We have been hearing and reading about Health Care Reform for 2+ years, and with many changes taking effect January 1, 2014, some big decisions and State laws passed, information trickles now almost daily. Most recently in our home State of Minnesota, both the House and Senate voted in favor of setting up our own Exchange, rather than have the Federal Government install their generic version. This is good as it gives us more ability for input, knowing what has worked well and what does not. This Exchange called MN-Sure, will be an online marketplace system for shopping individual and small group health insurance. It is scheduled to open October 1, 2013, with policies being effective beginning January 1, 2014. Another bit of good news is that we agents & brokers will be able to assist you in the Exchange, just like we have done for you in the open market. We will be compensated by the insurance carrier, like we are now and not tax payer dollars. There will also be state employees called "Navigators", who can assist with questions but not necessarily have insurance training, and likely will be like employees for Centers for Medicare Services or Social Security.
With so many changes happening and when they take effect, it truly is overwhelming. Here are some facts I think are relevant for you now, and may answer some of your questions and concerns. More information can be found at Medica HCR.
Employer Mandate. Effective January 1, 2014, employers with 50 or more full-time employees must offer employees a health plan that meets minimum value requirements and is affordable, or pay an annual tax or "shared responsibility payment" of up to $3,000 per employee. Therefore, businesses with less than 50 full time employees, are not subject to this penalty. Individual employees in your employ who do not have coverage, however are subject to penalty, so keeping your plans in place will avoid a financial struggle for your employees...
Individual Mandate. Effective January 1, 2014, individuals will be required to maintain minimum essential coverage for themselves and their dependents, either on their own or with government assistance in the form of premium subsidies or cost-sharing reductions. Those who do not qualify for an exemption to this mandate will be assessed a tax penalty based on a percentage of household income.
Small Business Health Care Tax Credit. Effective January 1, 2010, this tax credit encourages small employers that meet eligibility requirements to offer and pay at least half the cost of health care coverage for their employees.
This new credit helps small businesses and small tax-exempt organizations afford the cost of covering their employees and is specifically targeted for those with low- and moderate-income workers. " If you are a small employer
with fewer than 25 full-time equivalent employees, pay an average wage of less than $50,000 a year, and pay at least half of employee health insurance premium", you may be eligible. See the following for more information:
IRS Small Biz Tax Credit
Summary of Benefits and Coverage: Effective September 23, 2012, the Patient Protection and Affordable Care Act (ACA) requires health insurers and group health plans to provide clear, consistent and comparable information about their benefits and coverage through a new document called the Summary of Benefits and Coverage (SBC). The SBC is a template document that individuals will receive when shopping for coverage, enrolling in coverage, renewing their coverage and within seven business days of requesting a copy from their health insurance issuer or group health plan. The insurance companies have been including these 3-4 page plan summaries with your renewals, or if you have changed plan designs, make sure you have the pertinent summary of benefits for your employees. This should be given to current members on your plan, and new employees reviewing their options.
You will be hearing terms like "Essential Health Benefits" (EHB), "Guarantee Issue", "Open Enrollment", "Actuarial Value", and "Silver, Gold, Bronze, or Platinum Plan". Minnesota has had many of these required covered expenses already built into their small-group-reformed plans, and these are elements that must be part of the insurance plans inside and outside the Exchange. You will probably see our state's insurance companies like Blue Cross, HealthPartners, Medica, Preferred One, and U-Care, in the Exchange, and there may also be a few new faces. Current members of MCHA and MN Care will mostly move to the Exchange, and anyone who qualifies for federal assistance (Medicaid) or qualify for a subsidy, will be required to get their insurance through the Exchange. Will there be more plans to choose from? We don't know yet. Will premiums go up? Most likely. More to come, and feel free to ask us questions and share concerns.