Offering Attractive Employer Provided Health …...Restaurant with 40 employees Advantages of...

Copyright Gravie 2015

Offering Attractive Employer

Provided Health Benefits

in This Changing Environment

Presented by First Franchise Capital and

Michael Haffey - Sales Leadership - Gravie

Today’s Presenter:

Michael Haffey

Michael has helped employers of all sizes for

over 25 years find the best solutions to provide

health coverage for their employees.

His roles include founder and principal of

successful insurance agencies and leadership

for a top national independent brokerage firm.

He and the team at Gravie are assisting

employers in providing innovative health plan

solutions that:

• control spend

• provide more choice

• eliminate hassles



Today’s Agenda

• Review the options available for providing

a health plan today

• What might the future hold – The AHCA

• Review real success stories - 3 Case studies

• A new option – the Small Employer HRA


• What are my options other than group health insurance if it

really doesn’t work for my business?

• How can we mitigate or eliminate the employer mandate

penalties and will they be around in the future?

• How can we help our employees access subsidies and/or

tax friendly employer provided dollars to buy individual

health insurance plans?

• How does a defined contribution health plan work?

Some of the questions we will answer…


How are employees offering

health benefits?

Traditional Group Health Insurance Model Common approach for many employers where the executive team works with an advisor to

determine the plans that will be offered as well as the premium price point for the employees.

Employees then opt in or waive coverage during their enrollment.

TODAY’S ENVIRONMENT

PERCENT OF PRIVATE-

SECTOR ESTABLISHMENTS

THAT OFFER HEALTH

INSURANCE


Legislative update as of 5-8-2017Now that the House has passed the AHCA,

what might the future hold for employers?

• Eliminates the Employer and Individual Mandate Penalties

• Subsidies will continue

• Gives states more control in what is covered in health

plans, Essential Health Benefits

• Gives states a say in how to cover pre-existing conditions

Continuous Coverage rules

• Opens up HSA and FSA contributions


What the ACA continues to provide

and most likely the AHCA…

1. Cover pre-existing conditions

2. Guarantee availability and renewability

3. Cover adult children up to age 26

4. Cap out-of-pocket expenditures

5. No health status underwriting

6. No lifetime and annual limits


1. Fully Insured Group Health Plan

2. Partially Self-Funded Group Health Plan

3. Fully Insured Individual Market Health Plan

What are my options today to provide

competitive employer provided health benefits?

A. Provide a plan, you have 3 options:

B. Don’t provide a plan;1. < 50 EES no penalty, not so happy employees

2. > 50 EES pay the penalty or use a strategy

to mitigate or eliminate the penalty


Case Study #1 –

Restaurant with 40 employees

Fact Pattern:• Currently providing a group plan

• Can't afford the premiums anymore • Can't meet the insurance companies participation requirements

• Just 10 of 40 employees on the plan

Solution:• Provide a Defined Contribution approach using the Individual market

private exchange

• Taxable and Discriminatory Contributions


Case Study #1 –

Restaurant with 40 employees

Advantages of defined contribution health benefits:

• Employers set their own budget

• Employers get out of choosing one-size-fits-all group plans that fit few

employees’ needs

• Employees get more options than they would with traditional group

benefits and are able to choose benefits that fit their unique needs

• In some cases, employees may be eligible to receive tax credits, which

could lower the cost of benefits or use the new Small Employer Health

reimbursement Arrangement –HRA to provide tax friendly dollars

Defined Contribution Strategy


Case Study #2 –

Home Health Agency with 200 full time

employees and 100 on their plan

Fact Pattern:• Currently providing a self funded group plan

• Can’t afford the claims cost anymore

• Want to offer a plan that allows them to provide more choice and control their spend

Solution:• Provide a Defined Contribution approach using the Individual market

private exchange

• Taxable and Discriminatory Contributions with a MEC – Minimum

Essential Coverage plan to reduce the employer mandate penalty


Individual Market Case Study #2

FINANCIAL ANALYSIS DETAIL-197 Employees, PSF 15 years

Actual Enrollment Results


When Given a Choice…


The Value of Choice



Case Study #3 –

56 Employee Hair Care Franchise

Fact Pattern:• Currently don't provide any form of a health benefit

• Would like to, but can't afford it

• Facing the employer mandate penalty for not offering a group plan

and can’t afford the penalty

Solution:• Offer a MEC plan – Minimum Essential Coverage to reduce penalties

• Offer key employees a defined contribution


Case Study #3 –

56 Employee Hair Care Franchise


A New Option – the SEHRA

Defined Contribution Individual market plan

Taxable or Tax friendly Employer dollars

Two options for providing employees with $$$:

1. Supplemental Wage – Taxable – Subsidies – Discriminate

2. Small Employer Health Reimbursement Arrangement

SEHRA - Tax Friendly - No Subsidies - Limited Discrimination


21st Century Cures Act & Small Employer

HRA Passed into Law – December 13, 2016


Beginning on January 1st 2017, a company with fewer than the

equivalent of 50 full-time employees can reimburse employees

for purchasing individual health insurance as if it were directly

paying the premiums on a group health policy: the employee

won’t have to pay taxes on the company’s premium

contribution, and the company won’t owe payroll taxes on it

either.

Qualified Small Employer Health Reimbursement

Arrangement

New Law Eases Small Business

Health Care Burden Forbes Dec 14, 2016


QSEHRA - Qualified Small Employer Health

Reimbursement Arrangement 1-1-2017

• A new type of HRA that provides tax free benefits to Small Employers

<50 and does not offer a group plan

• To get the tax advantage, an employee must have an individual

market plan funded solely by the employer and they can be FT or PT

• No ERISA or Cobra requirements

• The contribution can vary by Family status or age and the 2017 Max

amounts are –

Single - $4950 annual or $412.50 monthly

Family - $10,000 annually or $833 .33 Monthly

• If the employer wants to provide dollar in excess of the limits, they

can – it is just taxable as normal income


• 37,800 employers moved workers to an exchange

• 2.8 million employees signed up for benefits through one

of the online marketplaces

• 5.6 million people covered by benefit plans sold through

the sites

PBE Index enters 2017 with impressive numbers

Employee Benefit News February 2017

The Growth and Acceptance of the

Private Benefit Exchange


What is GRAVIE?Provides next generation health plans combining

3 key ingredients:

1) A Private Marketplace for Health Plans

– Smart Technology

2) A New World Third Party Administrator

– A Complete Scope of Services

3) Human Involvement using GravieCare Member Advisors

and Account Managers

– Advocacy, support, guidance

Launched in November 2013

Founders also established

leading companies like

Bloom Health, RedBrick Health

and Definity Health

Over 1000 employers

representing 50,000+ employees

have registered on Gravie as their

health benefit.

Featured in:


WHO IS GRAVIE?


HOW IT WORKS.

You choose the dollar

amount to give each

employee

We check if your employees

are eligible for government

tax credits (and help them

apply if they are)

We help employees choose a

plan in the individual market

We provide year-round

service and health insurance

advice to all your employees


How does Gravie Help Employers?

1. Control Spend – Defined Contribution

Next Generation Health Plan

2. Eliminate Hassles – New World Third Party

Administrator

3. Provide More Choice – Private Marketplace

(Exchange) for all Individual Health Plans


THANK YOU!

Questions or comments?

Michael Haffey

[email protected]

317-714-8495

mailto:[email protected]

Offering Attractive Employer Provided Health …...Restaurant with 40 employees Advantages of...

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