Health Reform

The Affordable Care Act (ACA), or ObamaCare for slang, is here to stay, at least for now. The initial framework for the ACA is still intact, but there have been many changes since 2010. Now that we’re almost to 2016, there promises to be even more changes and “tweaks” to ObamaCare with more legislation on the way. For now, groups with over 100 employees have to comply with the Employer Mandate which requires them to offer health insurance to their full time workers. For employers with 50-99 employees, that mandate takes effect January 2016, unless something changes.

Tax Credits

If you are a small employer, you MAY be able eligible for tax credits from the government of up to 50% of the health insurance premiums paid by the employer.  We always recommend researching with your CPA to see if you qualify as a business.  The health insurance plans have to be purchased through the SHOP program at Covered CA to be eligible for the credit.  Hey…it’s worth exploring.

Health Reform Compliance

Effective in September 2013, ALL employers must have specific compliance paperwork on hand in case of a Department of Labor audit, (SEE BELOW). The paperwork is easy to put together; if you need help or more information, give us a call.
For larger employers, the most important new requirement of health reform is the so-called “play-or-pay” mandate, effective in 2014, that requires all employers with more than 50 full-time employees (or full-time-equivalent employees) to offer affordable, minimum health coverage to all full-time employees, or else pay a potentially hefty penalty.

Below is an ObamaCare timeline for employers

        • Small Business Tax Credit becomes available
        • High Risk Pool established for people with pre-existing conditions
        • Dependent children can remain on parent’s health plan until age 26
        • Preventative Services are now FREE
        • Lifetime coverage limits removed from Health Plans
        • Insurers must spend at least 85% of premiums on healthcare costs
        • Over the counter medications no longer paid for by HSA funds
        • Reduced paperwork required/electronic health record incentives
        • Incentives for Accountable Care Organizations to form (ACOs)

Beginning in 2012, ALL small businesses must have specific compliance paperwork on hand or face penalties by the Dept of Labor

      • Expanded Medi-Cal services available
      • Increased funding for Children’s Health Programs
      • Medicare payment “bundling” to improve coordination and care
      • Insurers cannot exclude people with pre-existing conditions
      • State Health Insurance Exchange opens
      • Small Business Tax expanded
      • Medi-Cal coverage expanded
      • Individuals required to purchase Health Insurance or be taxed
      • Health Insurance plans to cap deductibles at $2000/$4000
      • Businesses with 100+ employees required to offer Health Insurance
      • Business with 50-99 employees required to offer Health Insurance
      • The “Cadillac tax” kicks in – this may be repealed some time this year