Healthcare Reform 2012
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Transcript of Healthcare Reform 2012
Benefits: Health Care Reform
Health Care Reform
What It Means to My BusinessPresented by: eESI
Ken BargeShannon Schumacher
•What is Health Care Reform?•Why was Health Care Reform passed?•Where are we now?•What’s up next? •Questions for my business?•What can I do?
Benefits: Health Care Reform
What is Health Care Reform?
• Patient Protection and Affordable Care Act (PPACA) – Signed by President
Obama March 23, 2010
• Health Care and Education Reconciliation Act of 2010– Signed by President
Obama March 30, 2010
– Amends PPACA provision and adds new provisions
Benefits: Health Care Reform
• Provide Broader Coverage for Americans– Implementing a health exchange program
– Implement employer and individual mandates
• Increase Level of Care – Removing annual and lifetime limitations
– Removing pre-existing limitations
• Control Costs– Minimum loss ratios
– Provide new regulations and policies
Was Reform a Necessity or Political?
Why was Health Care Reform passed?
Benefits: Health Care Reform
Where Are We Now?Benefits: Health Care Reform
• Expansion of preventative services • Dependants coverage up to age 26• No pre–existing conditions for children
under the age of 19• Changes to lifetime maximum benefits
and annual limits• Expansion of non-discrimination
requirements• Annual rebates on fully insured plans• Elimination of FSA reimbursements for
over-the-counter drugs• Small employer tax credits• Waiting periods no longer than 90 days• Coverage appeals• Grandfather plans • High risk pools
Where Are We Now?Benefits: Health Care Reform
• Enforcement delayed on 105 (h) non-discrimination rules for all fully insured non-grandfathered plans– IRS solicited comments in March– Guidance expected later this year
• W2 Reporting made optional for 2011– New guidance issued March 29 for 2012– Relief for smaller employers (those filing
fewer than 250 W-2 forms) by making this requirement optional for them at least for 2012 and possibly longer (till more guidance is issued)
– For larger employers - includes information on how to report, what coverage to include and how to determine the cost of the coverage
• 1099 Reporting requirements repealed• Employee Free Choice Voucher Program
eliminated• Most of the funding for Cooperative
Plans eliminated
What Up Next?• 2012
– Form W-2 reporting– Uniform summary of benefits
• 2013– Increase in medical
deduction – Medicare tax on High Income
earners/Self Employed/Unearned income
– Premium Tax-Research– Flexible spending
arrangement maximum imposed ($2500)
– Notice of insurance exchanges due to employees
Benefits: Health Care Reform
• The Big 2014– Individual health insurance mandate fine 1%
– Employer Mandate 50+(less than 50 exempted)
– Small employer tax credit increased to 50% (less than 25)
– Auto enrollment for companies with 200+ employees
– Waiting period greater than 90 days eliminated
– Pre existing conditions eliminated
– Premium assistance credit
– Insurance exchanges begin
– Penalties and vouchers for unaffordable insurance
• 2015-2017– Large employers now eligible for health insurance exchanges
– Increase on medical deduction threshold for tax payers 65+
What Up Next?
Benefits: Health Care Reform
Questions For My Business
• Can I anticipate health care costs to increase at a smaller percentage?
• Should I prepare for government health care system?• Should I offer health insurance in the future?• How will the exchanges work? • Why and How do I need to pay attention?
Benefits: Health Care Reform
• Pray
• Take Action– Education
– Wellness
– Change in Philosophy
What Can I Do?
Benefits: Health Care Reform
• Education– Review key components of the Act
• Keep up-to-date
– Work with subject matter experts
– Health Insurance Exchanges• How do you manage risks
• Rates may look attractive
• Will this work for my Company?
What Can I Do?
Benefits: Health Care Reform
• Wellness – Government tried but fell a little short
– Health Conditions• According to BCBS of TX 5 most expensive medical conditions
– Heart Disease, Ortho-Back, Renal Failure, Hypertension, Diabetes
• Among minority groups two major health concerns – Hypertension & Diabetes
• For every pound of weight that you lose, it removes 3 pounds of pressure off your knees and back.
– Benefits of Wellness• Increase productivity
• Reduce absenteeism
• Reduce health insurance rates
What Can I Do?
Benefits: Health Care Reform
• Change in Philosophy – Understand
• Consumer Driven Health Plans
• Employees have skin in the game
• Work with subject matter experts – Understand how your plan works
– Deductibles, Out of pocket maximums, HSA’s Gap Products, Supplemental Insurance Products
– Pay Penalty vs. Offering Health insurance?• 30% of companies are considering canceling insurance
plans
• Penalties less than the offering health Insurance– AT&T – 2.4 billion to offer insurance vs. 600 million penalty.
– Chance employees will leave to other companies
What Can I Do?
Benefits: Health Care Reform
• Updates – Subject matter experts
• Take action– Education
– Philosophical changes
– Wellness
Overview
Benefits: Health Care Reform
Questions?
Benefits: Health Care Reform
Contact Information
Benefits: Health Care Reform
Web: www.eesipeo.com/peopletalk_eevents
Facebook: www.facebook.com/eEmployersSolutions
LinkedIn: www.linkedin.com/company/eesi---eemployers-solutions-inc
Twitter: @eESI_Talk
Thank you to the North Chamber, members and guest
for the opportunity to participate in the
Small Business How 2 Series.