Hutson Etherredge Companies Cynthia Kelly Benefits Specialist Hutson Etherredge Companies 129 Park Ave SW Aiken, SC 29801 803-649-5141 ckelly@hecos.com

President Obama on March 23, 2010 Health Care Reform Law was signed By President Obama on March 23, 2010 To be Effective January 1, 2014

Objectives of the Law Provide Health Coverage for all Individuals No Pre-Existing Condition exclusions Unlimited Coverage Mandatory Requirements to Large Employers +50 Tax Penalty for Non-Compliance Control Insurance Company Profits

Availability of Coverage Large Employers Small Group Employers Individual and or Family Plans

Large Group Employers + 50 FTE Must Provide Minimum Essential Coverage (MEC) Must Be Affordable Tax Penalty for Non-Compliance Can Enroll any time during the year

Small Group Employers 2-49 FTE Not Mandated Must be Affordable (9.69% of GHHI for 2017) Employer Must Pay 50% of Employee Premium 70% of Eligible Employees must participate Can enroll any time during the year Spouse cannot be considered a second employee

Individual and or Family Plans Required to have a MEC Plan Only Enroll during the Open Enrollment November 1 to January 31 each year Tax Penalty for Non-Compliance

Physician Networks Large Group PPO Small Group PPO Shop Small Group PPO in State PPO-B out of State Individual EPO

Premium Comparison Small Group VS Individual Bronze Silver Gold Group Ind. Group Ind. Group Ind. 30 Y/O $310 $277 $319 $292 $415 $393 48 Y/O $447 $400 $453 $421 $599 $566 62 Y/O $786 $702 $796 $739 $1054 $995 Smoker Rates will be increase by 20% --- Based on 2016 rates

Small Employer Should I Provide Group Medical Coverage for My Employees??? What are the Pros and Cons

Pro Con Retain Employees thru Quality Employee Benefits Premium is tax deductible Cost Employee’s Dependents cannot get Subsidy’s thru the Marketplace Individual Plans

Individuals with NO Access to Group Coverage Have Two Options: MarketPlace Premium based on Income Subsidy May Apply Must file a tax return Private No Income Requirement No Subsidy No Tax filing required

ObamaCare Facts Objective was to create Competition and Lower Rates Lowest U.S. Uninsured rate in history at 8.6% 31 States Expanded Medicaid to 100% of FPL 2017 to have largest rate increase. Average of 25% Insurance company must spend 80% of premium on claims for individual and small group. Large group is 85% Of the 23 original Co-Ops that were established, as of 2017 only 6 will remain.

Who’s Left 2014 - 3 Ins. Companies: BCBSSC, BCHP, CCHP 2015 - 5 Ins. Companies: BCBSSC, BCHP, CCHP, Assurant, and UHC 2016 - 3 Ins. Companies: BCBSSC, BCHP, UHC 2017 - 2 Ins. Companies: BCBSSC, BCHP. Only BCBSSC will write FFM

Why??? Large Losses with NO Caps 90 Day Cancellation for MarketPlace Policies Doctors leaving the Networks Getting Treatment and Canceling policies Young and Healthy NOT enrolling Tax Penalty is Cheaper