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Health Care Reform Update Florence Unified School District Governing Board July 11, 2012

Health Care Reform Update Florence Unified School District Governing Board July 11, 2012. Florence/2013/Meetings/07112 Board meeting/12 board ppaca overview 0711.ppt. Supreme Court Decision. Affirmed PPACA Future: Debate, Elections in November Further Legal Challenges Possible

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Health Care Reform Update Florence Unified School District Governing Board July 11, 2012

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  1. Health Care Reform Update Florence Unified School District Governing Board July 11, 2012 Florence/2013/Meetings/07112 Board meeting/12 board ppaca overview 0711.ppt

  2. Supreme Court Decision • Affirmed PPACA • Future: Debate, Elections in November • Further Legal Challenges Possible • So, Onward and Upward

  3. Upcoming PPACA Issues • 2013: 2012 W-2 to contain Aggregate Health Benefit Cost Information • Open Enrollment (7/1/2013): Summary of Benefits and Coverage (SOBC) • 4 Pages Maximum • Specific Information • $1000 Penalty for non compliance

  4. Upcoming PPACA Issues • 2014 Reporting Requirements • Minimum Essential Benefits • Qualifying and Affordable Coverage • Penalty for non compliance: • $50 for each missed employee; $100,000 maximum

  5. Upcoming PPACA Issues • 2018: Cadillac Tax • 40% Excise Tax on Value of Benefits in excess of • $10,200 Individual • $27,500 Family

  6. Upcoming PPACA Issues • State Exchange to be “up and running” as of 2014 • Deductible limits of $2,000 individual and $4,000 family, unless contributions are offered that offset excess deductibles. • Maximum out of pocket: $5,950 Individual; $11,900 Family

  7. Upcoming PPACA Issues Plans to be offered through the State Exchange: • Bronze Plan Provides 60% of actuarial value of minimum qualifying coverage. • Silver Plan Provides 70% of actuarial value of minimum qualifying coverage. • Gold Plan Provides 80% of actuarial value of minimum qualifying coverage. • Platinum Plan Provides 90% of actuarial value of minimum qualifying coverage. • A catastrophic only policy would be available for those 30 • and younger.

  8. Upcoming PPACA Issues • Individual Mandate to Purchase Health Insurance • If employer does not offer “affordable and qualifying” coverage: • Penalty for non compliance (or “tax” as SCOTUS has interpreted) • Possible subsidy depending upon income

  9. Helping Employees Prepare for Health Care Reform Legislation (Individual Refusal to Purchase Coverage) Penalty Table

  10. Upcoming PPACA Issues • Employer Mandate: • Don’t have to offer, but….. • Penalty “if you don’t” • Penalty possible “if you do” • If coverage is not “qualifying or affordable”

  11. “Qualified and Affordable Plans” and Penalties

  12. Determination and Potential Application of Employer Penalty for Categories of Employees

  13. PPACA Modeling • Recommending a Customized Impact Study to quantify effect of PPACA in 2014 • Modeling Scenario: • Actual employee and employer contributions • US census data • To project cost impact and employee migration due to PPACA • Report generated based upon: • No change to current benefit plans in 2014 • Termination of group medical plan in 2014 • Employer sponsors only a 60% actuarial value plan in 2014

  14. Questions

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