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- 1. USA Benefits Group “The State of Health Insurance” • Patient Protection and Affordable Care Act aka: Obama Care Tom Koanui 541-914-8441 Shonna Butler 541-357-8751
- 2. • The information given within this presentation is accurate as of May 2013 and comes directly from the Cover Oregon Public Exchange. It is subject to change. • Note that ACA details shared informally by word of mouth may not represent the state of Oregon. A number of states around the country are defaulting to the Federal Exchange program or choosing the Co-op Exchange format. Disclosure Tom Koanui 541-914-8441 Shonna Butler 541-357-8751
- 3. Patient Protection Affordable Care Act Changes for January 01, 2014 • All individuals MUST have M.E.C. (Minimum Essential Coverage). • Guaranteed acceptance • No pre-existing condition exemptions • NO RATING for health, gender, build & industry • Essential Health Benefits as defined by program • Metallic Levels: Bronze- Silver- Gold- Platinum Tom Koanui 541-914-8441 Shonna Butler 541-357-8751
- 4. Affordable Care Act – Small Employers Small Employers of <50 Employees: • Employer is NOT required to provide group insurance in 2014 • NO tax penalty will be assessed to employers if group insurance is not provided in 2014 or 2015 • A 35% to 50% tax credit will be available to employers through 2015 who DO offer group insurance • Metallic Plans currently available to employer: Bronze, Silver, and Gold Tom Koanui 541-914-8441 Shonna Butler 541-357-8751
- 5. • Oregon Zip Code • 2-50* Employees • Pay at least 50% of employee only premiums • At least 75% participation *2016 up to 100 employees 2017 over 100 employees • Have less than 25 FTEs (full- time equivalent) • Have average income of less than $50K • Contribute at least 50% of employee only premiums *Federal small business tax credits for 2-yrs (2014 & 2015) Small Employer Program Requirements To Qualify for Tax Credits:*To Shop Through Cover Oregon: Tom Koanui 541-914-8441 Shonna Butler 541-357-8751
- 6. Four Options for Employers • Option 1: Employer chooses plan and carrier • Option 2: Employer chooses carrier but employee chooses plan • Option 3: Employer chooses plan but employee chooses carrier • Option 4: Employee chooses both plan and carrier Tom Koanui 541-914-8441 Shonna Butler 541-357-8751
- 8. Oregon Exchange Plan Design Platinum Plan details are not yet available Tom Koanui 541-914-8441 Shonna Butler 541-357-8751
- 9. Tom Koanui 541-914-8441 Shonna Butler 541-357-8751 Platinum Plan details are not yet available
- 10. Exchange Prescription Drug Plan Tom Koanui 541-914-8441 Shonna Butler 541-357-8751 Platinum Plan details are not yet available
- 11. How the Exchange Will Work
- 12. Now What? This is a confusing new health care act. We would enjoy speaking with you and your organization about the changes happening through the Oregon Exchange and what it means for you and your company. Please contact Shonna at: 541-357-8751 or Tom at: 541-914-8441 to set up an appointment to discuss your health care options in greater detail. Thank you for your time and attention! Where there is no vision the people perish, but he that keeps the law, happy is he. Proverbs 29:18 Tom Koanui 541-914-8441 Shonna Butler 541-357-8751