinar focused on what the new healthcare law, the Affordable Care Act, means for North Carolina small businesses. It focused on both federal and state provisions to help local small business owners understand how the law will affect them.
Hosted by the United States Department of Health and Human Services and Small Business Majority. This webinar focused on what the new healthcare law, the Affordable Care Act, means for Florida small businesses. It focused on both federal and state provisions to help local small business owners understand how the law will affect them.
How can you smooth the healthcare reform transition? Learn about the mandates currently in place, the mandates that are coming in the near future, what employers need to do, and what employees need to do. Participants can also ask specific questions about how healthcare reform may impact their organization.
Hosted by the United States Department of Health and Human Services and Small Business Majority. This webinar focused on what the new healthcare law, the Affordable Care Act, means for Tennessee small businesses. It focused on both federal and state provisions to help local small business owners understand how the law will affect them.
Franchising is an all-American business model that has enabled tens of thousands of veterans to become small business. Join Stacy Swift, owner of FranNet Colorado and a franchise industry expert, to learn how to separate the myths from the facts. What is a franchise? What are the requirements? How do you find the “best” one for you?
By: Stacy Swift, FranNet
This presentation is targeted at businesses who have already begun looking at teaming arrangements and wondered whether it was a good route for them. Teaming arrangements can be simple or complex. As a VOB or SDVOB you bring certain assets to the arrangements that work to your advantage if you know how to leverage them. Some business have had bad experiences and questions can be asked so mistakes are not repeated.
By: Kenn Quick, Acquisition Management Resources
As you grow your business you will soon subcontract to a government prime contractor or prime a contract with the government directly. When you do you understand that your financials are open to being audited by the government to ensure fair and compliant in-voicing. What do you need to know to be “compliant”? Is your accounting system already compliant? This and other questions are worth knowing before that day comes.
By: Gary Henry, McNew & Associates
What skills do you bring to the table as a veteran? In this workshop, Commander Izzy Abbass will show you how to put your best foot forward to make a favorable impression. You will learn common misperceptions of veterans, what skills veterans can bring to the table, and how to translate those skills into the business world. Finally, you will receive tips on how to use LinkedIn, Twitter and Facebook to sell your abilities!
By: Izzy Abbass, VFW Post 1
Is your business stagnant? Are you barely breaking even? This presentation will take your business to the next level by reaching untapped revenue streams and discovering where you can cut costs. You will learn tips to help you identify new customers, improve cash flow, and spend less time managing.
More from Denver Metro Small Business Development Center (6)
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2. Recap of Previous Sessions
Changes through 2013
2
2010 – 2011 • Small employer tax credit rolled out
• Employers can declare their plans grandfathered
• No lifetime maximum on benefits
• Kids covered up to age 26
• Preventative care provided with no cost sharing
• No over-the-counter drugs under HSA/health FSA
2012 • Must report value of health coverage onW2
• New SBC format for easier plan comparisons
• Expanded preventative care including free contraceptives
2013 • Health FSA now limited to $2,500
• New PCORI fee of $1 per employee per year ($2 next 6 yrs)
• New Medicare taxes on those earning over $200,000
3. Recap of Previous Sessions
Changes in 2014 & Beyond
3
Market
Changes
• All policies must be guaranteed issue with no exclusions for
pre-existing health conditions
• All group policies for 2-50 EE’s will be community rated
• New individual and small group exchanges will be available
• New fees on insurance companies will be added to premiums
Pay or Play
Mandate
• NO MANDATE ON EMPLOYERSWITH LESSTHAN 50 EE’S
• Larger employers must provide coverage or pay penalties
• If no coverage, penalty is $2,000 per EE except first 30
• If coverage not “affordable,” pay $3,000 for each EE w/subsidy
Coverage
Changes
• Waiting periods can’t exceed 90 days
• Cost sharing limits: $2,000/$4,000 deductible for small
employers, out of pocket max is limited to HSA limits for all
• Cadillac tax in 2018 on premiums that exceed $850/mo single
6. •Exchanges will be online
marketplaces for individuals and
small businesses to compare and
purchase coverage
•Exchanges are not a new concept
•But the scale is bigger
Shop features of plans containing
the same base benefits
Compare information regarding
cost and quality
Determine eligibility for tax
credits (premium relief)
Call or sit down with someone
for help
Enroll in a plan
What is the Colorado Health Benefit
Exchange (Connect for Health
Colorado)?
7. Features of the Connect for
Health Colorado Marketplace
• Serving individuals, families and small
employers with 2-50 employees
• A new/different way to shop for health
insurance
• The sole access to new federal financial
assistance, based on income
• A separate non-profit, committed to
Colorado mission
8. • Not a replacement for the current market or
brokers
• Not engaged with negotiating rates between
carriers and providers
• Not part of Medicaid
• Not a new government health care system
• Not a State agency or regulatory body
• Does not pull funding from Colorado
General Fund
The Connect for Health Colorado
Marketplace Is Not
9. Why will people use the
individual exchanges?
Exchange participation
Any U.S. citizen or legal immigrant is allowed to purchase coverage on the individual exchanges
Exchange subsidies
A sliding scale of subsidies to pay for coverage
purchased through the exchanges
Individuals and families with incomes between 100% and
400% of the Federal Poverty Level can receive subsidies
Individual mandate
Requires everyone to have health coverage or pay a tax penalty
Guaranteed issue and rating limits
Anyone who applies for coverage must be accepted
Insurers can only adjust premiums based on age,
family size, tobacco use and location
10. • The Marketplace is for Coloradans who currently
buy insurance on their own, who are uninsured,
or don’t have access to coverage through their
employer
• Online shopping, with assistance, if desired, by
phone and in-person
• Health plans will provide a range of coverage
levels
• Customers can access new federal financial
assistance to lower premiums, co-pays and
deductibles
• Several ways to shop: browse health plans,
estimate savings, or apply online for federal
financial assistance
Individuals and Families
12. • The Marketplace will provide small group plan options
to Colorado employers with 2-50 employees
• Employers with up to 100 employees can be served in
2016
• Employers can provide greater choice to their
employees with multiple carriers/ plans
• Employees can use benefit allowance to shop for
health plans
• Small business tax credits will be available (up to 50%
of premium) for employers with 2-25 employees,
earning on average $50,000 or less
• Other value-added services will be provided, like
payment aggregation, management tools and ability
to use brokers
Small Employers
13. Financial help to reduce the cost of
premiums
– Individual earning between $15,282 to
$45,960/year
– Couple earning between $20,628 to $62,040/year
– Family of 4 earning $31,322 to $94,200/year
• Tax credit applied up-front by IRS
• Tax credit is higher for Coloradans ages 55-64
Financial help to reduce out of pocket
costs (co-pays and deductibles)
• Individuals earning $15,282 to $28,725/year
• Family of 4 earning $31,322 to $58,875/year
Cost Reductions for Individuals
and Families
15. Federal law will require health plans sold to individuals and
small businesses inside and outside of the Marketplace to
provide, at a minimum, the following categories of services
(essential health benefits):
• Ambulatory patient services
• Emergency Services
• Hospitalization
• Maternity/newborn care
• Mental health/substance abuse
• Prescription drugs
• Rehab/habilitative services and devices
• Laboratory services
• Preventive and wellness care/chronic disease management
• Pediatric services, including oral and vision care
Comprehensive Coverage
16. • The intent is to make comparing and
purchasing health coverage convenient and
competitive
• Increase choice
• Helps consumers make an informed decision
by creating transparency about options
• Only place to check eligibility and register for
tax credits and other benefits
• In addition to insurance brokers, the
Marketplace will offer a statewide network of
trained professionals to assist consumers
Benefits for Consumers
17. Actuarial Value
ACTUARIAL VALUE: The percentage of total average costs for covered
benefits that a plan will cover. (source: www.healthcare.gov)
Source: www.healthcare.gov and www.kff.org
18. Qualified Health Plans (QHP)-
Metal Tiers
•To offer coverage through the
exchanges, carriers must have
their plans certified by the
state as Qualified Health Plans
(QHPs). QHPs must:
– Cover Essential
Health Benefits
– Meet coverage,
quality and
transparency
standards
– Fit into at least the
Silver and Gold tiers
of exchange
coverage
– Cannot be more
than +/- 2% of AV
•Available to those up to
age 30 or to those who are
exempt from the mandate
to purchase coverage
Catastrophic
•Pays for 60% of the costs of
the planBronze
•Pays for 70% of the costs of
the planSilver
•Pays for 80% of the costs of
the planGold
•Pays for 90% of the costs of
the planPlatinum
19. • Varies from state to state- carriers in
Colorado must file rates and plan
designs by the end of April
• We should know by May 2nd which
carriers will be participating in both
Marketplaces
• By the June session we should have
a better idea of how the plans stack
up inside and outside the exchange
Deadlines
20. • The Individual Marketplace opens for business on
October 1, 2013 for January 1, 2014 effective dates
– The first open enrollment period goes through March
with the latest effective date of 4/1/14. Future open
enrollment period will be 10/15-12/7 with an effective
date of 1/1
• All plans are guarantee issue
• Individuals must enroll during the “open enrollment”
period or will be subject to penalties
• Cannot obtain coverage outside of open enrollment
without a “qualifying event”
• Qualified individuals can only obtain subsidies through
the Individual Marketplace
Individual Enrollment
21. Penalties for individuals
2014
• $95 per adult and $47.50 per child (up to $285 for a
family) or 1% of taxable income, whichever is greater
2015
• $325 per adult and $162.50 per child (up to $975 for a
family) or 2% of taxable income, whichever is greater
2016
• $695 or per adult and $347.50 per child (up to $2,085 for
a family) or 2.5% of taxable income, whichever is greater
2017
• And beyond – annual adjustments
22.
23. • Small groups can enroll in the SHOP any month (no
specific open enrollment period)
• Employers that decide to drop their group plans do
not need to do so until their renewal
– We believe this creates a qualifying event for those
employees to obtain coverage outside of open
enrollment
• Small groups are not subject to penalties for not
offering health coverage and do not have to comply
with the rules of offering coverage
– Can currently discriminate (contributions, management
carve outs by class, salary, etc), but this is expected to
change for all non-grandfathered plans, but likely won’t
implement until group renewal following ruling
SHOP (Small Business Health
Options Program) Marketplace
24.
25. • Pre-tax small group plans will be
available in and out of the Marketplace
• If employer decides to drop coverage
and gross up salaries to encourage
employees to obtain coverage through
the Marketplace, employer must pay
payroll tax on gross up and employee
pays income tax and loses tax
advantage on premium contribution
Tax Treatment of Group vs
Individual Coverage
26. A Summary of Your Choices
Advantages: Advantages: Advantages:
EE's may get subsidies Choose multiple carriers No new process
Simplifies compliance Aggregate Billing May be more plan choice
No cost to employer Small Biz Tax Credit Broker can assist group & EE's
Broker can help EE's enroll Broker can assist group & EE's
Individual
Exchange
SHOP
Exchange
Small Group
Market
27. Brought to you by:
Thank You!
Questions?
Eden Ripingill
(303) 306-2561
Eden.M.Ripingill@kp.org
Kristen Russell
(303) 369-3200
kristen@fallriverbenefits.com