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Patient Provider and Affordable Care Act (ACA)

Patient Provider and Affordable Care Act (ACA). Impact on Public Employers. Goal o f Presentation. ACA was signed into law on March 23, 2010 Over 2,000 pages of legislation and 14,000 pages of regulations…so far Effective dates of numerous provisions stretch out to 2020

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Patient Provider and Affordable Care Act (ACA)

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  1. Patient Provider and Affordable Care Act (ACA) Impact on Public Employers

  2. Goal of Presentation • ACA was signed into law on March 23, 2010 • Over 2,000 pages of legislation and 14,000 pages of regulations…sofar • Effective dates of numerous provisions stretch out to 2020 • Goal of this presentation is to introduce the impact on schools • Focus on employer responsibilities for coverage and risk of penalties

  3. 2013 Changes • $2500 limitation on employee contributions to health flexible spending accounts • October – MN exchange enrollment system is scheduled to open for 1/14 effective coverage • Minnesota is one of 18 states moving to develop a state based exchange • Private Exchange options are available

  4. 2014 Changes • “applicable large employers” must provide “minimum essential coverage” to “full-time employees” • Jan 1, Minnesota Public Exchange goes into affect • “Pay or Play” • Coverage needs to be affordable and meet minimum essential coverage valuation

  5. Pay • If employer over 50 full-time employees and offers no coverage • Penalties • Fail to provide “minimum essential coverage” and at least one employee receives a subsidy form the Exchange • Penalty is $2000 per employee per year minus the first 30 employees • Offer “minimal essential coverage” that is not “affordable” to some employees • Penalty up to $3000 for each employee who enrolled in Exchange and received a subsidy • Fulltime means over 30 hours per week or 130 hours per month • Part-time and seasonal employees have separate calculations

  6. Play • Unaffordable means the employee portion >9.5% of household income based on W-2 taxable income • Based on single coverage • Must offer dependent children coverage, but not spouses • Coverage minimum value = 60%/40% actuarial coverage

  7. Taxes and Fees • Patient Centered Outcomes Research Fee, 2013 • $2.00 per life per year • Expires 2019 • Insurer Fee, 2014 • Applies to fully insured • Application to self insured being researched • Estimated 1.9% of premium • Reinsurance Fee, 2014 • $63 dollars per life per year in 2014, expiring in 2017 • MN Exchange Fee, TBD • Expected to apply to fully insured plans • Excise Tax, or “Cadillac Tax”, 2018 • Set at 40% of benefits exceeding annual limit values • Fees for drug manufacturers (2011), insurers (2014) and medical devices manufactures (2013)

  8. Summary • Educate • Seminar on insurance reform and the affect on Highly compensated employees • Host Health Care Reform Seminar – Darcy Hitesman (benefits attorney) • Feb 13, 2013 – Boardroom – 9-11 AM • Employer rights and responsibilities • Q & A session • Professional Organizations • Evaluate • Current plans for coverage • Cadillac plans? • Affordability (9.5%)

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