Virginia Council of CEOs - The Healthcare Reform Hurricane

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Hurricane Warning

description

Wondering how you can continue to grow, or even survive, in the face of Obamacare and increased healthcare costs? Fellow business owner Rich Boehling, who runs a company with 380 employees, shared the unique strategy he has implemented in his company to turn this big problem into a big opportunity. A FREE, comprehensive white paper, additional details, and many of the resources Rich used in developing his strategy can be found at http://www.pbjandaca.com/. "ACA Business Strategies: Workshop for Employers of Vulnerable Wage Populations" presented by: Rich Boehling, President and CEO of Productiv Inc. (http://getproductiv.com/) on July 16, 2013, hosted by the Virginia Council of CEOs (http://www.vaceos.org/).

Transcript of Virginia Council of CEOs - The Healthcare Reform Hurricane

Page 1: Virginia Council of CEOs -  The Healthcare Reform Hurricane

Hurricane Warning

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ACA Business StrategiesWorkshop for Employers of

Vulnerable Wage populations

Presented by: Rich Boehling

President and CEO of Productiv [email protected]

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•Property•Provisions•Processes •People

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•Property•Provisions•Processes •People

ACA has significant impact on some percentage of this “P”

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ACMEPBJCo.

Case Study

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ACME PBJ170 FTE’s

ACME PBJ: 2012 YE

BASELINE: $216,000

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$216,000

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Data Source: Bureau of Labor Statistics

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PBJ Financial Results

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ACME Chooses ALL PLAY with Part TimeAND RAISES PRICE by 6.5%

TotalCOST

5.3% of Sales

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Scenario Average Results: Owner’s NET = ($115,000) excluding any supply chain price increase.

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ACME Steps to ACA Compliance

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What the Law Really Says

• Americans must purchase health insurance• Minimum standard• Costs less than 9.5% of their income• Large Employer fines• If an Employer (large or small) offers a

qualified plan to an employee then NO subsidies for the employee in HIX

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How Are the Feds Doing This?

• Through 3 insurance markets:1. Employer Group Plans 2. Expanded Medicaid 3. Govt Assisted Markets / Exchanges

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Employer Shared Responsibility (simplified)

Understanding Your VulnerabilityKEY: Think Large stay Small

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X Axis: 2 Time Bands

• Part Time “P”– Less than 30 hours per week

• Full Time “L” – Greater Than 30 hours per week

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0 +Paid Hours

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Y Axis: 3 Wage Bands

• Disadvantaged Wage Class “1”– Minimum wage to 100% FPL

($11,400 W2)• Semi Skilled “2”– 101% to 300% FPL (up to $34,470

W2)• Skilled and Professional “3”– 301% FPL and Up (over $34,470 W2)

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0

+

100%

300%

Earn

ed W

age

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A Census Grid Wage Band + Time Band

Paid Hours

Earned Wage

Medicaid Cutoff

300% FPL Cutoff Part Time Cutoff

P3

P2

P1

L3

0

+

+

L2

L1

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Large Employer Grid

Paid Hours

Earned Wage

Medicaid Cutoff

Part Time CutoffP3P2

P1

L3

0

+

+

L2

L1

Part TimeSAFE HARBOR

Some exchange eligibility

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Large Employer Grid

Paid Hours

Earned Wage

300% FPL Cutoff Part Time Cutoff

P3

P2P1

L3

0

+

+

L2

L1

Part Time SAFE HARBORAll exchange

subsidy eligible

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Large Employer Grid

Paid Hours

Earned Wage

Medicaid Cutoff

300% FPL Cutoff Part Time Cutoff

P3

P2

P1

L3

0

+

+

L2

L1

Part Time SAFE HARBOR

Medicaid eligible

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Large Employer Grid

Paid Hours

Earned Wage

Medicaid Cutoff

300% FPL Cutoff Part Time Cutoff

P3

P2

P1

L3

0

+

+

L2

L1Full Time

Medicaid SAFE HARBOR

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Large Employer Grid

Paid Hours

Earned Wage

Medicaid Cutoff

300% FPL Cutoff

P3

P2

P1

L3

0

+

+

L2

L1

Current Employer Group plan is OK and

typically affordable

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Large Employer Grid

Paid Hours

Earned Wage

Medicaid Cutoff

300% FPL Cutoff Part Time Cutoff

P3

P2

P1

L3

0

+

+

L2L1

Full TimeAll Subsidy

Eligiblew/ FINES

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Hurricane Preparedness

Paid Hours

Earned Wage

Medicaid Cutoff

300% FPL Cutoff Part Time Cutoff

P3

P2

P1

L3

0

+

+

L2

L1

SAFE HARBOR

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Paid Hours

Earned Wage

Medicaid Cutoff

300% FPL Cutoff Part Time Cutoff

P3

P2

P1

L3

0

+

+

L2

L1

Productiv Inc Example

L3

9P2 L2

35 128L1

303

Current CENSUS

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End of Q1 2013

Paid Hours

Earned Wage

P3

P2

P1

L3

0

+

+

L2

L1

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End of Q2 2013

Paid Hours

Earned Wage

P3

P2

P1

L3

0

+

+

L2

L1

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IRS Delays Penalties til 2015!

• Will likely cause a few things1. Removes urgency, Employers may blink2. Exchanges open offering HUGE subsidies for

enrollees3. Your EID will be reported through the application

process “Appendix A”4. Every Appendix A completed in 2014 will likely

cost you $5200 pretax (as a Large Employer) in 2015

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Paid Hours

Earned Wage

Medicaid Cutoff

300% FPL Cutoff Part Time Cutoff

P3

P2

P1

L3

0

+

+

L2

L1

Migration Patterns

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EXCHANGE Benefit VALUE for an L2 Worker

Single 30yrs Old Married 28,30 with 2 children

W2 Income

Exchange Benefit Value

AGHI Income

Exchange Benefit Value

Source: Kaiser Family Foundation

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Data ACME MUST Use forStorm Tracking

• Name• DOB• Hire DATE• Gender• Zip Code• YTD Hours paid• YTD Compensation• Statutory Notifications• Employment Status

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Small Employer• Rules center on “Are you a Large Employer?”• For ACA sake, small only means “NOT Large”• Common Law Employer is defined by IRS Revenue

Ruling 70-630• Think, “Who is the Pay Master” that is the

employer• Control Group aggregation rule defined by IRC

414• FTE’s are Count of Full Time plus Part Time on pro

rata basis

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Small Employer Grid

Days Paid

Earned Wage

Medicaid Cutoff

300% FPL Cutoff

Seasonal Cutoff(4 to 5 months)

UnlimitedSeasonalWorkers

S3

0

+

+

S2

S1

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Small Employer Grid

Days Paid

Earned Wage

Medicaid Cutoff

300% FPL Cutoff

Seasonal Cutoff(4 to 5 months)

UnlimitedSeasonalWorkers

S3

0

+

+

S2

S1

SAFE HARBOR

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Outsourcing“L2S”

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ACME PBJ CORP StructureHQ

(Corporate)

Location 1Physical Plant,

shop, store

Location 2Physical Plant,

shop, store

Location 3Physical Plant,

shop, store

Property, Plant Equipment,

and Inventory

ProcessesCore Business Functions (L3)

Staff (L1, L2)

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ACME Plant Location 1 Group Population Map

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Think About Building a House

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ACME Hires a General Contractor:“An L2S Safe Harbor Pilot”

General Contractor

Subcontractor Subcontractor

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L2S Conversion

Paid Hours

Earned Wage

Medicaid Cutoff

300% FPL Cutoff Part Time Cutoff

P3

P2

P1

L3

0

+

+

L2

L1

Days Paid

Earned Wage

Medicaid Cutoff

300% FPL Cutoff

Seasonal Cutoff(4 to 5 months)

UnlimitedSeasonalWorkers

S3

0

+

+

S2

S1

SAFE HARBOR

Large Employer “L2” Multiple Small Employers

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L2S SAFE HARBOR StructureHQ

(Corporate)

Location 1Physical Plant,

shop, store

Location 2Physical Plant,

shop, store

Location 3Physical Plant,

shop, store

Property, Plant Equipment,

and Inventory

ProcessesCore Business &

Management

Process OperatorSubcontractor

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PBJ Financial Results

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L2S Outsourcing

• Tax ID (Separate Accounting)• No Common Ownership or Affiliated Group status• No Brother/Sister• No co-employment• ACA Safe Harbor <50 FTE’s• Statutory Obligations FICA/FUTA/SUTA/WC• Business Banking• Capital Financing• Payroll Functions• B2B Transactions (Invoicing/Payments)

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Call to Action

• Meet with your Executive Team• Share what you have learned about L2• Help them complete their own case study• Help guide them to the their best solution• Go to PBJandACA.com for additional

assistance

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Thank You

Rich BoehlingPresident CEO, Productiv Inc

PBJandACA.com

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