1. Patient Protection and Affordable Care Act (PPACA) The Good, The Bad, The Ugly

2. PPACA applies to everyone Those who offer group health insurance plans Those who don’t offer health insurance Those who aren't covered now Those who are covered under individual plans Those who are covered under Medicare

3. The Good Starting now – Dependants covered up to age 26 – No maximums on lifetime limits – Premium increases subject to rating bands – Medical Loss ratios subject to rebating – Guaranteed renewal – Primary Care Doctors – Emergency Services (In network) – Small Employer tax credit (up to 35%, 2014/50%)

4. The Bad All plans subject to non-discrimination testing Report health insurance costs on W-2 (2011) Comparative effectiveness fee (2012) Medicare tax increase ($200 to $250K) (2013) New tax on unearned income (same as above) (2013) Medical Expense deduction (7.5% to 10%) Required notice to Employees of Exchange (2013) Employer reports to government (2014)

5. The Bad Continued…. Individual Mandate (2014) Pay or Play Mandate (2014)

6. The Ugly Medicare cuts (now) Tax on Tanning Services (7/2010) Tax on Pharmacy Companies (2011) Tax on Medical Device Manufacturers (2013) Tax on Health Insurance Providers (2014)