hCentive Health Insurance Exchange PlatformAlisha North
Take advantage of hCentive's deep expertise in the healthcare insurance industry. Browse through or download our white papers to get an in-depth understanding of the industry.
This presentation educated attendees on Obamacare from the employment law and employer's perspective.
Topics from the presentation included the effects on different size businesses - small, medium and large employers - including relevant potential credit and penalty provisions of the Affordable Care Act which might apply to your business, the role of public programs, timeline for the effective dates of various PPACA provisions and their enforcement as well as typical information and documents sought under an audit by the United States Department of Labor.
Obamacare - The Patient Protection and Affordable Care Act - ACAAndrew F. Bennett
This short presentation will help bring you up to speed on the Affordable Healthcare act, eligibility requirements to buy in the online marketplace, and coverage that will be available.
Did you have time to read the 1,990 page healthcare bill that was recently passed through Congress? Have you since wondered about the impact that massive bill will have on the average American, health insurance providers, business owners and YOU? If yes, then join the Young Professionals of Chicago as we host a panel of diverse health care professionals that will be discussing current healthcare reform and taking questions on the impact of the United States' new healthcare policy. The distinguished panelists will also provide some insight and clarity into what this massive bill means for individuals like you. There will also be an opportunity for open networking with other young professionals before and after the discussion.
hCentive Health Insurance Exchange PlatformAlisha North
Take advantage of hCentive's deep expertise in the healthcare insurance industry. Browse through or download our white papers to get an in-depth understanding of the industry.
This presentation educated attendees on Obamacare from the employment law and employer's perspective.
Topics from the presentation included the effects on different size businesses - small, medium and large employers - including relevant potential credit and penalty provisions of the Affordable Care Act which might apply to your business, the role of public programs, timeline for the effective dates of various PPACA provisions and their enforcement as well as typical information and documents sought under an audit by the United States Department of Labor.
Obamacare - The Patient Protection and Affordable Care Act - ACAAndrew F. Bennett
This short presentation will help bring you up to speed on the Affordable Healthcare act, eligibility requirements to buy in the online marketplace, and coverage that will be available.
Did you have time to read the 1,990 page healthcare bill that was recently passed through Congress? Have you since wondered about the impact that massive bill will have on the average American, health insurance providers, business owners and YOU? If yes, then join the Young Professionals of Chicago as we host a panel of diverse health care professionals that will be discussing current healthcare reform and taking questions on the impact of the United States' new healthcare policy. The distinguished panelists will also provide some insight and clarity into what this massive bill means for individuals like you. There will also be an opportunity for open networking with other young professionals before and after the discussion.
Observations on the needs for, the contents of, and many of the practical effects of the Affordable care Act or Obamacare. Understanding its benefits and shortcomings
Single Payer Systems: Equity in Access to Caresoder145
Presentation by Lynn Blewett at "The True Workings of Single Payer Systems: Lessons or Warnings for U.S. Reform' conference sponsored by the Journal of Health Politics Policy and Law, May 10 2008.
CHAPTER 1History of the U.S. Healthcare SystemLEARNING OBJECTI.docxmccormicknadine86
CHAPTER 1
History of the U.S. Healthcare System
LEARNING OBJECTIVES
The student will be able to:
■ Describe five milestones of medicine and medical education and their importance to health care.
■ Discuss five milestones of the hospital system and their importance to health care.
■ Identify five milestones of public health and their importance to health care.
■ Describe five milestones of health insurance and their importance to health care.
■ Explain the difference between primary, secondary, and tertiary prevention.
■ Explain the concept of the iron triangle as it applies to health care.
DID YOU KNOW THAT?
■ When the practice of medicine first began, tradesmen such as barbers practiced medicine. They often used the same razor to cut hair as to perform surgery.
■ In 2014, the United States spent 17.5% of the gross domestic product on healthcare spending, which is the highest in the world.
■ As a result of the Affordable Care Act, the number of uninsured is projected to decline to 23 million by 2023.
■ The Centers for Medicare and Medicaid Services predicts national health expenditures will account for over 19% of the U.S. gross domestic product.
■ The United States is the only major country that does not have universal healthcare coverage.
■ In 2002, the Joint Commission issued hospital standards requiring them to inform their patients if their results were not consistent with typical care results.
▶ Introduction
It is important as a healthcare consumer to understand the history of the U.S. healthcare delivery system, how it operates today, who participates in the system, what legal and ethical issues arise as a result of the system, and what problems continue to plague the healthcare system. We are all consumers of health care. Yet, in many instances, we are ignorant of what we are actually purchasing. If we were going to spend $1,000 on an appliance or a flat-screen television, many of us would research the product to determine if what we are purchasing is the best product for us. This same concept should be applied to purchasing healthcare services.
Increasing healthcare consumer awareness will protect you in both the personal and professional aspects of your life. You may decide to pursue a career in health care either as a provider or as an administrator. You may also decide to manage a business where you will have the responsibility of providing health care to your employees. And last, from a personal standpoint, you should have the knowledge from a consumer point of view so you can make informed decisions about what matters most—your health. The federal government agrees with this philosophy.
As the U.S. population’s life expectancy continues to lengthen—increasing the “graying” of the population—the United States will be confronted with more chronic health issues because, as we age, more chronic health conditions develop. The U.S. healthcare system is one of the most expensive systems in the world. According to 2014 statistics, the ...
4202020 Right to Health Care - Pros & Cons - ProCon.orgh.docxtaishao1
4/20/2020 Right to Health Care - Pros & Cons - ProCon.org
https://healthcare.procon.org 1/15
RIGHT TO HEALTH
CARE
Should All Americans Have the Right (Be Entitled)
to Health Care?
Last updated on: 2/14/2019 | Author: ProCon.org
28.5 million people in the United States (8.8% of the US population) do not have health
insurance. Among people who do have health insurance, 67.2% have private insurance while
37.7% have government-provided coverage through programs such as Medicaid or Medicare.
Employer-based health insurance is the most common type of coverage, applying to 56% of
the US population. The United States is the only nation among the 36 OECD (Organization for
Economic Co-operation and Development) nations that does not have universal health care
either in practice or by constitutional right.
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4202020 Right to Health Care - Pros & Cons - ProCon.orgh.docxblondellchancy
4/20/2020 Right to Health Care - Pros & Cons - ProCon.org
https://healthcare.procon.org 1/15
RIGHT TO HEALTH
CARE
Should All Americans Have the Right (Be Entitled)
to Health Care?
Last updated on: 2/14/2019 | Author: ProCon.org
28.5 million people in the United States (8.8% of the US population) do not have health
insurance. Among people who do have health insurance, 67.2% have private insurance while
37.7% have government-provided coverage through programs such as Medicaid or Medicare.
Employer-based health insurance is the most common type of coverage, applying to 56% of
the US population. The United States is the only nation among the 36 OECD (Organization for
Economic Co-operation and Development) nations that does not have universal health care
either in practice or by constitutional right.
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In today’s modern workplace, where the primary resource is knowledge, collective knowledge building is a key strategic task. The Business Case for Transformative Training
The relationship between employer and employee is based on a free and voluntary exchange, which helps maintain the competitiveness of the economy. While the relationship can be terminated by either party, with or without cause with penalty, there are legal exceptions.
Exploiting Artificial Intelligence for Empowering Researchers and Faculty, In...Dr. Vinod Kumar Kanvaria
Exploiting Artificial Intelligence for Empowering Researchers and Faculty,
International FDP on Fundamentals of Research in Social Sciences
at Integral University, Lucknow, 06.06.2024
By Dr. Vinod Kumar Kanvaria
This presentation includes basic of PCOS their pathology and treatment and also Ayurveda correlation of PCOS and Ayurvedic line of treatment mentioned in classics.
This slide is special for master students (MIBS & MIFB) in UUM. Also useful for readers who are interested in the topic of contemporary Islamic banking.
it describes the bony anatomy including the femoral head , acetabulum, labrum . also discusses the capsule , ligaments . muscle that act on the hip joint and the range of motion are outlined. factors affecting hip joint stability and weight transmission through the joint are summarized.
Normal Labour/ Stages of Labour/ Mechanism of LabourWasim Ak
Normal labor is also termed spontaneous labor, defined as the natural physiological process through which the fetus, placenta, and membranes are expelled from the uterus through the birth canal at term (37 to 42 weeks
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
How to Add Chatter in the odoo 17 ERP ModuleCeline George
In Odoo, the chatter is like a chat tool that helps you work together on records. You can leave notes and track things, making it easier to talk with your team and partners. Inside chatter, all communication history, activity, and changes will be displayed.
3. U.S. Supreme court heard oral argument on the
constitutionality of the Affordable Care Act on
March 26-28, 2012
3
4. Insurance Reform
High-risk pool created (2010)
Dependent coverage to age 26 (2010)
Children with pre-existing conditions cannot be denied coverage (2010)
No denial for pre-existing conditions eliminated (2014)
No Charge for annual wellness visit (2014)
Guaranteed issue policy (2014)
Modified community ratio (2014)
80 – 85% medical loss ratio (2014)
Long-term insurance program (2014)
No pre-existing condition exclusions (2014)
4
5. All Plans Must Provide
Essential Health Benefits
“Essential Health Benefits” requires minimum set of
benefits, with no lifetime of annual coverage limits
Ambulatory patient services
Emergency services
Hospitalization
Maternity and newborn care
Mental health and substance abuse coverage
Prescription drugs
Rehab services and medical devices
Preventative and wellness/chronic disease management
5
7. Automatic Enrollment
All new “full-time” employees will be automatically
enrolled, subject to regulations. Notice will include
opportunity to opt out. Current employees will be
auto enrolled
Applies to employers with 200 or more “full-time”
employees and who offer a health care plan. “Fulltime” employees means on average 30 or more
hours per week.
7
9. Health Delivery Reforms
Research on best provider practices
Research on comparative evidence outcomes
Pilot program that pays for outcomes on flat fee
basis rather than fee for service for treatments
Medical IT
Standards for extended living arrangements
Hospice, home-health reimbursement
9
10. Community Investment
Health Care Clinics
Primary Care Training
Grants to States
Diversity and Cultural Competency
Education Curricula Development in Health Sciences
Food Labeling
10
11. The Health Insurance Exchange
Uninsured individuals not eligible for Medicare or
Medicaid will be permitted to purchase insurance
through state Exchanges (purchasing pools).
Individuals will be eligible for subsidies.
Employers with fewer than 100 employees will be
permitted to enroll.
Employer eligibility may be expanded in 2017.
11
14. Wellness and Prevention Programs
75 cents of every dollar is spent on chronic diseases
100 billion dollars of health care is directly attributable to
behavior
The Act amends HIPAA, permitting premium discounts to
employees who participate in wellness programs.
Insurers that sell in the Exchange must provide discounts
for wellness and health promotion activities.
14
15. Smokers can be charged up to 50% more for
coverage purchased in the Exchange.
Employees who participate in HIPAA-approved
wellness programs can receive up to 30% off in
premium.
15
16. Minimum Essential Coverage
Requirement
(the Personal Mandate 2014)
A federal requirement that individuals purchase
health care insurance or pay penalty up to 2.5%
of income is unprecedented.
16
17. All five congressional committees
reported out a bill containing the
Individual Mandate
17
18. 6 lobbyists for every member of Congress
Insurance Industry - $100 million
Pharma - $110 million
Providers - $80 million
Hospitals - $90 million
Medical Device - $30 million
18
19. The pharmaceutical industry alone spent
over $600,000 per day in lobbying (2.3
lobbyists per member of Congress)
19
20. Hospitals, physicians, insurance companies and
others agree that without the Individual Mandate
the consumer protection and benefits reforms
would ruin the health care market
20
21. Florida v. U.S. Dept. of HHS
11th Cir. Court of Appeals (2011)
Congress has no authority to require citizens to
purchase health care insurance. Remainder of
law remains intact.
Thomas Moore Law Center v. Obama
6th Cir. Court of Appeals (2011)
Congress has authority to enact personal
mandate under commence clause.
21
22. NFIB v. Sebelius
U.S. Supreme Court (2012)
Personal Mandate exceeds Congress‟ power to
regulate commerce but is a valid tax
22
23. Congressional Authority
Express authority to regulate interstate commerce
Express authority to tax and spend for the general welfare
Power to enact “necessary and proper” laws to execute
express authority
23
24. U.S. Health Care Spending
About 16% of the U.S. economy (in 1950, 5%)
Estimated $2.24 trillion in 2009
Most health care spending per capita in the world
24
26. Health Care Spending Per Capita
(2003)
United States
$5,711
Luxembourg
$4,611
Switzerland
$3,847
Norway
$3,769
Belgium
$3,044
26
27. Health Care Outcomes – U.S.
33rd among developed nations in infant mortality
(6.3/1,000)
50th in life-expectancy (78-years)
27
28. Who is Insured?
Most people are insured through an employersponsored plan (177 million Americans, 62% of
people are under age 65)
99% of employers with 200 or more employees
offer health insurance
78% - 10 to 24 employees
49% - 3 to 9 employees
28
29. Employer-Plan Crisis
Premiums have grown 4-times faster than
wages since 1999.
Average employee contribution has gone up
200% since 2000.
Out-of-pocket and co-payments have gone
up 115% since 2000.
29
30. Who is Insured
(continued)
About 70 million Americans are insured
under a “public plan”
Medicare
Medicaid
Government spends about 42% of every
dollar spent on health care
30
31. Average Health Care Spending
by Age (2006)
under 5
$1,508
5 - 17
$1,267
18 - 24
$1,441
25 - 44
$2,305
45 - 64
$4,863
65 an older
$0
$8,776
$2,000
$4,000
$6,000
$8,000
$10,000
31
32. Spending during the last year of life
accounts for 27.4% of total Medicare
spending.
32
33. Race and Medical Care (U.S.)
Life expectancy for blacks is six years shorter than whites
Black babies are almost three times as likely as white babies
to die before first birthday
Blacks get bypass operations at a rate of one-quarter that of
whites
Blacks get angioplasties at one third the rate of whites
Blacks wait longer for kidney transplants
33
34. The Uninsured
Estimated 46 million Americans lack health
care insurance (15% of U.S. population)
34
35. Who Are The Uninsured?
27 million have personal income over $50,000
66% of uninsured have family incomes of $45 - $85,000
14 million are eligible for Medicaid on the Children‟s
Health Insurance Program
10 million „illegal‟ aliens
1/3 are between 18 to 29 years of age
35
37. Commerce Clause
“The Congress shall have power to regulate
commerce with foreign nations and among the
several states, and with the Indian tribes.”
Article I, Section 8
37
38. Congressional Authority to
Regulate Commerce
Sherman Antitrust Act (1890)
Federal Meat Inspection Act (1906)
Pure Food and Drug Act (1906)
Food and Drug Act (1906)
Federal Trade Commission Act (1914)
Pure Milk Act (1923)
Import Milk Act (1927)
38
39. United States v. Darby
U.S. Supreme Court (1941)
Fair Labor Standards Act upheld
Minimum wage
Overtime pay
Child labor restrictions
Court defers to Congress in determining
what constitutes interstate commerce.
39
40. Wickard v. Filburn
U.S. Supreme Court (1942)
Federal law regulates wheat production. Filburn, a
small farmer, produces wheat over his designated
allotment. The surplus was used for feeding his poultry
and livestock, and was not sold in the marketplace.
Holding: Congress has the authority to regulate any
article or product that could be sold in interstate
commerce.
40
41. Can Congress require Americans to engage in
commerce, i.e.: purchase healthcare insurance?
NO
41
42. Congress can regulate commerce but
can not be able to require someone to
engage in commerce.
42
43. The Power to Tax and Spend
Congress has authority “to pay the debts and
provide for the common defense and general
welfare of the United States” and “to lay and
collect Taxes, Duties, Imports and Excises”.
43
44. Can Congress tax (penalize) a decision not to
purchase health care insurance?
YES
44
45. About 500,000 New Jerseyans are eligible to
purchase a healthcare plan on the Health
Insurance Marketplace
Most work full-or part-time for a small employer
About 80% will be eligible for a subsidy
525,000 undocumented workers in N.J. not eligible
45
46. Eligibility for Premium Subsidy
Individuals with incomes up to 400 FPL.
$46,000 / year (2013)
$94,200 / year (family of 4)
Expected amount of subsidize for N.J. - $700
million
46
47. Notice to Employees – October 1, 2013
(thereafter at the time of hire)
Part A: General information about Health Insurance
Marketplace, coverage standards and help paying
premiums.
Part B: General information about coverage offered by
employer (if any)
Detailed information about plan is optional.
47
48. Employer Healthcare Plans
Essential Benefits
Consumer Protections
Minimum Value
Affordable
Employee will not get subsidy if employer offers
coverage that meets standards.
48
49. Health Insurance Marketplace
A one-stop web portal where individuals and small
businesses can shop for plans, compare prices, and
receive other information.
Plans must 1) offer essential benefits, 2) have
consumer protection standards, 3) have a minimum
value, and 4) be affordable.
States define “small business.” Cannot exceed 50
employees.
49
50. “Average” Employer Plan
“Essential Health Benefits” requires minimum set of
benefits, with no lifetime of annual coverage limits
50
Ambulatory patient services
Emergency services
Hospitalization
Maternity and newborn care
Mental health and substance abuse coverage
Prescription drugs
Rehab services and medical devices
Preventative and wellness/chronic disease management
51. Consumer Protections
All Plans
No lifetime maximums of essential benefits
No annual maximums on essential benefits, except as
allowed by the secretary of HHS
Provide coverage for children up to age 26
No pre-existing condition exclusion on children under
age 19
No rescissions of coverage
51
52. Consumer Protections
(continued)
Cover preventive services at 100%
Includes immunizations, child preventive care and women‟s
health screenings
Insured health plans must comply with
nondiscrimination requirements
Generally prohibits discrimination in favor of highly
compensated individuals as to eligibility and benefits under
the plan
New Appeals process for insurers
Waiting periods cannot exceed 90-days for
employee or dependent otherwise eligible to enroll
52
55. Affordability
Full-time employee cannot pay more than 9.5% of
household income for his/her share of premium for single
coverage. Lowest cost plan.
Safeharbor: Employer may use W-2 income for employee.
(Box 1)
Rate of Pay Safeharbor – Hourly rate multiplied by 130
hrs/month. Determine affordability using monthly premium
based on monthly wage. For salaried employee, monthly
wage can be used. Does not apply where wages were
reduced during the year.
55
56. Maximum Out -of-Pocket Premium
Payments
400% of poverty level
Single - $4,115
Single/Spouse - $5,537
Family 3 - $6,958
Family 4 - $8,379
Source HHS (2009)
56
57. The Marketplace, Prices and
Subsidies- N.J.
29 plans within 4 categories
Platinum
Gold
Silver – benchmark plan (70% of healthcare costs)
Bronze
October – December, 2013
4 of 5 enrollments eligible for subsidy
54% - women
46% - men
57
58. Family Income and Gender
Women contribute 42.29% of family income
(2009)
5% (1970)
58
59. Wages
About half of all jobs in U.S. pay $20/hr or less.
Women earn about 80 cents of every dollar a
man earns.
Women managers make 73 cents
59
60. Percentage of the unionized workforce
has decreased every year since its peak
in 1955 (35%)
7.4% in 2006
60
62. Reasons for Decline
Technological advancements
Outsourcing
Worker mobility and immigration
Organizational changes (teamwork, checks
and balances)
Social legislation (wage and hour, OSHA,
FMLA, etc.)
62
63. Unemployment and Gender
Since 2000, manufacturing has lost six million jobs
Men represented 80% of job losses during 2007-09
recession
1 in 5 working-age men are unemployed (2012)
In 2012, N.J. had 3.9 million jobs, down from 4.13 million
in 2008
Men and women competing for retail and service jobs.
63
64. More Women in the Workplace
Half of the work force are women; 2/3
are of child-bearing age
Women comprise the majority of
professional, technical, administrative
support workers
Women comprise the majority of sales
and service workers
64
66. The Workforce is Getting Older
In 1970, the median age of workers was 28
In 2002, the median age was 35
By 2030, the median age will be over 40
Reality Check: Every 7.5 seconds someone
in America turns 50 years of age
66
67. Workforce Education Level
52% of U.S. population ages 16 – 65
cannot pass the GED test
ETS Report (2003)
Functional Illiteracy:
12% White
25% Asian
33% African-Americans
49% Hispanic
67
68. 27-year old earning $25,000/year
Silver plan - $260/month
with subsidy - $145/month
Family of 4 earning $50,000
Silver Plan - $943/month
with subsidy - $282/month
Bronze Plan with subsidy - $131/month
68
69. Employee Protections
Employer can not interfere or discriminate against
an employee for seeking or receiving subsidy.
Does failure to provide notice constitute
“interference?”
69
71. “Large” Employer Penalty
Employers with 50 or more “full-time” employees will be penalized for not
offering coverage or coverage that does not meet standards.
All employees counted in a calendar month (part-time, temporary, seasonal).
“Full-time” employee is someone who is employed to perform services on
average of 30-hrs per week or 120 hrs/month.
Part-time employees are grouped together to create “full-time” equivalents.
Aggregate number of hours worked by part-time workers in any month and
divide by 120 to determine number of full-time equivalents.
71
72. Penalty for not offering insurance or to less than 95%
of full-time employees and at least one FTE receives a
subsidy to pay for insurance on the Exchange
$2,000 per full-time employee after first 30 employees
Penalty for offering unaffordable or less than minimum
value when employer offers to at least 95% of FTE
and at least one FTE receives subsidy
72
$3,000 for each full-time employee receiving a subsidy or $2,000 per full-time
employee after first 30
73. Auditing and Enforcement
U.S. Department of Treasury (IRS)
U.S. Department of HHS
U.S. Department of Labor
Combined databases – Form W-2, Form 5500,
Social Security Administration database.
73
74. W-2 Reporting
Employers are required to disclose the value of health
coverage provided to an employee on a W-2
This value includes medical coverage, HRA
contributions, and possibly EAPS and wellness
programs
Contributions to HSAs, Archer MSAs, and health FSAs are
not included
Need additional guidance
Does not include Dental or Vision care
Effective for taxable years beginning January 1, 2011
74
75. Coordinated Care
Creates incentives for “Accountable Care
Organizations”.
Team of healthcare providers are paid
incentives to lower costs and keep patients out
of expensive emergency room visits.
75
78. Medicaid Eligibility
Up to 133% of poverty level
Family of 4-$31,325 / year
October – December, 2013
71,000 enrolled (NJ)
300,000 eligible
78
79. Industries with Most Minimum
Wage Workers
Leisure and Hospitality (includes restaurants and
food service)
Retail
Other Services
Fast – Food Industry
Median hours/week - 30
Median wage/hr $8.69
52% of families of front-line, fast-food
workers rely on public assistance - $7
billion/year
79
80. Minimum Wage and Public
Assistance
Supplemental Nutrition Assistance – eligibility at 30/
hrs/week at minimum wage (A parent with 2 children
making minimum wage receives $276/month)
NJ FamilyCare – Parents with incomes up to $31,322 for
family of four; Adults without children $15,282
Housing Assistance – Low-income individuals whose
housing costs exceed 30% of household income
Collectively worth $18.62/hr if eligible for all maximum
assistance – Cato Institute
80
82. Contraception Coverage
Mandate (No-Cost Coverage)
Hobby Lobby v. Sebelius (10th Cir)
Conestoga Wood Specialties v. Sebelius (3rd Cir)
Does a profit-making, secular employer have a
right to exercise religion?
82
83. Citizens United v. Federal Election Comm.
U.S. Supreme Court (2010)
Corporations have First Amendment right to
political speech. Congress cannot regulate
campaign contributions made by Political
Action Committees.
83
84. Government as a “Stakeholder”
53% of CEOs say government and regulators will
be among the stakeholders with the biggest
economic impact on their companies over the
next 3-5 years.
McKinsey Global Study
2011
84