Health Care Reform


Going Above & Beyond!

When it comes to benefits options, the sky’s the limit. We can help you create a benefits plan that offers better benefits with fewer costs for you and your employees.

 

Clarifying Health Care Reform Requirements

The Affordable Care Act (ACA) was passed in 2010, and employers have had questions about its rules, regulations, and requirements ever since. Health care reform continues to evolve, and we’re here to help clarify the rules and help you stay compliant.

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Services

Get Your Questions Answered

Discover the answers to the most common questions about ACA and health care reform. The Patient Protection and Affordable Care Act has left many employers wondering if their health care benefits package meets new federal requirements. We have answers to the most common questions regarding health care reform.

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Health Care Reform FAQ

Is my company required to comply with the Affordable Care Act?

If you employ fewer than 50 people, you do not need to comply. If you employ 50 to 100 employees, you must comply by 2016. If you employ 100 or more employees, you must have complied by 2015.

If so, whom do I need to cover?

All full-time employees who work at least 30 hours of service each week and their dependent children under the age of 26.

What are the potential penalties of not complying?

  • $3,000 per full-time employee if you offer unaffordable coverage or if your coverage does not meet minimum value requirements.
  • $2,000 per full-time employee if you do not offer any coverage.

What’s the waiting period under the Affordable Care Act?

The new waiting period is 90 days for group health plans and group health insurers.

What is the small employer tax credit?

The tax credit is for companies who employ fewer than 25 employees, pay less than $50,000 per full-time employee in wages, and provide health insurance through a government health insurance marketplace. The tax credit is equal to 35 to 50 percent of the amount the employer pays in premium contributions.

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Provide Voluntary Benefits

Learn how offering supplemental insurance can help offset employee costs from changes to your health care plan.

Why Voluntary Benefits?

Although the marketplaces are designed to provide coverage for millions of uninsured Americans, the plans could likely leave enrollees with considerable financial exposure. Based on the plan level, lower premiums can mean more out-of-pocket costs at claim time.

Voluntary benefits can help offset out-of-pocket costs such as deductibles, co-pays and co-insurance. We can help you offer this added protection through employer-paid, shared or employee-paid plans, so you can provide your employees access to greater financial protection, with little to no effect on your bottom line.

Our voluntary benefits:

  • Are not directly impacted by market reforms
  • Can be offered in addition to qualified health insurance, or as supplemental coverage

 

Are often exempt from:

  • Health plan design changes
  • Coverage requirements, including requirements for covering preventive services
  • Restrictions on limits
  • Loss ratio requirements
  • Coverage for dependents to age 26
  • Waiting period limits
  • Guaranteed issue (no pre-existing condition) requirements
  • Summary of Benefits and Coverage document requirements

 

Your employees may benefit from:

  • Disability insurance
  • Accident insurance
  • Cancer insurance
  • Critical illness insurance
  • Supplemental life insurance
  • Hospital confinement indemnity insurance

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Discover What’s Required

Get up to speed on what health care reform requires of you.

Provisions

General Provisions

  • Summary of Benefits and Coverage Documents: Supply your employees with a summary of their benefits and coverage or risk a daily penalty.
  • End of Pre-Existing Condition Limits: Health plans may no longer exclude employees from coverage due to a pre-existing condition.
  • Dependent Coverage: If your plan covers dependent children, it must cover all married and unmarried children until they reach the age of 26.
  • Simple Cafeteria Plan: Small businesses that employ 100 or fewer workers may offer simple cafeteria plans.
  • Health Flexible Spending Accounts: Salary reduction contributions to health FSAs is capped at $2,500, and unused funds carry over.

 

Tax Provisions

  • Medicare Taxes: Employers must withhold additional tax for employees who earn more than $200,000 (filing single) or $250,000 (filing jointly)
  • Retiree Prescription Subsidy: This subsidy has been eliminated.
  • Small Employer Health Insurance Credit: Available to small businesses with 25 or fewer employees, pay full-time employees $50,000 or less on average, and offer qualified insurance plans.
  • W-2 Reporting: If you file more than 250 W-2s, you must disclose the value of the employer-paid health benefits each employee receives.

 

Stay informed.

Learn about the new provision requirements under the Patient Protection and Affordable Care Act.

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Learn Whether You Should Pay or Play

Discover if you’re better off providing health insurance to your employees or paying the penalty.

Beginning in 2015 and 2016, the “employer mandate” requires many employers to provide health insurance for their employees or they have to pay a penalty. In the chart below, follow the path to help you decide what’s best for your company – and your employees.