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Transamerica’s Health-Pak A guide to successful solutions for 2014 & beyond Presented by: Cas Sharp Area Sales Manager of Health Distribution, Central.

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Presentation on theme: "Transamerica’s Health-Pak A guide to successful solutions for 2014 & beyond Presented by: Cas Sharp Area Sales Manager of Health Distribution, Central."— Presentation transcript:

1 Transamerica’s Health-Pak A guide to successful solutions for 2014 & beyond Presented by: Cas Sharp Area Sales Manager of Health Distribution, Central Region

2 Your Group’s Statistics Number of Currently Insured employees = 60 Number of full time Employees = 691 Average Salary = $31,960.07 – ( Calculated for Affordability (4) ) GROSS “Pay” Penalty under ACA = $1,784,700 Total savings under ACA GROSS penalties & Taxes while providing a Bronze equivalent or greater plan that meets “Affordability” Mandate… $647,287.62

3 ACA Penalties 1.From the Patient Protection and Affordable Care Act of 2010 (PPACA). 2. Full-time employees work 30 hours or more per week on monthly average. 3. No penalty is paid on part-time employees or full-time employee equivalents. 4. If total employee cost exceeds 9.5% of employee's family income, then the employee is eligible for subsidized coverage in the new state-based Exchange purchasing group. 5. The first 30 full-time employees are exempt from the mandate penalty. 6. The penalty amount is the lesser of the actual penalty or $2,000 times all full-time employees minus the first 30.

4 Your NET Penalties under ACA* If you do not provide coverage to full-time employees, and at least one receives an Exchange Subsidy (4), then your total annual penalty owed to the Federal Government will be $1,322,000 (5). If you do offer qualified coverage to full-time employees, but one or more receives an Exchange Subsidy (4), then your penalty for each subsidy-recipient employee will be $3,000 (6). Listed below are possible penalties based on the information you have provided. Subsidy Recipients 172 345 518 % of full time Workforce 25% 50% 75% Penalty $516,000 $1,035,000 $1,322,000 Please see Calculator: http://www.retailmeansjobs.com/health-care-calculator

5 Your GROSS Penalties + Taxes At 75% your penalty is $1,322,000 Assuming a 35% taxation $1,322,000 x 35% = $462,700 $462,700 + $1,322,000 = $1,784,700 $1,784,700 annual Penalty for 75% (518) of your employees, or… $287.11 per employee ($1,784,700 / 518 = $287.11 )

6 Objective Provide the best Benefits possible to you & your employees in comparison to your GROSS penalties & taxation under the ACA for 2014 and beyond.

7 How? 1.Combining a Max-Funded Self-Insured MEC & MVP that meets the Affordability mandate. 2.Integrating “Expected” Benefits to fill the Gaps left behind by HCR, & offering Limited Indemnity benefits for those that decline. 3.Creating the best benefit available for you that is under or equal to your GROSS Penalties & taxes under ACA.

8 A Little Q & A Does an employer have to offer any other type of coverage such as a Minimum Value plan in order to avoid the $3,000 penalty if an employee who is eligible for subsidies on the Exchange waives off of the employer group plan and purchases coverage on the Exchange? Yes, employers need to offer a Minimum Value plan which meets the government’s 60% rule of “allowed costs” in order to avoid the $3,000 penalty per employee who is eligible for subsidies on the Exchange, who waives off of the employer plan, and who purchases coverage on the Exchange. The employer cannot charge a full time employee whose total family income is at or below 400% of the Federal Poverty Level, which is currently $92,000 for a family of four, more than 9.5% of that employee’s W2 Box 1 income for the Minimum Value plan. The W2 Box 1 income equals the employee’s total income minus his contribution to the pension plan and minus any monies the employee set aside in his Flex 125 Program. This 9.5% limitation applies only to the single contribution rate of the Minimum Value plan but not for the charge attributable to any dependents.

9 Your Max-Funded Self-insured Options

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14 Proposal is based on the following: Male or female DOB Salary or Pay Rate* (to determine “Affordability”) Location (Zip Code) Job title Type Of Coverage of each employee (EE,ES,EC, or EF) » RATES SUBJECT TO CHANGE DUE TO UNDERWRITTING


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