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Healthcare Reform

Health Care Reform NOVEMBER 3, 2010 Sponsored by: FMS BGBC Partners LLP Presented by: Mark Sherman First Person Inc. Healthcare Reform. Health Care Reform By the numbers. 1048. Agenda. Health Care Reform 2010/2011 Expanded health coverage Small Employer Tax Credit

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Healthcare Reform

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  1. Health Care ReformNOVEMBER 3, 2010Sponsored by: FMS BGBC Partners LLP Presented by: Mark Sherman First Person Inc.

  2. Healthcare Reform

  3. Health Care ReformBy the numbers 1048

  4. Agenda Health Care Reform 2010/2011 Expanded health coverage Small Employer Tax Credit Grandfathering (including Union impact) Miscellaneous Provisions Reporting New/increased taxes 2014 Individual “mandate” Employer mandate

  5. Health Care Reform

  6. 2010/2011

  7. Health Care Reform2010/2011 Lifetime/Annual coverage limits Expanded Dependent coverage Preventive care requirements HCE discrimination Grandfathered plan determination

  8. Grandfathered Plan Design Limits Co-pays $5 + “medical inflation” Deductibles/Annual OOP max 15% + “medical inflation” Co-Insurance no increase allowed Employee/Employer cost share Employer % cannot decrease by > 5%

  9. Health Care Reform2010/2011 Lifetime/Annual coverage limits Expanded Dependent coverage Preventive care requirements HCE discrimination Grandfathered plan determination Small business tax credit

  10. Small Business Health Insurance Tax Credit

  11. Miscellaneous Provisions 2011 – 2013

  12. Health Care ReformMiscellaneous Provisions Pre-tax Healthcare Costs OTC Medications HSA Distributions Flexible Spending Accounts

  13. Health Care ReformMiscellaneous Provisions Individual Taxes Hospital Insurance (Medicare) Unearned Income

  14. Health Care ReformMiscellaneous Provisions Employer Reporting Form W-2 • Form 1099

  15. 2014

  16. Health Care ReformDefinition of Terms Small Business Qualified Plan Design Minimum Essential Coverage Federal Poverty Level

  17. Small Business Definition

  18. “Qualified”/Credible Plan Designs Small Group Plans Only Deductible can NOT exceed $2,000 single/$4,000 family

  19. Minimum Essential Coverage Hospitalization & Ambulatory (Outpatient) services including: Emergency services Maternity & newborn care Preventive/wellness services and chronic disease management Pediatric services including oral and vision care Laboratory services Rehabilitative services & devices Mental health & substance use disorder services including behavioral health treatment Prescription drugs

  20. Federal Poverty Level

  21. Health Care Reform2014 Individual Impact: Access via Insurance Exchanges No pre-X/guarantee issue Penalty if no coverage purchased Premium credit for those with low/moderate income “Free choice” vouchers

  22. Individual Mandate Penalty is the greater of: 2014 $ 95 or 1.0% of excess household income 2015 $325 or 2.0% of excess household income 2016+ $695 or 2.5% of excess household income

  23. Premium Assistance Tax Credit

  24. Free ChoiceVouchers

  25. Health Care Reform2014 Employers(over 50 FTEs): Communication Requirements Penalties for offering: “unaffordable” coverage non qualifying coverage “Free choice” vouchers Cadillac Tax

  26. Small Business Impact (50 or fewer FTEs) No Requirement to Offer Coverage If Coverage is offered it must provide: Unlimited Lifetime/Annual Coverage Preventive Care with no EE Cost Share Dependent Coverage to Age 26 Section 105(h) discrimination testing

  27. Employer Communication Requirements

  28. Potential Employer Penalties

  29. Survey Says…….

  30. Health Care Reform Where does that leave us? Where do we go from here?

  31. What you need to do now If you offer health coverage: Do you qualify for a small business tax credit? Should you elect grandfathered status? If not grandfathered, is your plan discriminatory? Notify employees re: Dependent Coverage to age 26 Preventive Care coverage (unless grandfathered) Start planning for W-2 reporting for 2012 (Jan 2013)

  32. Questions / Comments Please call: Mark Sherman (317) 218-1506 msherman@firstpersonadvisors.com Bradley S. Bell and Bill Owen, Jr. (317) 633-4700 bradb@bgbc.com & bowen@bgbc.com

  33. Mark Sherman – Mark brings his nearly 30 years’ experience in human resources to FirstPerson clients helping them make better benefit decisions and providing depth of experience in complex situations. His education as a CPA and tax practitioner adds to his benefit-buying and implementation background. Clients get the advantage of sound advice incorporating different facets of the employee-benefit process. Prior to the merger, Mark was a senior consultant at Benefit Consultants. Mark has held a variety of senior human resources positions at Price Waterhouse, Walker Information, Universal flavors, and Brightpoint. Mark is a member of the Anthem Agent Advisory Council, the Indiana State Chamber of Commerce’s Health Care Policy Committee, UHC Advisory Council, and the Manchester College Board of Trustees. He is a founding board member of the International Kidney Stone Institute. He graduated from Manchester College with a degree in accounting.

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