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IEDA. PROFITING UNDER OBAMA: HOW SMART BUSINESS OWNERS WILL SUCCEED DURING THE SECOND TERM. 1 . Have Dinner With Your Accountant . THE PROMISE – Patient Protection and Affordable Care Act March 23, 2010 $1.1 Trillion cost $140 Billion reduction in the deficit

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IEDA

PROFITING UNDER OBAMA:

HOW SMART

BUSINESS

OWNERS

WILL SUCCEED

DURING THE

SECOND TERM


1. Have Dinner With Your Accountant


  • THE PROMISE – Patient Protection and Affordable Care ActMarch 23, 2010

  • $1.1 Trillion cost

  • $140 Billion reduction in the deficit

  • Coverage for all: Cover 2/3 of the uninsured (the rest on Medicaid).

  • A new market for 30-34 million uninsured.

  • State exchanges provide consumer protection/risk pooling/lower costs


Seven Things You Need To Know

1. Understand The Timeline

2. Determine If Your Plan Qualifies

3. Figure Out The Mandate

4. Calculate Full vs. Part Time Employees

5. See If You’re Eligible For A Tax Credit

Get Ready For The State Exchanges

Your Next Actions…Now


2011

  • Higher Premiums

  • Tax Credit

  • Dependent Care

  • Pre-Existing Conditions

  • Cannot rescind

  • Preventative Care

  • Wellness Program Grants

  • Unreasonable Rate Hikes (over 10%)

  • HSA Contributions Limited

  • OTC drugs excluded from HSA Accounts

  • 20% Tax on Distributions from HSA (unqualified exp)

  • Automatic enrollment in health plans


2012

  • 1099 Reporting - REPEALED

  • W-2 Reporting

  • Summary of Benefits and Coverage. This summary will be required for all health plans at companies, and will be due on or after September 23, 2012, during the first open enrollment period.


Women's Preventative Health Care Amendment - Free contraceptives, breast-feeding supplies, screenings for sexually transmitted infections, counseling for domestic violence and routine check-ups for breast and pelvic exams, Pap tests and prenatal care.

2012…a few other interesting provisions

Abstinence Only Education - $50 million but states must match.

10% Tanning Tax.

Calorie Information In Restaurants

Parent And Coping Skills - $1.5 billion so that young mothers who need them can get visits once or twice a month from nurses.

Breast-feeding Friendly Workplace – Bathrooms don’t count


2013 contraceptives, breast-feeding supplies, screenings for sexually transmitted infections, counseling for domestic violence and routine check-ups for breast and pelvic exams, Pap tests and prenatal care.

  • Medicare Part D (prescription drug) deduction ends

  • Social Security Tax back to 6.2%

  • Individual Medicare taxes rise from 1.45% to 2.35% for ‘high income’ people

  • Additional 2.9% Tax on unearned income begins for ‘high income’ people

  • Capital gains tax increases from 15% to 20%

  • Dividends tax increases from 15% to 20%

  • Itemized deduction ceiling rises from 7.5% to 10%

  • Flexible spending accounts limited to $2,500 withdrawals

  • Notification to employees about Health Exchanges


2014…It Hits The Fan! contraceptives, breast-feeding supplies, screenings for sexually transmitted infections, counseling for domestic violence and routine check-ups for breast and pelvic exams, Pap tests and prenatal care.

Waiting periods cannot exceed 90 days

Pre-existing conditions waived for everyone

New reporting requirements to the government – Employers must report on health coverage of each employee and family members covered: name, SSN, coverage detail.

Individual Mandate

Employer Mandate


Seven Things You Need To Know contraceptives, breast-feeding supplies, screenings for sexually transmitted infections, counseling for domestic violence and routine check-ups for breast and pelvic exams, Pap tests and prenatal care.

1. Understand The Timeline

2. Determine If Your Plan Qualifies

3. Figure Out The Mandate

4. Calculate Full vs. Part Time Employees

5. See If You’re Eligible For A Tax Credit

Get Ready For The State Exchanges

Your Next Actions…Now


DO YOU HAVE 50 FTEs? NO? contraceptives, breast-feeding supplies, screenings for sexually transmitted infections, counseling for domestic violence and routine check-ups for breast and pelvic exams, Pap tests and prenatal care.

No health insurance requirement

No penalties

Tax credit available


DO YOU HAVE 50 FTEs? YES? contraceptives, breast-feeding supplies, screenings for sexually transmitted infections, counseling for domestic violence and routine check-ups for breast and pelvic exams, Pap tests and prenatal care.

Must pay >60% of employees premiums

OR

Employee’s premium payment cannot exceed 9.5% of their income


DO YOU HAVE 200 FTEs? YES? contraceptives, breast-feeding supplies, screenings for sexually transmitted infections, counseling for domestic violence and routine check-ups for breast and pelvic exams, Pap tests and prenatal care.

Required to automatically enroll new FTE in a health plan with the lowest employee premium (unless they opt out)

AND

Must cover >72.5% of cheapest individual health plan or >65% for family plans


Seven Things You Need To Know contraceptives, breast-feeding supplies, screenings for sexually transmitted infections, counseling for domestic violence and routine check-ups for breast and pelvic exams, Pap tests and prenatal care.

1. Understand The Timeline

2. Determine If Your Plan Qualifies

3. Figure Out The Mandate

4. Calculate Full vs. Part Time Employees

5. See If You’re Eligible For A Tax Credit

Get Ready For The State Exchanges

Your Next Actions…Now


THE MANDATE contraceptives, breast-feeding supplies, screenings for sexually transmitted infections, counseling for domestic violence and routine check-ups for breast and pelvic exams, Pap tests and prenatal care.

  • Beginning 2014 everyone must have coverage, either purchased individually or provided by an employer

  • By 2019: Penalties for the individual is the higher of $695 or 2.5% of Adjusted Gross Income

  • By 2019: Penalties for companies are $2,000 per employee with the first 30 FTE exempt

  • If an employer has 75 FT employees and 30 get their insurance elsewhere you still have to provide insurance

  • No requirement to provide insurance for PT employees


Seven Things You Need To Know contraceptives, breast-feeding supplies, screenings for sexually transmitted infections, counseling for domestic violence and routine check-ups for breast and pelvic exams, Pap tests and prenatal care.

1. Understand The Timeline

2. Determine If Your Plan Qualifies

3. Figure Out The Mandate

4. Calculate Full vs. Part Time Employees

5. See If You’re Eligible For A Tax Credit

Get Ready For The State Exchanges

Your Next Actions…Now


How many full time employees do you have? contraceptives, breast-feeding supplies, screenings for sexually transmitted infections, counseling for domestic violence and routine check-ups for breast and pelvic exams, Pap tests and prenatal care.

Those are the ones who you will have to cover

How many full time “equivalent” employees (FTE) do you have.

Those are the ones who will figure into your >50 calculation.

FULL VS PART TIME EMPLOYEES


Seven Things You Need To Know contraceptives, breast-feeding supplies, screenings for sexually transmitted infections, counseling for domestic violence and routine check-ups for breast and pelvic exams, Pap tests and prenatal care.

1. Understand The Timeline

2. Determine If Your Plan Qualifies

3. Figure Out The Mandate

4. Calculate Full vs. Part Time Employees

5. See If You’re Eligible For A Tax Credit

Get Ready For The State Exchanges

Your Next Actions…Now


THE TAX CREDIT contraceptives, breast-feeding supplies, screenings for sexually transmitted infections, counseling for domestic violence and routine check-ups for breast and pelvic exams, Pap tests and prenatal care.

  • <25 FTE

  • <$50,000 average salary

  • 35% - 50% credit for health insurance


Employers with 10 fte example
Employers with <10 FTE Example contraceptives, breast-feeding supplies, screenings for sexually transmitted infections, counseling for domestic violence and routine check-ups for breast and pelvic exams, Pap tests and prenatal care.


Employers with 11 25 fte example
Employers with 11-25 FTE Example contraceptives, breast-feeding supplies, screenings for sexually transmitted infections, counseling for domestic violence and routine check-ups for breast and pelvic exams, Pap tests and prenatal care.


Seven Things You Need To Know contraceptives, breast-feeding supplies, screenings for sexually transmitted infections, counseling for domestic violence and routine check-ups for breast and pelvic exams, Pap tests and prenatal care.

1. Understand The Timeline

2. Determine If Your Plan Qualifies

3. Figure Out The Mandate

4. Calculate Full vs. Part Time Employees

5. See If You’re Eligible For A Tax Credit

Get Ready For The State Exchanges

Your Next Actions…Now


SHOP EXHANGES.... contraceptives, breast-feeding supplies, screenings for sexually transmitted infections, counseling for domestic violence and routine check-ups for breast and pelvic exams, Pap tests and prenatal care.

Small Business Health Options Programs

State run by 2014

Small businesses: 100 FTE. Companies that grow can be grandfathered. Before 2016 States can limit to companies with less than 50 FTE

After 2017 state exchanges will expand to >100 FTE

Employers can buy through SHOP or from private agents.


AND.... contraceptives, breast-feeding supplies, screenings for sexually transmitted infections, counseling for domestic violence and routine check-ups for breast and pelvic exams, Pap tests and prenatal care.

Pools to purchase insurance

Private insurance plans

Multi State Health Plans (min 2 are required)

Consumer Operated and Oriented Plans (Co-Ops)


Seven Things You Need To Know contraceptives, breast-feeding supplies, screenings for sexually transmitted infections, counseling for domestic violence and routine check-ups for breast and pelvic exams, Pap tests and prenatal care.

1. Understand The Timeline

2. Determine If Your Plan Qualifies

3. Figure Out The Mandate

4. Calculate Full vs. Part Time Employees

5. See If You’re Eligible For A Tax Credit

Get Ready For The State Exchanges

Your Next Actions…Now


WHAT’S YOUR BEST HEALTHCARE STRATEGY…. contraceptives, breast-feeding supplies, screenings for sexually transmitted infections, counseling for domestic violence and routine check-ups for breast and pelvic exams, Pap tests and prenatal care.

1 – Do Nothing

2 – End coverage, pay the penalty

3 – Take a hybrid approach


THE SEARS APPROACH contraceptives, breast-feeding supplies, screenings for sexually transmitted infections, counseling for domestic violence and routine check-ups for breast and pelvic exams, Pap tests and prenatal care.

  • Discontinue health care

  • A flat payment to employees

  • Reflects tax effects

  • Employee free to buy wherever

THE WALMART APPROACH

  • Newly hired part-time employees at Wal-Mart will have to work a minimum of 30 hours a week,

  • Elimination of some high premium plans,

  • Creating six health care centers,

  • Access to a healthcare advisor.


THE BENEFITS contraceptives, breast-feeding supplies, screenings for sexually transmitted infections, counseling for domestic violence and routine check-ups for breast and pelvic exams, Pap tests and prenatal care.

  • Drop in Premiums!! Rise in Coverage!!

  • Small businesses excluded and get a tax credit

  • Business opportunities from growth in healthcare/bigger market

  • Easier for workers to move from jobs

  • Easier to budget

  • Potential less admin for small companies


So What’s Your Best 2013 Tax Strategy? contraceptives, breast-feeding supplies, screenings for sexually transmitted infections, counseling for domestic violence and routine check-ups for breast and pelvic exams, Pap tests and prenatal care.


So What’s Your Best 2013 Tax Strategy? contraceptives, breast-feeding supplies, screenings for sexually transmitted infections, counseling for domestic violence and routine check-ups for breast and pelvic exams, Pap tests and prenatal care.

Defer (or accelerate) Income

Tax Exempt Investments

Section 179

$5,250 tax free education benefits to employees

529 Plans


  • PROBLEMS THAT WON’T GO AWAY contraceptives, breast-feeding supplies, screenings for sexually transmitted infections, counseling for domestic violence and routine check-ups for breast and pelvic exams, Pap tests and prenatal care.

  • Potential “sticker shock”…why buy?

  • More docs opting out of taking insured patients

  • Potential arguments over rescinding

  • The viability of the “34 million”

  • State participation – Exchanges and Medicaid

  • Higher Taxes

  • No decrease in healthcare costs?

  • More government


RESOURCES contraceptives, breast-feeding supplies, screenings for sexually transmitted infections, counseling for domestic violence and routine check-ups for breast and pelvic exams, Pap tests and prenatal care.

Blue Cross Tax Calculator - http://www.bluekctaxcredit.com/taxcalculator.aspx

Department of Health and Human Services – www.hhs.gov

Healthcare Reform Site – www.healthcare.gov

Washington Post Wonkblog:

http://www.washingtonpost.com/blogs/wonkblog/


2. Have A Mobile Strategy contraceptives, breast-feeding supplies, screenings for sexually transmitted infections, counseling for domestic violence and routine check-ups for breast and pelvic exams, Pap tests and prenatal care.


Apple, Google, Microsoft contraceptives, breast-feeding supplies, screenings for sexually transmitted infections, counseling for domestic violence and routine check-ups for breast and pelvic exams, Pap tests and prenatal care.

Search

Devices

Elance, Guru, Craigslist

Apps - Custom

Square, Intuit, Sage, Microsoft, QuickBooks

Apps – Out of the box

Location

2. Have A Mobile Strategy


Have Dinner With Your Accountant contraceptives, breast-feeding supplies, screenings for sexually transmitted infections, counseling for domestic violence and routine check-ups for breast and pelvic exams, Pap tests and prenatal care.

Have A Mobile Strategy


www.genemarks.com contraceptives, breast-feeding supplies, screenings for sexually transmitted infections, counseling for domestic violence and routine check-ups for breast and pelvic exams, Pap tests and prenatal care.

[email protected]