Health Care Reform in 2013 and Beyond. Nicole Simpson, CPA Partner Regier Carr & Monroe, LLP (520) 624-8229 email@example.com. Jay Heydt and Chris Gordon Crest Insurance (520) 784-7655 firstname.lastname@example.org. Agenda. 2010 Small Employer Health Insurance Credit 2012
Nicole Simpson, CPA
Regier Carr & Monroe, LLP
Jay Heydt and Chris Gordon
2010-2013: Eligible Small Employers that purchase health insurance for their employees.
2014-2015: Eligible Small Employers that purchase health insurance for their employees through the insurance exchange.
Components of Reform to Consider
Requirements of a small employer
Requirements of a large employer
The Exchanges – What do they mean?
Do we Pay or Play?
Rate Review (2010)
Small business Tax Credits (2010)
“Patient Bill of Rights” (2010)
Network access – PCP Choice
Independent appeals process
No pre-ex for kids <19
Coverage for dependents up to age 26
100% coverage for wellness/prevention
No Annual and lifetime limits
Medical Loss Ratios – MLR (2010)
Defines “maximum” insurance company profits
15% Large groups
20% small groups
Requires refunds to groups is profit is too high
National high risk pool (PCIP)
Established by HHS
Started July 2010. Ends 2014.
$5B set aside
Health FSA Accounts
Increases in Medicare Payroll Taxes
Increases in Medicare Contribution Tax
Mandatory Form W-2 Reporting (100+ ee’s)
Health Care Exchange Notices
Guaranteed Issue - Insurers must issue a policy to any applicant, regardless of health condition. No pre-existing condition limitations.
Community Rating – Everyone is charged essentially the same amount for insurance. Variations for geography, smoking and age (3:1), was 7:1.
All individuals must have coverage. If not through work or the government, then through the Individual market.
Assuming an employer offers minimal essential coverage to all FTE employees and dependents
We can help to answer some big questions for you…
Is my plan as it is today in compliance?
What is the real net cost of my plan today?
What will it cost me if I cancel my plan and send my employees to the exchanges?
What penalties am I subject to based on my plan today?
How much will it cost me to make the changes necessary to get into compliance?
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