HEALTHCARE REFORM
BY : STEVE STREGE NESBIT AGENCIES
What Business Owners Need to Know about Healthcare Reform
For anyone who has been following the news ( and most people who haven ’ t been following the news as well ), it shouldn ’ t be much of a surprise to hear that healthcare is a hot button issue . Love it or hate it , the Affordable Care Act ( ACA ) has been around for a while . Though it significantly differs from what it was originally , it hasn ’ t gone away , and it doesn ’ t look like it ’ s going to be going away anytime soon . Business owners should especially take note of this , considering that large portions of the ACA are devoted to dictating who gets health insurance and what employers have to do about it .
It seems like every couple of years around election time , whether it ’ s the Presidency , the Senate , or the House , one of the key talking points is what ’ s happening with healthcare . Either the ACA is going to “ stay forever ” or “ be repealed and replaced ” or simply “ be repealed .” It always comes up and it ’ s never quite clear exactly what might happen .
Recently , for example , the individual mandate has been repealed as part of a tax plan put forth by Republicans . What does this mean ? Well , for employers , it doesn ’ t mean a whole lot . However , it is a large step forward in terms of what could affect employers in the future . After all , the individual mandate isn ’ t the only mandate in the ACA . The other one is the employer mandate , which is an issue that comes up time and time again . As it currently stands , if an employer doesn ’ t offer a health plan that provides a minimum amount of coverage for its full-time employees , it is subject to a large penalty per employee , over a minimum number of 30 employees . While Democrats are currently opposed to a change , Republicans are pushing for it .
Now come the questions . You are a business owner , so consider some of the following :
• Without an adequate view of the ROI of your healthcare plans , how can you make a good decision regarding which plans to go with ?
• Do you know enough about the current regulations to understand what plans your employees need to have in order to avoid fines or other regulatory penalties ?
• What kind of plan do you need to have in order to satisfy your employees needs , the current regulations , and attract new talent in a competitive marketplace ?
• Have you ever considered a self-funded plan ? Do you even know what a selffunded plan is ?
• What are your current costs and how much are they increasing each year ?
For many employers , the answers to some ( or all ) of these questions are difficult to arrive at due to the simple fact that it ’ s next to impossible for the average person to figure this out themselves . Worse , since everything is continuously in flux , it can be a full-time job simply keeping up with what regulations and requirements may be changing . Business owners can be sure of one thing , however ; not understanding quite what is expected of them in terms of providing healthcare won ’ t be a valid excuse should the government come knocking at their door asking why they aren ’ t following regulations properly .
Here are a few things every business owner should know right now :
The Small Business Health Options Program ( SHOP ) has been established for employers with 50 full-time equivalent employees or fewer who also wish to provide health coverage .
• For the most part , SHOP programs are the only way for small businesses to qualify for tax credits in order to lower the costs of their premiums .
• Regardless of whether they provide health insurance , employers have to provide information about the healthcare marketplace to their employees .
If you are going to offer health insurance , it has to be done within 90 days of an employee ’ s start date .
• Employers have to provide employees with a Summary of Benefits and Coverage form which outlines what their health plan costs and what it covers .
• There are incentives built into the ACA to establish wellness programs for the workplace .
This list is by no means exhaustive . In fact , the things on the list may change by the time of publication . If there is one constant in the healthcare landscape , it is change . Unfortunately for business owners , that can be frustrating and leave them confused as to their options .
So that is the story that brings us to today . What does it all mean ? Where do you go from here as a business owner with all of this information ? Good questions . Not only are they good questions , but unfortunately they are questions which don ’ t have solid or concrete answers right now . Healthcare has become a hot button issue , politically speaking , and until it cools down some , the entire idea of a stable system is something of a pipe dream . Understanding the changes to healthcare requires more time and commitment than you , as a business owner , probably have to devote to it . That ’ s why seeking out professional help to navigate your options in the current climate is the best course of action .
To begin reviewing your company healthcare options and start saving money , contact Steve Strege at 952-746-4365 or sstrege @ nesbitagencies . com . +
Steve Strege has over 20 years of experience in all areas of employee benefits consulting , especially creative cost trend reduction , union negotiation , mergers and acquisitions . Seamless HR , compliance , and benefit integration with constant guidance . He believes in lowering trend through better utilization of employee benefits and is a Certified WELCOA Well Workplace Practitioner Levels I & II . You can contact Steve at 952- 746-4365 or sstrege @ nesbitagencies . com
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