Peter Kilmartin Boston MA HEALTH CARE REFORM UPDATE FOR RIBGH THE ROAD TO IMPLEMENTATION JUNE 14, 2013 Not Peer Reviewed

NEW SURVEY RESULTS THE ROAD TO IMPLEMENTATION Released Jun 12, 2013 (2 days ago!) Almost 900 employer participants

© 2013 Mercer This is for informational purposes only, and is not intended to be used as legal advice. 11/17/2015 The Most Disruptive Requirement for the Most Employers: Extending Coverage to all Employees Working 30 or More Hours per Week Retail and hospitality Financial services Health care services GovernmentOther servicesTransportation/ Communication/ Utility Manufacturing One-third of all survey respondents currently do not offer coverage to all employees working 30+ hours per week Percent of employers that currently do not offer coverage in a qualified plan to all employees working an average of 30 or more hours per week 2 Source: Mercer’s Survey on Health Care Reform: The Road to Implementation

© 2013 Mercer This is for informational purposes only, and is not intended to be used as legal advice. 11/17/2015 A 12-Month Look-Back Period is the Most Common…But a Third of Respondents Haven’t Decided What Period To Use Will use 12-month look-back period Other period 3 month period 6 month period Don’t know yet 4% Among respondents that track and record hours for employees working variable hours (a Shared Responsibility issue) 3 Source: Mercer’s Survey on Health Care Reform: The Road to Implementation

© 2013 Mercer This is for informational purposes only, and is not intended to be used as legal advice. 4 November 17, 2015 Expected cost increase due to ACA requirements effective in 2014 Retail and hospitality Other services Manufacturing Government Health care services Financial services Transportation/ Communication/Utility Expect cost increase of 3% or more due to ACA requirements effective in 2014, by industry Source: Mercer’s Survey on Health Care Reform: The Road to Implementation In 2011, 25% of Employers Thought ACA Would Have Little or No Impact on Their Costs…Only 9% Think So Now Don’t know Increase of 1%–2% Increase of 5% or more Increase of less than 1% Increase of 3%–4%

STRATEGIES FOR 2014 AND BEYOND

© 2013 Mercer This is for informational purposes only, and is not intended to be used as legal advice. 11/17/2015 Taking Steps Now to Avoid the Excise Tax in 2018 Introduce a CDHP or take steps to increase enrollment in an existing CDHP Drop a higher-cost health plan Add or expand health management programs Eliminate health care FSAs Unbundle dental and medical plans Other change(s) Based on the 36% of respondents who say changes they are making for 2014 are influenced by their concerns over the 2018 excise tax 6 Source: Mercer’s Survey on Health Care Reform: The Road to Implementation

© 2013 Mercer This is for informational purposes only, and is not intended to be used as legal advice. 7 November 17, 2015 About a Third of Respondents are Considering Switching to a Private Exchange to Deliver Benefits to Retirees or Actives Within Two Years – and Nearly Half Would Consider Switching Within Five Years Active employeesPre-Medicare- eligible retirees Medicare-eligible retirees Considering private exchanges for either actives or retirees Source: Mercer’s Survey on Health Care Reform: The Road to Implementation

© 2013 Mercer This is for informational purposes only, and is not intended to be used as legal advice. 8 November 17, 2015 Final Wellness Regulations Program Types Participatory No health standard to meet 1.Annual opportunity 2.Limited reward: 30% / 50% max 3.Personal physician recommendations 4.Reasonably designed 5.Notice and disclosure Health-contingent Mercer is not engaged in the practice of law and this report, which may include commenting on legal issues or regulations, does not constitute and is not a substitute for legal advice. Accordingly, Mercer recommends that employers secure the advice of competent legal counsel with respect to any legal matters related to this report or otherwise. The information contained in this document and in any attachments is not intended by Mercer to be used, and it cannot be used, for the purpose of avoiding penalties under the Internal Revenue Code or imposed by any legislative body on the taxpayer or plan sponsor.

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