The document summarizes the key provisions and timeline of the Affordable Care Act (ACA) for businesses and individuals. It outlines that by 2018, businesses with over 50 employees must provide health insurance where 95% of full-time employees are covered, or face penalties. It also mandates that all individuals have health insurance through state or federal exchanges, with penalties for non-compliance increasing each year. The document suggests using supplemental benefits from ProVantage to help individuals and employees save money on out-of-pocket costs for high deductible plans required by the ACA.

1. The Affordable Care Act: The Basics ProVantage Benefits: November 2014

2. What YOU Will Learn • The History • The Effects on Businesses and Individuals • The Schedule, as Mandated By Law • Types of Insurance Coverage • Health Exchanges

3. History of the Affordable Care Act (ACA): Introduced by Congress, Amended, Passed and Signed into Law by President Barack Obama on March 23, 2010, the ACA is designed to make Healthcare Affordable to those uninsured and those with pre-existing conditions.

4. The intention of the ACA was to bring in competition that would drive Insurance Premium costs down by introducing a new and younger segment of the population to the "Universe" of the Insured, or face penalties (as a provision of the Act) for non-compliance.

5. These Insurance policies would be offered through State Exchanges, or via the US Government, in the event that a State "opted out" of the Exchange. Challenged in Court by a majority of Attorney Generals serving the 50 States of the USA, The Supreme Court in June 2012 ruled that the ACA was indeed Constitutional as the penalties were taxes imposed by the IRS. Implementation of the ACA was to begin in Tax Year 2014.

6. Since many Businesses were unprepared for such a roll-out, President Obama granted Businesses a one year Grace Period to begin implementation, in effect allowing them an extra year to be prepared and not be penalized in the process. The first year for Compliance by Businesses is Tax Year 2015 (January 1 through December 31, 2015).

7. Individuals were mandated to register for Insurance through healthcare.gov beginning in October 2013 for the 2014 Tax Year. If covered by an Approved Business Insurance Plan provided by the Individual's Employer, that Individual was exempt from penalties. Subsidies are provided for those who meet certain income/family size guidelines, anywhere from 1% to 100% discounts on their ACA Plan. However, this would also be verified months later by the Individual's IRS 1040 Tax Form. From this point on, this presentation will focus on Business Mandates beginning in 2014, and Individual Mandates, also beginning in 2014.

8. Business Mandates Tax Year 2014 • No Penalties • Ensure all Full-Time employees (over 30 hours per week) have option for 2015 • Businesses Over 50 Employees need be readied for Compliance • Businesses Under 50 Employees Exempt in Future • Enrollment Plans for 2015 MUST HAVE Wellness Guidelines in place

9. Business Mandates Tax Year 2015 • All Businesses with over 100 Full-Time Employees Must Provide Health Care • The 20/80 Rule: for every 100 FT Employees, 20 of them MUST be covered • IRS Penalty for Non-Compliance: $2,000 per Employee NOT Covered • Penalties will be imposed Quarterly as Businesses file Quarterly Returns • Employee Wellness a priority based on a Questionnaire completed by Employee

10. Business Mandates Tax Year 2016 • All Businesses with over 50 Full-Time Employees Must Provide Health Care • The 70/30 Rule: for every 100 FT Employees, 70 of them MUST be covered • IRS Penalty for Non-Compliance: $2,000 per Employee NOT Covered • Penalties will be imposed Quarterly as Businesses file Quarterly Returns • Employee Wellness a priority based on a Questionnaire completed by Employee

11. Business Mandates Tax Year 2017 • All Businesses with over 50 Full-Time Employees Must Provide Health Care • The 95/5 Rule: for every 100 FT Employees, 95 of them MUST be covered • IRS Penalty for Non-Compliance: $3,000 per Employee NOT Covered • Penalties will be imposed Quarterly as Businesses file Quarterly Returns • Employee Wellness a priority based on a Questionnaire completed by Employee

12. Business Mandates Tax Year 2018 • All Businesses with over 50 Full-Time Employees Must Provide Health Care • The 95/5 Rule: for every 100 FT Employees, 95 of them MUST be covered • IRS Penalty for Non-Compliance: $5,000 per Employee NOT Covered • Penalties will be imposed Quarterly as Businesses file Quarterly Returns • The "Cadillac" Tax for "Premium" coverage will be imposed on Businesses

13. Individual Mandates Tax Year 2014 • All Citizens MUST Have Health Care • Subsidies are allowed based on Income/Family members as credits • IRS Penalty for Non-Compliance: 1% of Taxable Income • Exchanges offer the following plans: Catastrophic, Bronze, Silver and Gold • State approved carriers allowed; if State not involved, US Gov't approved

14. Individual Mandates Tax Year 2015 • All Citizens MUST Have Health Care • Subsidies are allowed based on Income/Family members as credits • IRS Penalty for Non-Compliance: 2% of Taxable Income • Exchanges offer the following plans: Catastrophic, Bronze, Silver and Gold • State approved carriers allowed; if State not involved, US Gov't approved

15. Individual Mandates Tax Year 2016 • All Citizens MUST Have Health Care • Subsidies are allowed based on Income/Family members as credits • IRS Penalty for Non-Compliance: 2.5% of Taxable Income (IRS Verified) • Exchanges offer the following plans: Catastrophic, Bronze, Silver and Gold • State approved carriers allowed; if State not involved, US Gov't approved

16. Why Does This Matter? How can we use this to our advantage?

17. Here's why: Because of the Mandate of the ACA with regards to Businesses, Insurance Premiums have already been increased in preparation for the new Mandated provision. This means to save employees and employers more money, High Deductible (Catastrophic Care) plans are becoming the rule instead of the exception.

18. Since we also offer Individual Medical Savings and Benefits, those with High Deductibles ($6,000 and higher) and little or no coverage until those Deductibles are met can use our Benefits as a "Safety Net" to keep costs down; an overlay over their ACA Approved Plan. The same is true for Business Employees. Think of us as "The Cookie!"

19. What Do I Need to Know? You need to know that we are NOT Insurance; we are a cost-saving and economically saving addition for Business Owners and Individuals so that they can keep their hard earned money and use their high-premium, high deductible Catastrophic, Bronze or Silver plan for TRUE Emergencies like surgeries, treatments and other high-cost medical procedures.

20. Need An Example? The 24 hour Teledoc ™ Program is a BIG HIT! 365 days a year, an elite Medical Doctor is available via phone to diagnose 95% of the calls received, call in a prescription to the employee’s Pharmacy of choice – all of this WITHOUT a CO-PAY or cost (except for the meds). HR personnel love this because if a child is sick at night, the parrent can call in, get the proper diagnosis and pick up the prescription, and 70% of the time NOT have to stay with the child because that first dose is usually enough to send the child to school the next day and the employee doesn’t miss any time. Productivity saved, and no money OUT OF POCKET except for the Prescription (which is also one of our Benefits)!

21. Need a Second Example? The Dental Benefits: compared to Delta Dental of Kansas, ALL procedures are at a lower cost and there’s no having to meet a deductible. Root canals are $200 or more LESS than Delta Dental, and there’s no $1000 cap on payments to the provider for the year! Best part – it’s likely that their favorite Dentist is on this same list; there are 132,000 Providers and Specialists that accept our Benefits.

22. Leveraging ProVantage Benefits • Know your Customer's "Pain" and listen • Think of the Benefit that can ease his/her pain • Use examples - the two listed are appropriate • Know that the ACA no longer covers Chiropractic and Hearing in most plans • Know the Math; calculate the savings and close the deal

23. The End ProVantage Benefits: November 2014