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Smart Benefits: Next Steps in Healthcare Reform for Employers

Monday, January 13, 2014

 

The time to plan is now.

With the January open enrollment season finally winding down, it's time for employers to start planning for the next phases of healthcare reform.

While many employers enjoyed a temporary reprieve thanks to delays of some rules, 2015 is just around the corner and the first of four important requirements will kick in then. And the time to prepare is now.

1. 30 is the new 40

Starting in 2015, large employers will face penalties if they don't offer coverage to employees who average 30 or more hours per week. That means, if employers previously only covered employees who worked 40 hours, they will likely have to incur the cost of covering more employees. And if they can't afford to offer coverage to more employees? They may have to cut back workers' hours and risk losing valuable employees.

2. Pay or Play

Not only must large employers offer coverage to employees who average 30 or more hours per week or face penalties, it must be affordable, minimum plan value coverage. If minimum essential coverage is not offered to at least 95% of full-time employees and children to age 26, employers will pay a penalty based on the number

of full-time employees. So, for example, 30 employees x $166.67 month. If coverage is offered but it's unaffordable or below minimum value, the penalty is $250 per month for each full-time employee who gets a premium credit subsidy through a healthcare exchange.

3. IRS Reporting Kicks In

In 2016, insurers will need to report information on minimum essential coverage it provides and covered individuals, while large employers subject to the pay or play rules must report on its affordable, minimum plan value coverage offered to full-time employees. Penalties for both are $50 per failure.

4. Cadillac Tax

Effective January 1, 2018, large and small employers will pay an excise tax if the total cost of medical benefits (including employer and employee contributions) exceeds $10,200 for single plans or $27,500 for family plans. This is indexed for

medical, HRA and Section 125 plans (pre-tax and FSA). The penalty is steep: a 40% non-deductible excise tax on the value of the benefits. Employers will need to determine if their plan designs falls below the threshold and, if not, they should consider plan design changes to avoid the tax -- sooner versus later.

 

Amy Gallagher has over 21 years of healthcare industry experience guiding employers and employees. As Vice President at Cornerstone Group, she advises large employers on all aspects of healthcare reform, benefit solutions, cost-containment strategies and results-driven wellness programs. Amy speaks regularly on a variety of healthcare-related topics, and is often quoted by national publications on the subject matter. Locally, Amy is a member of SHRM-RI, the Rhode Island Business Group on Health, and the Rhode Island Business Healthcare Advisory Council.

 

Related Slideshow: 13 Biggest Healthcare Stories in RI in 2013

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To see which insurer has already opened up a retail outlet in RI, click here.

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9 A Healthier You in 2013

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8 RI’s Sexual Health

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Click here for our full coverage of our study.

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7 Deloitte's Big Contract

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Click here for our coverage of the announcement.

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6 Non-Profit Hospital CEO

Rhode Island Non-Profit Hospital CEOs Criticized For Big Paychecks

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Click here for the full breakdown.

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5 Healthiest Counties

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4 Health Exchange Rebrand

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Dubbing the Health Exchange HealthSource RI and announcing the state's new contact center in Providence, the exchange announced it would employ 70-100 Rhode Islanders when fully operational who would be accessible to  individuals and small employers to talk in-person or over the phone with engagement specialists who would provide personalized assistance in finding, comparing, and purchasing health insurance options available through HealthSource RI. 

Click here to read more about the announcement.

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3 Heart Health

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2 Health Exchange Launch

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Click here for our coverage of the rate announcements.

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1 Patients Rank Hospitals

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Click here for the ranking of New England's Top 20 Hospitals

 
 

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