The Affordable Care Act

You need to know….

Dr. Ann HawkinsWellCare Dimensions Inc.

24hour MD Now214.886.1113

www.24hourmdnow.com

What To Do Now

Effect of ACA

All About Health

• If you have less than 50 employees the ACA does not affect you!

•But you need coverage

•Offering programs to your employees could help recruit and retain employees

If you have a plan now

• Stay on the insurance plan through 2015• If you have been dropped from your previous

plan Call your agent and get their advice

• If you have a high deductible, look into alternative coverage and gap plans

If you

• Offer insurance to your employees and dependents you can not pay toward dependents coverage By releasing dependents they qualify for

subsidies Coverage - available through state exchanges

or private companies like Blue Cross Blue Shield, Humana

• Contact insurance company or carrier about your changes

Trend

• ACA “provides strong incentives for employers—with the agreement of their employees—to drop Employer Sponsored health insurance for as many as 35 million Americans.” • Douglas Holtz-Eakin, president of the American Action Forum

• Many companies, with the concurrence of the employees, will drop insurance

Trend

• Many full time employees will be dropped to part time and not be covered Get a 2nd job Start their own business

• Buy less expensive limited medical programs with other health benefits, pay the penalty

Healthy and younger people are economically incented to pay penalty vs. paying for “qualified” health insurance Supplemental insurance Accident Medical Telemedicine Catastrophic

At this point in 2015

• Employers – if you pay toward employees insurance Employee after tax impact Whatever the $ amount an employer pays

toward an employees insurance counts as part of the employees taxable income

Salary of $40,000 plus $500/month paid by employer for insurance = total taxable income of $46,000

Self Employed

Metal Exchange Plans

Cost

Tax Penalty

Metal Plans

• Bronze• Silver • Gold• Platinum• Private

Blues Humana

• Public plan available through the exchanges

Plans coverage and cost Vary dependent if you go through a private or

public exchange Need to talk to an agent

Metal Plans

• Max out-of-pocket $6,350 individual/$12,700 family Excluding monthly premium % of coverage – 60-90% Deductible: Bronze $5,000/Silver $2,000 Most plans are HMO’s – restrictive

• IRS cost estimate of the Bronze plan – family of 4 – $20,000

The Tax Penalty

No “qualified” health insurance whichever is higher: • 2015

$95 per person up to three people ($285) or 1% of taxable income ($100K = $1,000)

• 2016 $325 per person up to three people ($975) or 2% of taxable income ($100K = $2,000)

• 2017 $695 per person up to three people ($2,085) or 2.5% of taxable income ($100K = $2,500)

Those who opt out

• Look into group supplemental/gap insurance • You and most of your employees are:

Young Fit Healthy

• Health concerns are related to accidents and doctor visits

Affordable, Alternative Coverage

• Accident• Disability• Short Term Medical• Vision• Dental• Telehealth - Doctor Visits by phone• Prescription Savings• Lab and Imaging Savings• Diabetic supplies Savings

Great News• U.S. healthcare system will revolve around

wellness and prevention• Medical model, of treating illness, financially

unsustainable • New England Journal of Medicine

• Healthcare services will transition from treating illnesses/injuries to maintaining good health as far into old age as possible• Dr. Daniel Alexander

It’s All About Health• True economic need to stay healthy

Focus marketing on the non elderly who want to stay healthy in lieu of buying health insurance

• Pay IRS penalty not get major medical Supplemental Accident/Medical Catastrophic Telehealth/Telemedicine

• Focus on staying healthy Provide educational classes Build the aspect of community in the club Partner with small businesses Make exercise – play, add fun, innovative ideas

Suggestions

• If you have an individual plan – renew, keep it until the end of 2014 • If you have been cancelled from your individual

plan and have a pre-existing condition Take a look at one of the exchange plans

• If you need insurance and are healthy Research individual plans from a Major Medical

provider before year end and keep that policy through 2014

Suggestions

• If you can not afford a Major Medical Plan look at alternatives Accident Short term Major Medical – no pre-existing

conditions Telehealth for doctor visits

• Look at Metal Plans with subsidy

For more information:

Dr Ann Hawkinsdrann@24hourmdnow.com

www.24hourmdnow.com214.886.1113

For direct questionsGuy Gilson

303 579 8783