The Smart Business Guide to Health Care Reform (Including the Effect of the Employer Mandate Delay)
By Kevin Rejent
()
About this ebook
Even with the delay of the Employer Mandate, Health Care Reform is radically changing the health insurance environment for employers. The Smart Business Guide to Health Care Reform is your plain-language, yet detail-rich, ticket to understanding the impact of the law on employers (and everyone else). It will help your company navigate the new challenges presented by the law to reduce costs and keep employees happy.
The law is complicated, and if you are responsible for making insurance decisions for your company, it is causing stress and anxiety that impacts your work life, and likely your personal well-being, as well. Like all laws, however, it is manageable when you are able to determine what portions impact you and concentrate on those issues.
This book is your short cut to understanding what PPACA says, what it doesn’t say, and how both will impact your business. The purpose is not to tell you everything about the law; but rather to inform you of the relevant provisions and translate those provisions from bureaucrat-speak to plain English. So while you may not fully understand every obscure provision, you hopefully will have the tools you need to assess your organization’s exposure to key aspects of PPACA.
This book is NOT a legal treatise, a magic bullet in the form of legal/accounting/insurance advice, or an op-ed piece telling you how wonderful or horrible the law is. It is information presented in a manner intelligent people can understand and apply. Bureaucrat-speak is translated, and the interaction between various provisions is discussed.
Some issues addressed are:
How do we know if the Employer Mandate applies to us?
What about part-time and seasonal workers?
What are the advantages and disadvantages of dropping coverage?
Should we consider exchanges as the answer to our health insurance issues?
Other than complying with the Employer Mandate, what else do businesses need to do to be in compliance with PPACA?
What about FSAs, HSAs, and HRAs?
Are defined contribution or self-insured plans options?
What role does the Coast Guard have in implementation of Health Care Reform?
This practical, easy to navigate, and easily understood discussion of the law will demystify topics that have been built up as unsolvable, and put you in the best position possible to analyze your company's health insurance responsibilities and opportunities.
Kevin Rejent
Kevin Rejent is an attorney in St. Louis, Missouri with over a decade of health law experience. He formed the Rejent Firm, LLC in 2011 to advise small businesses and insurance brokers how to comply with laws and regulations relating to health care reform, and also assist businesses with litigation and operational matters. He frequently lectures business, insurance industry, and legal audiences regarding the latest developments with PPACA and its related laws and regulations.Kevin is a graduate of Saint Louis University School of Law and served as an Editor of the Law Review. He is also a proud Sun Devil, as he received his Bachelor of Science in Political Science from Arizona State University.
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The Smart Business Guide to Health Care Reform (Including the Effect of the Employer Mandate Delay) - Kevin Rejent
The Smart Business guide to Health Care Reform
(Including the Effect of the Employer Mandate Delay)
By Kevin J. Rejent
~~~
Smashwords Edition
Copyright © 2013 by Kevin J. Rejent. All rights reserved.
www.rejentfirm.com
Smashwords Edition, License Notes
This ebook is licensed for your personal enjoyment only. This ebook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each recipient. If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy. Thank you for respecting the hard work of this author.
First Edition: August 2013
ISBN: 978-1-60796-629-6
To my wife Lori, daughters Amelia and Charlotte, and twin boys coming any day now,
Thank you for your patience and inspiration.
TABLE OF CONTENTS
INTRODUCTION
What this book IS
What this book IS NOT
Book Structure
>SECTION 1< HOW DID WE GET HERE?
CHAPTER 1: THEY PASSED THE LAW, NOW WE GET TO FIND OUT WHAT IS IN IT.
Title I – Quality, Affordable Healthcare for All Americans
Title II – Getting More People Into Government Programs
Title III – Improving the Quality and Efficiency of Health Care
Title IV – Keeping People From Getting Sick
Title V – Health Care Workforce
Titles VI-IIX and X – Stuff That Has Been Repealed, Has No Real Impact on Businesses, and/or Very Few People Outside of the Health Care Provision Industry Care About
Title IX – Revenue Provisions
CHAPTER 2 - SO WHAT DID THE SUPREME COURT DO AGAIN?
It’s Constitutional, but Not for Any of the Reasons Anyone Thought It Would Be
So We’re All Finished with the Court Challenges, Right?
CHAPTER 3 – WHY ARE PREMIUMS RISING?
Is PPACA the Problem?
Community Rating/Age Bands
Guaranteed Issue
Essential Health Benefits
Ban on Annual and Lifetime Limits
Provisions to Lower Premiums
>SECTION 2< EMPLOYER RESPONSIBILITIES
CHAPTER 4 – THE EMPLOYER MANDATE
Does the Law Apply to You?
Play or Pay
Unaffordable/Low Quality Coverage Penalty
I Have a GREAT Idea!
CHAPTER 5 – WHY OFFER INSURANCE AT ALL?
Penalties are Not Tax Deductible
Giving Raises Equal to Exchange Coverage Costs
Business Value of Retaining Coverage
Employee Relations and Morale
Employee Health
CHAPTER 6 – FORGET FULL TIME EQUIVALENT, HOW DO WE DETERMINE WHO IS FULL TIME AND GET THEM ENROLLED?
Variable Hour Employees
Seasonal Employees
Auto-Enrollment
CHAPTER 7 – CHANGES TO THE ALPHABET SOUP OF HEALTH RELATED EMPLOYEE BENEFITS
Flex Spending Accounts
Health Savings Accounts
Health Reimbursement Accounts
CHAPTER 8 –THOSE EXCHANGES
YOU KEEP READING ABOUT…
In the Beginning…
Who is in Charge Here?
How Do They Work?
Exchange Tax Credits
CHAPTER 9 – OTHER PROVISIONS IMPACTING EMPLOYERS
Medical Loss Ratio
Summary of Benefits and Coverage
W-2 Reporting
Notice of Exchange Rights
New Taxes on Insurance Companies
>SECTION 3< OPPORTUNITIES AND STRATEGIES
CHAPTER 10 – TAX CREDITS AND WELLNESS PROGRAMS
Small Business Tax Credit
Wellness Grants
Wellness Programs
CHAPTER 11 – CHANGING THE ENTIRE PLAN DESIGN
Defined Contribution
Self-Insuring
>SECTION 4< GAZING INTO THE CRYSTAL BALL
CHAPTER 12 – LANDMINES AND LEGAL CHALLENGES
What if You Build It, But They Do Not Come?
What About Those Rascally Healthy Law Breakers?
How Would They Know?
Legal Challenges
CHAPTER 13 – FUN FACTS TO AMAZE AND ASTOUND YOUR FRIENDS AND CO-WORKERS
Tell the Truth
People Get Sick at Sea, Too
Is My Fishing Pole a Durable Medical Device?
You’re Hired! Let Us Know if You Can’t Do Your Work, So We Can Do It For You.
Who Better to Lecture Our Children on Financial Responsibility?
CLOSING THOUGHTS
ACKNOWLEDGEMENTS
ABOUT THE AUTHOR
END NOTES
Introduction
It’s The Law, It’s not Going Away, So You Probably Want to Follow It.
Health Care Reform, HCR, PPACA, ACA, Obamacare, Socialized Medicine, the Greatest Thing Since Sliced Bread. Whatever you want to call it and however you feel about it, all that matters is that the Supreme Court upheld it, voters refused to kill it by electing a new President, and while the Employer Mandate has been delayed, opponents in Congress are powerless to stop it. Even with the gift of a one year delay of the Employer Mandate, all of the energy you spent vigorously ignoring it while hoping it went away or got much simpler was for naught. And now employees are nervous, your renewal is near, and every day, you hear something new that sounds important, but you just don’t know where to mentally file that compliance strategy or requirement you just heard.
The Patient Protection and Affordable Care Act is complicated, and regardless of whether your company employs one or one-hundred thousand, it directly impacts your business’s current and future health insurance. If you are responsible for making these decisions for your company, more likely than not, it is also causing stress and anxiety that is also impacting your personal well-being, as well. Like all laws, however, it is manageable when you are able to determine what portions impact you and concentrating on those issues.
Short of reading and understanding the entire law and all corresponding regulations (over 10,000 pages by some estimates), there is no way to definitively state exactly what provisions are applicable to you. However, who, other than insurance professionals and attorneys who enjoy being tortured by regulations, has time to keep up?
What this book IS
This book is your short cut to understanding what PPACA says, what it doesn’t say, and how both will impact your business. The purpose is not to tell you