Copyright © 2012 United Benefit Advisors, LLC. All Rights Reserved. EMPLOYER STRATEGIES FOR ACA Presented by Terry Allard, CEBS Senior Benefits Advisor.

Slides:



Advertisements
Similar presentations
What You Need To Know About Health Care Reform. Health Care Reform Key Facts March 23, President Obama signed the Affordable Care Act. A central.
Advertisements

Nebraska’s Health Insurance Exchange Overview of the Essential Health Benefits Public Session August 16, 2012.
Vermont’s Health Insurance Exchange September 17, 2013 Paul Harrington, EVP Vermont Medical Society.
Department of Health and Mental Hygiene Behavioral Health Services 2013 and Beyond Lisa Hadley, M.D., J.D. ClinicalDirector Mental Hygiene Administration.
2014 Update of Affordable Care Act Provisions South Dakota Association of School Business Officials Annual Fall Conference September 25, 2013 Lisa Carlson.
Affordable Care Act & You: What every consumer should know
Affordable Care Act: Small Group and Individual Plan Impact – 2014 and Beyond Rod Wiltrout GuideStone Financial Resources State Representative GuideStone.
Healthcare Reform Benefit Consultants Northwest Plan Administrator “ Knowledge is Power in Benefit Management ” Quality Service Integrity Knowledge Support.
An independent licensee of the Blue Cross and Blue Shield Association. U7430b, 2/11 This presentation contains audio. Please make sure your speakers are.
Copyright © 2012 United Benefit Advisors, LLC. All Rights Reserved. Understanding PPACA.
Health Reform and Health Coverage: Changes Ahead for Kids and Families Kim VanPelt St. Luke’s Health Initiatives September 16, 2013.
2015 Benefit Enrollment Presentation November 2014.
1. Essential Health Benefits (10 categories of services): (1) ambulatory patient services (2) emergency services (3) hospitalization (4) maternity and.
GIOVANNI GOMEZ REGIONAL COORDINATOR OF OUTREACH The Affordable Care Act: Illinois Health Insurance Marketplace.
What do I Need to Know about the Affordable Care Act & The Health Insurance Marketplace?
Help is on the way! Health Care Reform: Health Plans Overview.
What is the Affordable Care Act? The Patient Protection and Affordable Care Act (PPACA),commonly called the Affordable Care Act (ACA) or Obamacare,is.
Health Insurance Marketplaces Presented by Cobbs Allen © 2013 Zywave, Inc. All rights reserved.
MARY FRANCES CHARLTON LEGAL AID JUSTICE CENTER The Affordable Care Act in Virginia.
Page 1 The Health Benefit Exchange and the Small Group Market Department of Health and Social Services.
State of Delaware Delaware Restaurant Association Education Symposium Health Insurance Exchanges and the Small Group Market February 21, 2012.
What is the ACA (“Obamacare”) ? The Patient Protection and Affordable Care Act (ACA) ACA will reform our complex health care system If you are not insured,
What Athletic Trainers Need to Know about the Health Care Law National Athletic Trainers’ Association December 9, 2013, 3:00 pm EST.
ARKANSAS BLUE CROSS and BLUE SHIELD An Independent Licensee of the Blue Cross and Blue Shield Association Health Care Reform From an Insurer’s Perspective.
What We Need to Know for October 1. What It Is How Signing Up Works Expert Advice – Protips Our Responsibilities Referral Agencies.
Page 1 Medicaid, Outreach, and the Health Insurance Exchange Delaware Department of Health and Social Services.
Kentucky Health Benefit Exchange April 18, 2013 Carrie Banahan, Executive Director Office of the Kentucky Health Benefit Exchange 1 COMMONWEALTH OF KENTUCKY.
Health Coverage Enrollment in Michigan What do I Need to Know? Understanding the Health Insurance Marketplace and Healthy Michigan Plan.
The Artists Health Insurance Resource Center A program of The Actors Fund Center for Emerging.
Copyright © 2012 United Benefit Advisors, LLC. All Rights Reserved. PPACA Highlights.
Association Insurance Cooperative PPACA 2013 – 2014 Summary Handouts: Click HereClick Here.
Impact of Healthcare Reform (PPACA)March The Impact of Healthcare Reform (PPACA) on City Employees Presented by: Lisa Ghotbi - Deputy Director,
What You Need To Know About Health Care Reform. Health Care Reform Key Facts March 23, President Obama signed the Affordable Care Act. A central.
The Affordable Care Act – What does it mean for you and your business? Ashli Watts Manager of Public Affairs.
Proprietary and Confidential Health Care Reform Update What you need to know 02/13/2014 Health Care Reform AWI Presentation.
Association Insurance Cooperative PPACA 2013 – 2014 Presentation Handouts: Click HereClick Here.
ACA Simplified The Affordable Care Act (PPACA) was signed into law on March 23, 2010— putting in place measures to improve access to affordable health.
Page 1 The Health Benefit Exchange and the Commercial Insurance Market Delaware Department of Health and Social Services.
The Affordable Care Act and Covered California El Dorado County Chamber of Commerce January 9, 2013.
CURRENT ISSUES IN HEALTHCARE REFORM Alice Helle BrownWinick 666 Grand Avenue, Suite 2000 Des Moines, IA Telephone: Facsimile:
Health Reform Highlights for Children with Special Health Care Needs May 19, 2010.
The Affordable Care Act’s Patients’ Bill of Rights Presented by Cobbs Allen © 2013 Zywave, Inc. All rights reserved.
Update October PPACAPPACA olitical rocess ssures haos gain.
Affordable Care Act – Current Issues in Healthcare Reform Alice Helle - Cynthia Boyle Lande –
The Latest On What Is Coming In 2014? What I Learned from the Humana Webinar #2* * some material taken directly from the Humana Power Point.
Affordable Care Act The information provided in this document is not intended to advise you on how to comply with any provisions of the referenced legislation.
Page 1 June 28, 2011 Health Benefit Exchange: Outreach, Education and Enrollment Delaware Department of Health and Social Services.
Overview Essential Health Benefits in the Affordable Care Act Deborah Reidy Kelch January 26, 2012 California Health Benefit Exchange Board Meeting.
Health Insurance Coverage: What you need to know. Joao dos Santos Faustino Coordinator of Member Services Hudson River HealthCare October 15, 2015.
HealthCare Reform (PPACA). Employer Mandate Employees are impacted by Employer decision to offer healthcare – Employee enrolling in non-compliant plan.
Health Care Reform September 18 th, Individual Marketplace O Which individuals can purchase insurance on the exchange? O Individuals who do not.
Affordable Care Act Red group Luke, Trevor, Noah, Sarah.
THE COMMONWEALTH FUND Essential Health Benefits Under the Affordable Care Act: HHS Guidance and Key Implementation Issues Sara R. Collins, Ph.D. Vice President,
Goals  What is ACA?  The Law & Key Benefits  Options & Plans  What’s Covered  Need to Know  Penalties & Exceptions  Resources.
Benefits 101: Health Care Reform Presented by Awesome Agency © 2013 Zywave, Inc. All rights reserved.
The Skinny Option aka. MEC Self-Funding AN OBAMACARE STRATEGY Hammett Marketing Group LLC.
ACA Jill Hanken Virginia Poverty Law Center
GET ANSWERS. GET COVERED. Affordable Care Act and the Health Insurance Marketplace.
Impact of Affordable Care Act on Alaska Carolyn Heyman-Layne October 2, 2013.
The Affordable Care Act [your name], Certified [NAV, IPA, CAC] [your organization name] [your and phone]
What You Need To Know About Health Care Reform
Health Coverage Enrollment in Michigan
Outreach & Enrollment 2017.
An Overview Name Certified Navigator Phone Number
Affordable Care Act in Illinois
Health Coverage Enrollment in Michigan
Health Coverage Enrollment in Michigan
MICHIGAN ASSOCIATION OF HEALTH PLANS
PA Health Insurance Navigator Program
The Patient Protection and Affordable Care Act
Presentation transcript:

Copyright © 2012 United Benefit Advisors, LLC. All Rights Reserved. EMPLOYER STRATEGIES FOR ACA Presented by Terry Allard, CEBS Senior Benefits Advisor

Copyright © 2012 United Benefit Advisors, LLC. All Rights Reserved. Key Parts of PPACA Intended to increase number of Americans with health coverage Penalties for individuals without coverage Encouragement for employers to offer coverage Market reforms to improve access Expanded Medicaid eligibility

Copyright © 2012 United Benefit Advisors, LLC. All Rights Reserved. A tough pill to swallow?

Copyright © 2012 United Benefit Advisors, LLC. All Rights Reserved. Employer Encouragement Tax credits may be available Small employers (100 or fewer employees in most states) may enroll in an exchange for small businesses

Copyright © 2012 United Benefit Advisors, LLC. All Rights Reserved. Employer Encouragement Employers are not required to offer medical coverage penalty applies to employers with 50 or more employees who do not offer “minimum essential” coverage, or who offer coverage but the coverage does not provide “minimum value” or is not “affordable”

Copyright © 2012 United Benefit Advisors, LLC. All Rights Reserved. Employer Requirements Coverage provided must meet “minimum value” 60% considers employee’s cost share (deductible, co-pays, coinsurance) 60% does not consider premium costs Must offer to full time employees - 30 hours Must provide after 90 days

Copyright © 2012 United Benefit Advisors, LLC. All Rights Reserved. Employer Strategies Strategies include: Maintain current program –Reduce employee hours –Restructure employer contribution –Eliminate spouse coverage Reduce benefits to minimum value Move to self funding

Copyright © 2012 United Benefit Advisors, LLC. All Rights Reserved. Employer Strategies SHOP exchange Private exchange Terminate plan and send employees to the marketplace/exchange

Copyright © 2012 United Benefit Advisors, LLC. All Rights Reserved. Exchanges Intended to make it simpler for individuals and small employers to purchase health insurance Exchange will not provide insurance

Copyright © 2012 United Benefit Advisors, LLC. All Rights Reserved.

Exchanges Exchange is somewhat like Orbitz or Expedia Will provide information on plan benefits and costs to make comparing options easier Will oversee the plans health insurers offer through the exchange

Copyright © 2012 United Benefit Advisors, LLC. All Rights Reserved. Exchanges Plans must meet “cost sharing” requirements and provide “essential health benefits” Deductible may not exceed $2,000 for single or $4,000 for family coverage Out-of-pocket cannot exceed $6,250 for single or $12,500 for family coverage

Copyright © 2012 United Benefit Advisors, LLC. All Rights Reserved. Exchanges Essential health benefits are: –Ambulatory (outpatient) care –Emergency services –Hospitalization –Maternity and newborn care –Mental health and substance abuse –Prescription drugs –Rehabilitative and habilitative services –Laboratory services –Preventive and wellness care, including chronic disease management –Pediatric care

Copyright © 2012 United Benefit Advisors, LLC. All Rights Reserved. Exchanges Coverage to be available at several actuarial levels: Platinum – cover 90% of costs Gold – cover 80% of costs Silver – cover 70% of costs Bronze – cover 60% of costs

Copyright © 2012 United Benefit Advisors, LLC. All Rights Reserved. Exchanges Small Business Health Options Program (SHOP) exchange to be provided for small employers Employer selects coverage level (e.g. a Silver plan) Each employee selects own plan within the selected coverage level (delayed to 2015) States may allow additional options Exchange provides consolidated bill to employer Employer must offer exchange coverage to all full- time employees No specific employer contribution required

Copyright © 2012 United Benefit Advisors, LLC. All Rights Reserved. Exchanges Alaska will have a Federally Facilitated Exchange A person may enroll in the exchange even if they have access to employer-provided coverage Annual open enrollment each fall for a January 1 coverage date Special enrollment required mid-year with life events

Copyright © 2012 United Benefit Advisors, LLC. All Rights Reserved. Exchanges Individuals are eligible for a premium tax credit (subsidy) if certain conditions are met : Income is between 100% and 400% of Federal Poverty Line –For 2013, FPL for Alaska:  Single person is $14,350 - $57,400  Family of four is $29,440 - $117,760 –Amount of subsidy reduces as income approaches 400% of FPL

Copyright © 2012 United Benefit Advisors, LLC. All Rights Reserved. Exchanges Exchanges also responsible for: Providing website, navigators and other enrollment assistance to individuals Determining eligibility for premium tax credits (subsidy)

Copyright © 2012 United Benefit Advisors, LLC. All Rights Reserved. Employer Considerations Discontinue coverage and rely on the exchanges Will that cause employees to demand additional, less tax-advantaged compensation?  Defined contribution strategy  More control over costs

Copyright © 2012 United Benefit Advisors, LLC. All Rights Reserved. Questions??? Contact: We are happy to answer your questions. Call The Wilson Agency at Or This information is general and is provided for educational purposes only. It reflects UBA's understanding of the available guidance as of the date shown and is subject to change. It is not intended to provide legal advice. You should not act on this information without consulting legal counsel or other knowledgeable advisors.