1. Hutson Etherredge Companies
Cynthia Kelly
Benefits Specialist
Hutson Etherredge Companies
129 Park Ave SW
Aiken, SC

2. 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

3. 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

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

5. 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

6. 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

7. 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

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

12. Premium Comparison Small Group VS Individual
Bronze Silver Gold
Group Ind Group Ind Group Ind.
30 Y/O $ $ $ $ $ $393
48 Y/O $ $ $ $ $ $566
62 Y/O $ $ $ $ $ $995
Smoker Rates will be increase by 20% --- Based on 2016 rates

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

14. 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

15. 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

18. 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.

19. Who’s Left 2014 - 3 Ins. Companies: BCBSSC, BCHP, CCHP
Ins. Companies: BCBSSC, BCHP, CCHP, Assurant, and UHC
Ins. Companies: BCBSSC, BCHP, UHC
Ins. Companies: BCBSSC, BCHP. Only BCBSSC will write FFM

20. 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