Transamerica’s Health-Pak

A guide to successful solutions for 2014 & beyond

Presented by:

Cas SharpArea Sales Manager of Health Distribution, Central Region

Your Group’s Statistics

• Number of Currently Insured employees = 60• Number of full time Employees = 691• Average Salary = $31,960.07

– ( Calculated for Affordability (4) )

• GROSS “Pay” Penalty under ACA = $1,784,700• Total savings under ACA GROSS penalties &

Taxes while providing a Bronze equivalent or greater plan that meets “Affordability” Mandate… $647,287.62

ACA Penalties1. From the Patient Protection and Affordable Care Act of 2010 (PPACA). 2. Full-time employees work 30 hours or more per week on monthly

average. 3. No penalty is paid on part-time employees or full-time employee

equivalents. 4. If total employee cost exceeds 9.5% of employee's family income,

then the employee is eligible for subsidized coverage in the new state-based Exchange purchasing group.

5. The first 30 full-time employees are exempt from the mandate penalty.

6. The penalty amount is the lesser of the actual penalty or $2,000 times all full-time employees minus the first 30.

Your NET Penalties under ACA* • If you do not provide coverage to full-time employees, and at least one

receives an Exchange Subsidy(4), then your total annual penalty owed to the Federal Government will be $1,322,000(5).

• If you do offer qualified coverage to full-time employees, but one or more receives an Exchange Subsidy(4), then your penalty for each subsidy-recipient employee will be $3,000(6).

Listed below are possible penalties based on the information you have provided.

•Subsidy Recipients 172 345 518 % of full time Workforce 25% 50% 75% Penalty $516,000 $1,035,000 $1,322,000

• Please see Calculator: http://www.retailmeansjobs.com/health-care-calculator

Your GROSS Penalties + Taxes

• At 75% your penalty is $1,322,000• Assuming a 35% taxation

• $1,322,000 x 35% = $462,700• $462,700 + $1,322,000 = $1,784,700

• $1,784,700 annual Penalty for 75% (518) of your employees, or…

• $287.11 per employee• ($1,784,700 / 518 = $287.11 )

Objective

• Provide the best Benefits possible to you & your employees in comparison to your GROSS penalties & taxation under the ACA for 2014 and beyond.

How?

1. Combining a Max-Funded Self-Insured MEC & MVP that meets the Affordability mandate.

2. Integrating “Expected” Benefits to fill the Gaps left behind by HCR, & offering Limited Indemnity benefits for those that decline.

3. Creating the best benefit available for you that is under or equal to your GROSS Penalties & taxes under ACA.

A Little Q & A • Does an employer have to offer any other type of coverage such as a Minimum

Value plan in order to avoid the $3,000 penalty if an employee who is eligible for subsidies on the Exchange waives off of the employer group plan and purchases coverage on the Exchange?

• Yes, employers need to offer a Minimum Value plan which meets the government’s 60% rule of “allowed costs” in order to avoid the $3,000 penalty per employee who is eligible for subsidies on the Exchange, who waives off of the employer plan, and who purchases coverage on the Exchange.

• The employer cannot charge a full time employee whose total family income is at or below 400% of the Federal Poverty Level, which is currently $92,000 for a family of four, more than 9.5% of that employee’s W2 Box 1 income for the Minimum Value plan. The W2 Box 1 income equals the employee’s total income minus his contribution to the pension plan and minus any monies the employee set aside in his Flex 125 Program. This 9.5% limitation applies only to the single contribution rate of the Minimum Value plan but not for the charge attributable to any dependents.

Your Max-Funded Self-insured Options

Proposal is based on the following:

• Male or female • DOB • Salary or Pay Rate* (to determine “Affordability”)

• Location (Zip Code) • Job title • Type Of Coverage of each employee

• (EE,ES,EC, or EF)

» RATES SUBJECT TO CHANGE DUE TO UNDERWRITTING