2013 Renewal and Healthcare Reform March 2013

Today, we will cover: March 2013 Benefits Connection 2013 Renewal Benefits Connection & ACA Benefits Connection & the Exchanges Change? Penalties and Taxes in 2014 What do you do next

March 2013 Benefits Connection 2013 Renewal

Benefits Connection  Philosophy of Operation  Only Open to Participating Members  Multiple Carriers to create Competition and Flexibility  Similar to Large Company Contracts (one contract with carrier)  Smaller Retention Factor  Increased Leverage for negotiating  Rates dependent on Benefit Connection experience  Renewal Process  Invitation to all small group carriers to quote  April 1 Renewal Date  Second Look  Common renewal to all members  Control and Confidentiality of Information (member/company)  Unique Products exclusive to our program  Field and Carrier Underwriting to maintain competitive rates  Wellness component-manage claims plus member benefits March 1, 2013

March 2013

Plans offered include: 2 HMO Plans and 3 Health Savings Accounts HSA plans have an almost 3% premium decrease HMO plans have an almost 1% premium increase March 2013 Plans offered include: 2 HMO Plans; 1 HRA Plan and 3 Health Savings Accounts HSA & HRA plans have an almost 9% premium increase HMO plans have an almost 10% premium increase

March 2013 NO premium increase and no plan changes. Renewal has a 4% increase for the PPO Plan Renewal has a 3.5% increase for DHMO Plan NO premium increase and no plan changes.

March 2013 NO premium increase and no plan changes. Prudential Life -NO premium increase and no plan changes. Prudential Disability -NO premium increase and no plan changes. NO premium increase and no plan changes.

This company offers Group Life, Short Term and Long Term Disability to our members. There are no plan or coverage changes and the premium is determined by the individual member company’s census and desired coverage. Aflac continues to offer an array of voluntary products to our members. Hartford also provides Workers Compensation with competitive rates for our Benefit Connection members. They offer a monthly ‘pay as you go’ program that many members find helpful. New to the Benefits Connection, this company offers a Workers Compensation program to our members that incorporates payroll services along with competitive pricing and works well with firms with high experience mods. March 2013

Wellness Free to our members and we strongly encourage all members and their employees to participate in our Wellness program by taking the Health Risk Assessment evaluation and touring the information available on our Wellness Website. Go to Also, free to our members, visit our Human Resource website for a vast array of information, forms, employee related materials and issues. Visit their website at We will be happy to provide you with your own logon. Call Allen Insurance Group or for your personal logon. March 2013

 Change plans – all employees do not have to enroll in the same plan within one carrier.  You can move your group to another insurance company and employees can select from any of the plans offered.  Your group can submit updated wellness forms to request a preferred rating.  You can delete or add dependents up to age 26.  You can add new eligible employees.  You can add or delete coverage. March 2013 Paperwork (due by 3/22/2013) for any of these changes are processed with Beth Fisher. You can reach Beth at or by at All changes will be effective April 1 st. During ‘open enrollment’ you can:

 Proud of our healthcare premium decrease with AMH and a modest increase with Highmark BCBS.  Proud of our ‘no increases’ for 2 of our 3 dental plans and no increase with our Vision, Life and Short Term Disability plan.  Proud to use respected, strong and financially sound insurance carriers.  Proud to continually add new benefits and plan offerings. And, the Benefits Connection is the largest ‘association’ plan in DE March 2013

Benefits Connection & ACA

Provide accessibility to health insurance for all Americans. Control and reduce health insurance costs. Standardization of health care coverage. Create accountability for health insurers. Provide guaranteed coverage with no pre-existing exclusions. Increased transparency and consumer protection. March 2013 The Foundation Behind Reform Affordable Care Act March 23 rd, 2010 Affordable Care Act Became Law

Coverage Mandates Essential Health Benefits Exchanges – Public and Private Pre-Existing Conditions Transparency Penalty/Taxes Non-Profit Plans 80% - 85% Rule Other Regional Markets January 2013 Healthcare Reform Components

Coverage Mandates Essential Health Benefits Exchanges: Public, Private, Marketplace No Pre-Existing Conditions Transparency Dependents to age 26 No lifetime limits March 2013 Healthcare Reform Components Benefits Connection and Healthcare Reform Components

Ambulatory Patient Services Emergency Services Hospitalization Maternity and Newborn Care Mental Health and Substance Use Disorder Services, including behavioral health treatment Prescription Drugs Rehabilitative Services and Devices Laboratory Services Preventive, Wellness Services & Chronic Disease Management Pediatric Services, including oral and vision care DE Autism coverage March 2013 Essential Benefits

March 2013 Benefits Connection and Essential Benefits

March 2013 Benefits Connection and the Exchanges

Exchanges, the purpose March 2013 Transparency Ease of comparing coverage and price Orbitz/Priceline/eShopping experience Federal partnership Includes Platinum, Gold, Silver, Bronze Plans Provide information on quality of plans Determine eligibility for Medicaid, Medicare and subsidies. Includes Essential Benefits

Carrier competition Ease of comparison Broader options Enrollment assistance Multiple product offerings Group purchasing power Broker assistance Claims assistance Composite billing of all products March 2013 Exchange Components Benefits Connection Public Exchange

March 2013

January 2013

Website/Portal Shopping & Pricing Benefits Connection Core Functions Benefit Plan Comparisons with Broker Assistance Enrollment Assistance Benefits Connection Administration LifeVisionDentalMedicalDisability Billing and changes March 2013 Wellness Voluntary Benefits WC Education Carrier Interface Product Development Legislative

March 2013 HCR Exchange Plans will be available for review and quoting 10/1/2013 with enrollment effective January 1, 2014.

March 2013 From Your Employer How Will I Get Health Insurance Per President Obama: “If you like your health care plan, you can keep your health care plan.”

From the Public Exchange *Poverty level in 2011 was $10,890 for a single individual, $22,350 for a family of 4 March 2013  Carriers that elect to participate  Bronze, Silver, Gold, Platinum Plans  Two National Not-For-Profit Plans  Determination if eligible Subsidies Medicare Medicaid CHIP

From the Private Exchanges March 2013  The Benefits Connection ?  Carriers Exchanges  Various Other Exchanges  Same rates as public exchange  No subsidies  Bronze, Silver, Gold, Platinum or actuarially equal

From the General Market Place March 2013  The Benefits Connection  Any Insurance Company  Any Broker (Also offering the Bronze, Silver, Gold and Platinum plans)

Accessing Coverage March 2013  Public Exchange  Private Exchange  General Market Place  Medicaid  Medicare  CHIP

Benefits Connection will continue to offer qualified plans. March 2013

Change ?

March 2013 Know the Facts 1.Full time employee 2.Part time employees 3.Minimum coverage requirements 4.Contribution requirements 5.Individual can only obtain subsides from the Bronze plan 6.Maximum waiting period is 90 days.

What will it cost? March 2013

Employer’s Cost  More employee participation, could increase your costs of benefits  Employees that previously declined coverage must now have coverage  Medicare payroll tax increased to 3.8% (from 2.9%)  An employer may elect to provide a ‘Defined Contribution’.

March 2013 Premiums ?  No Pre Existing Conditions  No declinations  No underwriting  Essential benefits  Added Benefits  No lifetime maximum Insurance companies are required to file rates for Bronze, Silver, Gold & Platinum plans by August 1 st 2013.

March 2013 Premiums ?  Lower deductibles  Dependents to Age 26  Rate compression  Future medical services  Previously uninsured  Rating factors (age, territory, smokers, family size, wellness) Insurance companies are required to file rates for Bronze, Silver, Gold & Platinum plans by August 1 st 2013.

March 2013 We will be there to help you navigate through ACA’s options, rules and regulations

March 2013 Penalties and Taxes in 2014 “Pay or Play”

For Employers with less than 50 employees Note: If the employer has 25 or fewer employees and average wages up to $50,000, they may be eligible for a tax credit. There is no direct penalty for the small employer. March 2013 Employer Penalty/Tax

For Employers with 50+ employees. Who offer a group plan with at least 60% coverage and the employee does not pay more than 9.5% of their income – No Penalty March 2013 Employer Penalty/Tax

The penalty is $3,000 annual for each full-time employee receiving a tax credit, up to a maximum of $2,000 times the number of full-time employees minus 30. The penalty is increased each year by the growth in insurance premiums. For Employers with 50+ employees. Who offers a group plan with at least 60% coverage and the employee DOES PAY MORE than 9.5% of their income – Penalty will apply March 2013 Example: A firm with 75 full time employees, with 10 employees receiving a tax credit. The penalty is $30,000 (10 employees, receiving a tax credit x $3,000 each=$30,000) The penalty would be $90,000 Maximum

The penalty is $2,000 annually times the number of full-time employees minus 30. The penalty is increased each year by the growth in insurance premiums. For Employers with 50+ employees. Who does NOT offer a group plan and who has at least one employee receiving a subsidy in an exchange – A Penalty will apply. March 2013 Example: A firm with 75 full time employees. The penalty would be $90,000 (75 employees, less 30 times $2,000 each)

The penalty is $3,000 annually for each full-time employee receiving a tax credit, up to a maximum of $2,000 times the number of full-time employees minus 30. The penalty is increased each year by the growth in insurance premiums. For Employers with 50+ employees. Who offer a group plan with less than 60% coverage – A Penalty will apply. March 2013 Example: A firm with 75 full time employees, with 35 employees receiving a tax credit. Penalty would be $105,000 (but maximum is $90,000) Mini Med Plan, costing $120,000 (75 employees, average annual premium $1,600) Total Mini Med Premium and Penalty cost would be $210,000 - or - A Bronze plan, inside the exchange, with an estimated annual premium of $3,500 times 75 employees would have an annual cost of $262,500 before any employee contribution.

March 2013

What Do You Do Next

What Do I Do Now? Nothing…continue to offer your Employer Group Health Plan March 2013

What will plans cost? Public – Private – Market Place March 2013

Options for 2014? Continue with your current healthcare plans. Purchase a plan through the Exchanges Offer employees a stipend for them to purchase their own coverage. Discontinue the Employer Group Health Plan March 2013

Network Providers Overall Concerns…… Plan Design Subsidy Levels Rates Viability of the exchanges Federally Managed Exchanges Healthcare cost containment March 2013

Today, we covered: March 2013 Benefits Connection 2013 Renewal Benefits Connection & ACA Benefits Connection & the Exchanges Change ? Penalties and Taxes in 2014 What do you do next

Some Helpful Resources Kaiser Family Foundation Illustrating How Healthcare Reform will work The Government’s Website Benefits Connection Website Allen Insurance Group’s Website HR360 – Online Human Resource Website (logon is DANA-DE and password is alleninsurance) March 2013

We will be there to help you navigate through ACA’s options, rules and regulations.

 Change plans – all employees do not have to enroll in the same plan within one carrier.  You can move your group to another insurance company and employees can select from any of the plans offered.  Your group can submit updated wellness forms to request a preferred rating.  You can delete or add dependents up to age 26.  You can add new eligible employees.  You can add or delete coverage. March 2013 Paperwork (due by 3/22/2013) for any of these changes are processed with Beth Fisher. You can reach Beth at or by at All changes will be effective April 1 st. Reminder during ‘open enrollment’ you can:

Our 2013 Renewal  Our healthcare premiums DECREASED with AMH and had a modest increase with Highmark BCBS.  Highmark BCBS (HSA Plan’s) will have a 15 month deductible.  NO increase with 2 of 3 Dental plans.  NO increase with our Vision, Life and Short Term Disability plans. March 2013

March 2013 Established in 1980 to serve the Newark and New Castle County businesses, now serving members throughout Delaware with a vast product line of Employee Benefits. Allen Insurance Group has provided Personal, Business, Life and Employee Benefits coverage to the Tri-State area since 1932, as well as, the Broker for The Benefits Connection since its inception.

March 2013 Thank you! Because of you, our members, we have a strong, stable and successful employee benefit program.