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Disclaimer  Please note that this presentation and any discussion generated from this presentation is for informational purposes only.  This should.

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Presentation on theme: "Disclaimer  Please note that this presentation and any discussion generated from this presentation is for informational purposes only.  This should."— Presentation transcript:

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2 Disclaimer  Please note that this presentation and any discussion generated from this presentation is for informational purposes only.  This should not be construed as legal or tax advice. Please seek a qualified lawyer or tax advisor should you need specific advice.

3 A Quick Note on Fully Insured Vs. Self Insured Plans

4 ObamaCare Vs. Affordable Care ActAffordable Care Act What Does The General Public Know?

5 Employee Vs. Employer  Employee Mandate January 1, 2014 Must HAVE coverage  Employer Mandate January 1, 2015 Must OFFER coverage

6 Employee Side- Individual Mandate  Individuals must have coverage or pay a penalty ○ Penalty is assessed when you file your personal income tax return and is based on your household income ○ 2014 ranges from $95 per person to $285 per family ○ 2015 ranges from $325 per person to $975 per family ○ 2016 ranges from $695 per person to $2,085 per family  How to get coverage Coverage will come from a government run marketplace or their employer’s plan

7 Employee Side- Marketplaces

8 Employee Side- Marketplace Rates

9 Employee Side- Subsidies If you have qualified Employer Coverage, Medicaid or Medicare you won’t qualify $$ Amount Determined at the State level and if Medicaid programs were expanded in that state FL Medicaid WAS NOT expanded Also Based on Income Level, # of Children, Smokers vs. Non-smokers, etc. IRS Reporting Requirements ○ Penalty for false information

10 Employee Side- Coverage Expansion Young Adults remain on plan until age 26 Insurance cannot drop you when you are sick Prevention against gender discrimination Life-time Limits and Annual Maximums can’t be set Pre-existing Condition Exclusions not allowed Essential Health Benefits defined Free preventative services

11 Employer Side- Three Tiers  Employer Mandate Healthcare must be Offered to all Full Time Employees ○ Defined as anyone regularly working more than 30 hours per week ○ Delayed Until January 1, 2015 Coverage must be Affordable ○ W-2 reporting Coverage must be Essential ○ ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care.* ○ https://www.healthcare.gov/glossary/essential-health-benefits/ https://www.healthcare.gov/glossary/essential-health-benefits/

12 How Do We Pay For This?  Taxes, taxes and more taxes Watch out for Fully-Insured Vs. Self-Insured ○ Taxes differ under each type of plan Individual mandate shared responsibility tax ○ Penalty tax if you don’t have coverage Employer taxes ○ PCORI Fee ( )*- $2/covered life- annual ○ Re-Insurance Fee ( ) $5.25/covered life- monthly ○ Cadillac Tax (2018) Excise Tax of 40% on High Value Plans * Fees are funded by ICUBA

13 Florida Tech Changes  Identify Who Is Eligible Healthcare must be offered to ALL FTE’s FTE = anyone that regularly works more than 30 hours per week Starts April 1, 2015  Ensure Plans are Compliant ICUBA plans are certified as Essential and GOLD LEVEL  Educate The Employees Controlling Claims Costs, Wellness Programs, What Do We Get For Free ○ Monthly Seminars Coming in 2014 and beyond

14 Florida Tech Changes  Open Enrollment is EARLY January 21 st and January 22 nd ○ Hartley Room from 9:00am - 7:00pm On-line Enrollment January 21 st - February 5 th ○ Computers will be available from 8am-5pm every day in the Human Resources Office ○ Make sure to update your ICUBA online account

15 Questions


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