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Thread: Obamacare ... Employer Mandate Delayed

  1. #51
    Senior Member Buzz's Avatar
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    Gerry, yes small business was supposed to be able to shop on the exchanges. Delaying the exchanges and refusing to set them up denies small business the resource. As much as you comment here about Obamacare, I am frankly a little stunned that you didn't know these things. I would suggest you broaden your reading a bit beyond what the political hacks are throwing out there. Being able to shop on an exchange could potentially be very helpful to small business as we have small groups with little purchasing power and we can easily be driven from the market by one tragic illness.

    see this:

    http://mybackoffice.biz/small-busine...layed-in-part/

    and this:

    http://mybackoffice.biz/small-busine...layed-in-part/

    A SHOP is an insurance exchange specifically for small businesses with fewer than 50 employees. Through a SHOP, these small businesses will be able to purchase health insurance for their employees and receive a
    tax credit in return.
    Under the PPACA, employers with fewer than 50 employees are not required to provide their workers with health insurance, but they can elect to either by participating in a SHOP or by purchasing coverage in the open market.
    If an employer chooses to participate in a SHOP, they get to choose how much money they want to contribute to their employees’ health insurance premiums. Employees then get a choice of several health insurance plans with varying levels of coverage — the same way they might if they worked for a large employer. Even if different employees choose different plans, the employer only has to pay one bill to the SHOP instead of paying each plan separately.



    and this:

    http://mybackoffice.biz/small-busine...nce-exchanges/



    What is an Affordable Insurance Exchange?

    This fall, small businesses will have the option to enroll employees in Affordable Insurance Exchanges, with coverage beginning in January 2014. Learning about the exchanges is a key part of understanding the PPACA and is especially important for small businesses with one to 100 employees. Now is the time for small businesses to look into the exchanges, compliance, and how to let employees know about the upcoming changes to health-insurance options.
    An Affordable Insurance Exchange is an arrangement where individuals and companies can purchase private health insurance. Under the PPACA, each state must set up an exchange where private and nonprofit insurers offer the ability to purchase health insurance. The act calls for exchanges to be open to small employers — those with up to 50 employees, and in some states up to 100 — in 2014, and progressively larger employers through 2017. Through these exchanges, businesses will be able to compare coverage options and prices for different plans.
    The insurance exchanges themselves may be established as nonprofit organizations or government agencies. States may also set up regional insurance exchanges that work together to provide the coverage required under the law. Exchanges make it possible for individuals and smaller businesses to choose a plan that works best for them. They level the playing field, making it easy for smaller employers to provide coverage for their employees at an affordable price by pooling costs and risks associated with health care coverage.
    What Will Insurance Exchanges Offer?

    Coverage options will vary from state to state, and many states have not finished setting up their exchanges. Part of the uncertainty about the PPACA stems from the fact that many specifics about coverage still haven’t been established and won’t be for some time. Generally speaking, however, exchanges are likely to offer four different levels of coverage, plus a catastrophic plan.


    • Bronze plans will provide essential health benefits covering 60 percent of the plan’s benefit cost, with an out-of-pocket limit equal to the Health Savings Account — or HSA — current legal limit. In 2010, that was $5,950 for individuals and $11,900 for families.


    • Silver plans will cover 70 percent of the plan benefit costs, with HSA limits.


    • Gold plans will cover 80 percent of the plan benefit costs, with HSA limits.


    • Platinum plans will cover 90 percent of the plan benefit costs, with HSA limits.


    • Catastrophic plans will be available to individuals up to age 30, or those exempt from the mandate to purchase coverage. These plans provides catastrophic coverage only, with the coverage level set at the current High Deductible Health Plan levels except that preventive benefits and coverage for three primary care visits would be exempt from the deductible.


    What are Small Businesses Required to Do?


    Starting in 2014, small businesses with at least 50 full-time employees must provide them with health insurance or pay a penalty (that number rises to 100 full-time employees in 2017). One concern many small businesses have is that they will be required to use the exchanges. They are not; the exchanges will simply provide another option for employers to find a health insurance plan that works best for them. Also, small businesses may be eligible for tax credits to help them pay for their employees’ health insurance through the exchange.
    Starting in late summer or fall of this year, employers will be required to provide a written notice to each employee and new hire outlining the existence of these exchanges, the services provided through them, and contact information for the exchange. The notice must also include information about possible tax credits and loss of employer contributions (if any) for employees purchasing a qualified plan through the exchange. This notice was originally due to be provided to employees by March 1, but has been pushed back to coincide with the first open enrollment period for the insurance exchanges.
    Now is the time for small businesses to be looking into insurance exchanges and learning about the options available to them, as well as the requirements they will be expected to meet. As more states establish their exchanges, small businesses will need to ensure they are keeping up with any mandates that may apply.


    MyBackOffice is an HR administration outsourcing firm that specializes in providing small businesses with access to kind of high-quality HR services and group benefits that usually only the biggest employers enjoy. Contact us to learn how the MBO Advantage can save you time and hassle, allowing you to focus on what you love the most — building your company.



    Last edited by Buzz; 07-10-2013 at 09:14 AM.
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  2. #52
    Senior Member Gerry Clinchy's Avatar
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    Buzz, your citations are enlightening. It appears that you subscribe to a service to provide you with this information. If I were an employer, I would probably do the same.

    I am not an expert on this 2000-page law with many more thousands of pages now of regulations. I just post what I stumble across. Actually, a lot of people probably focus in on those parts of the law likely to impact themselves. Since I am self-employed and over 65, my focus will be different from yours.


    This one is interesting:
    • Catastrophic plans will be available to individuals up to age 30, or those exempt from the mandate to purchase coverage. These plans provides catastrophic coverage only, with the coverage level set at the current High Deductible Health Plan levels except that preventive benefits and coverage for three primary care visits would be exempt from the deductible.
    It makes me wonder if this is a loophole that could end up involving the Senate's immigration bill, i.e. that the RPIs could participate in the exchanges since they are exempt from purchasing coverage.

    This is also something I did not know
    The act calls for exchanges to be open to small employers — those with up to 50 employees, and in some states up to 100 — in 2014, and progressively larger employers through 2017. Through these exchanges, businesses will be able to compare coverage options and prices for different plans.
    It doesn't mention if there is a upper end limit on "progressively larger." Could this eventually mean that all employers would enter into the exchanges? If so, on the one hand, I could see smaller employers benefiting from having a larger risk pool within the exchanges.

    The insurance exchanges themselves may be established as nonprofit organizations or government agencies.
    Not sure the idea of more govt agencies is a good thing.
    Under the PPACA, each state must set up an exchange where private and nonprofit insurers offer the ability to purchase health insurance.
    Did this change with the Supreme Court ruling? or did the Supreme Court ruling only apply to the individual exchanges, because those involved the expansion of Medicaid? A number of states have opted not to set up exchanges (the number I've seen varies between 26 and 27), thus the Fed govt has stepped in to set up exchanges in those states that have opted not to. The problem with that as I recall, was that the law did not stipulate any specific funding for a Federal exchange. I haven't seen any recent mention of this problem, so not sure how they resolved that.

    I really do appreciate hearing from the small business owners in the forum, who can give first-hand information on the impact from the law.

    I don't think that Ted Cruz is a political hack. He did a very thorough explanation of how O-care would interact with the Senate's immigration bill. Likely no one in Congress is perfect, but if he is a hack, what do we call Mrs. We-have-to-pass-this-bill-to-see-what's-in-it? We've got a bottomless supply of political hacks.
    G.Clinchy@gmail.com
    "Know in your heart that all things are possible. We couldn't conceive of a miracle if none ever happened." -Libby Fudim

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  3. #53
    Senior Member Gerry Clinchy's Avatar
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    http://www.forbes.com/sites/johngood...out-obamacare/
    People not enrolling for Medicaid or Obamacare

    About one in every four individuals who are eligible for Medicaid in this country has not bothered to enroll. About one in five employees who are offered employer-provided health insurance turns it down; among workers under 30 years of age, the refusal rate is almost one in three.
    Think about that for a moment. Millions of people are turning down (Medicaid) health insurance, even though it’s free! Millions of others are turning down their employers’ offers. Since employees pay about 27% of the cost of their health insurance, on the average, millions of workers are passing up the opportunity to buy health insurance for 27 cents on the dollar.

    The author (who markets health care solutions) offers his reason as why this occurs. Uninsured go through an emergency room process, just the same as Medicaid recipients do. So, the patient perception is that it doesn't really matter whether they have Medicaid or not, so why bother with all the forms.

    He also mentions how in the MA plan, the mandatory health insurance requirement is a payroll deduction. The system doesn't rely on the individual to initiate the purchase. It doesn't mention what happens for those who aren't employed.

    The bottom line is that people are not signing up, and this is a big problem for the way the law is structured.

    Why is it so important to the administration to have people enroll? If they don’t enroll in Medicaid, I don’t think it matters very much. But if they don’t enroll in private plans sold in health insurance exchanges, it will matter a great deal. Remember, these will be artificial markets in which insurance will be underpriced to the sick and overpriced to the healthy. A lengthy, complicated enrollment process will further discourage those with no health problems.But if the only people who enroll are those who are sick, the average premium will go through the roof. A death spiral will ensue as ever increasing premiums price more and more buyers out of the market, leaving only those whose expected medical expenses exceed those high premiums.

    In the end actuarial reality can't be ignored. That is proving out in the UK now. The UK experience (now encouraging people to get health care outside of the NHS system) makes me wonder if the full circle will be back to the way things were in the US many years ago ... paying directly for manageable medical expenses & using insurance appropriately for catastrophic expenses. What would car insurance cost if we used "insurance" for every oil change or new tires? (they thins we can predict and plan for).
    G.Clinchy@gmail.com
    "Know in your heart that all things are possible. We couldn't conceive of a miracle if none ever happened." -Libby Fudim

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  4. #54
    Senior Member luvmylabs23139's Avatar
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    Quote Originally Posted by Gerry Clinchy View Post
    http://www.forbes.com/sites/johngood...out-obamacare/
    People not enrolling for Medicaid or Obamacare


    The author (who markets health care solutions) offers his reason as why this occurs. Uninsured go through an emergency room process, just the same as Medicaid recipients do. So, the patient perception is that it doesn't really matter whether they have Medicaid or not, so why bother with all the forms.

    He also mentions how in the MA plan, the mandatory health insurance requirement is a payroll deduction. The system doesn't rely on the individual to initiate the purchase. It doesn't mention what happens for those who aren't employed.

    The bottom line is that people are not signing up, and this is a big problem for the way the law is structured.
    [/FONT][/COLOR][/FONT][/COLOR]

    In the end actuarial reality can't be ignored. That is proving out in the UK now. The UK experience (now encouraging people to get health care outside of the NHS system) makes me wonder if the full circle will be back to the way things were in the US many years ago ... paying directly for manageable medical expenses & using insurance appropriately for catastrophic expenses. What would car insurance cost if we used "insurance" for every oil change or new tires? (they thins we can predict and plan for).[/FONT][/COLOR][/FONT][/COLOR]
    I don't know if sighting those that are eligable for employer plans and decline really means much. DH and I prior to deciding to be self employed always ran the numbers on both employer plans. Sometimes it was better for us to each just insure ourselves and at other points in time it was more cost effective for one of us to opt for employee and spouse and the other to decline coverage. At one point we worked for the same employer and during year one of that it was cheaper for us to do an employee plus one. The next year SARA LEE SCREWED US. They got rid of employee plus one. The categories screwed us but employee plus 20 kids was less than employee and spouse and less than 2 employees paid. I got called in to the bosses office when I questioned the numbers behind the changes(they were self insured) in the employee meetings.
    God forbid you knew the real behind the scenes stuff because you had been an HR manager.
    Hihope Hiland Heathen of Perth CD, RE, CGC, TDI

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