CHECKLIST:

HEALTHCARE REFORM

CONSUMER

HELPING SMALL BUSINESS

NAVIGATE

THIS CHECKLIST WILL ASSIST YOU WHEN NAVIGATING HEALTHCARE REFORM.

Let’s get started.

WE. LIKE. THAT.

It’ll help you understand the important things… the things that will help you save time, money, and improve coverage.

By the time we finish, you’ll know exactly what you’re looking for. It’s JUST like running errands.

SO LET’S BEGIN. THIS PRESENTATION WILL HELP SMALL

BUSINESSES MORE EFFECTIVELY WORK THEIR WAY

THROUGH HEALTHCARE REFORM.

This is NUMBER ONE. You want to

establish this right away.

WHY? Because there are costly tax

penalties that may be incurred if you’re

actually a “large business” and don’t

provide health coverage to your

employees.

#1: DETERMINE IF YOU’RE A SMALL BUSINESS.

CHECK.

BUT SMALL BUSINESSES… ARE NOT.

YOU’RE CLEAR.

As it stands, “large

businesses” ARE

mandated to provide

health coverage to

their employees.

KNOWING WHETHER-OR-NOT YOU’RE A SMALL BUSINESS

WILL ALSO HELP YOU DETERMINE YOUR STRATEGIES

WHEN DESIGNING A PLAN. A SMALL BUSINESS’ HEALTH

PLAN WILL DIFFER GREATLY FROM A LARGE BUSINESS’.

That’s small biz.

QUESTION: WHAT IS THE DEFINITION OF “SMALL BUSINESS” WITH REGARD TO THE HEALTHCARE REFORM LAW?

Small businesses are

businesses with LESS than 50

fulltime equivalent employees

for the previous calendar year.

You’ll sometimes see “fulltime

equivalent employee” abbreviated

as “FTE.”

AND DON’T FORGET THIS IMPORTANT NOTE:

THEY COUNT.

YOUR FTE COUNT DOES INCLUDE

PART-TIME EMPLOYEES.

A part-time employee is defined as

working less than 30 hours per

week, and there’s a calculation

when determining their “fulltime

equivalency.”

…YOU’LL WANT TO MAKE SURE TO HAVE THIS ALL SORTED OUT. WHY?

BECAUSE THERE ARE COSTLY TAX PENALTIES FOR EMPLOYERS THAT ARE

OVER 50 FTE AND DON’T PROVIDE HEALTH COVERAGE.

So if you’re anywhere

NEAR 50 FTE…

LET’S MOVE ON TO THE NEXT ITEM ON OUR

CHECKLIST.

If you know anything

about health insurance,

you’ll know that these two

parts of the industry are

completely different.

#2: KNOW THE DIFFERENCES BETWEEN

INDIVIDUAL HEALTH PLANS AND SMALL GROUP

HEALTH PLANS.

CHECK.

THE LIST GOES ON.

• They have different

characteristics.

• There are different rules.

•There are different tax

incentives.

• There are different

eligibility criteria.

SMALL GROUP

Depending on your business, your objectives, your budget, and other considerations…

Decisions. Decisions.

… You’ll want to

determine what

kind of health

insurance plan

you want to

work with. INDIVIDUAL

The good news: because of healthcare reform, it’s now easier than ever before to work with individual health insurance

plans to provide coverage to your employees.

You’ve got

OPTIONS.

And in certain cases:

IT MIGHT EVEN MAKE MORE

SENSE.

So: know how individual health

insurance plans can work for

small business ALONG WITH

health insurance exchanges.

ONE REASON: Small group plans usually have the best tax incentives, especially if employees are contributing.

Yes.

TAX-FREE DOLLARS.

WITH ALL OF THAT BEING

SAID ABOUT INDIVIDUAL

HEALTH INSURANCE

POLICIES:

SMALL GROUP HEALTH

INSURANCE PLANS CAN STILL

BE AN IMPORTANT OPTION.

ANOTHER REASON: PHYSICIAN NETWORKS CAN SOMETIMES BE BETTER WHEN WORKING WITH GROUP HEALTH INSURANCE PLANS.

You might have

better access.

ADDITIONALLY, THERE IS NOW A GROUP HEALTH INSURANCE PLAN CALLED SHOP (SMALL BUSINESS HEALTH OPTIONS PROGRAM).

LOWER YOUR

COSTS.

SHOP is available through

the public health

insurance marketplaces.

It can provide substantial

tax-credits for qualified

small businesses to help

with premiums. Sometimes

up to a 50% reduction.

HERE’S THE MORAL OF THE STORY. YOU’LL WANT TO DECIDE

WHICH SEGMENT WILL WORK BEST FOR YOUR BUSINESS:

INDIVIDUAL HEALTH INSURANCE PLANS, OR A GROUP HEALTH

PLAN. AND NOW… ON TO THE THIRD ITEM ON OUR CHECKLIST.

HEALTH

INSURANCE

REMEMBER:

Small businesses (with less than

50 FTE) are NOT required to

provide health coverage to their

employees.

#3: DECIDE IF YOU’RE GOING TO PROVIDE

HEALTH INSURANCE FOR YOUR ENTIRE GROUP

OR JUST YOURSELF.

CHECK.

HOWEVER, IF YOU’RE NOT GOING TO PROVIDE COVERAGE…

There IS a tax.

…You and your employees will

STILL need to find a health

insurance plan somewhere on

your own.

Why? Everyone has got to

have health coverage or

pay a tax penalty.

SO: Determine whether-or-not you have a budget for your entire group. There could be strategies that are surprisingly affordable, especially based on the size

and average income of your group.

EASY PEASY. UP NEXT: THE FOURTH ITEM ON

OUR CHECKLIST.

#4: UNDERSTAND THE DIFFERENT PLANNING

STRATEGIES FOR SMALL BUSINESS.

CHECK.

THERE ARE A VARIETY OF

DIFFERENT PLANNING

STATEGIES THAT ARE

AVAILABLE TO SMALL

BUSINESSES.

REMEMBER TO KEEP IT SIMPLE.

TWO concepts.

Your strategies will only utilize:

• Individual health

insurance plans.

• Or… a group health

insurance plan.

WEIGH

DECISIONS.

So if you determine that you’d

like to help provide coverage

for your employees, you’ll want

to come up with a program that

fits your objectives best.

AND DON’T FORGET: HEALTH INSURANCE IS A VERY BASIC BENEFIT

THAT CAN HELP YOU ATTRACT AND RETAIN QUALITY EMPLOYEES.

FOR EXAMPLE, YOU COULD USE A DEFINED CONTRIBUTION STRATEGY.

You’ve GOT to

strategize.

“Defined Contribution”

is a retirement

planning phrase. It’s

been around for a long

time. You can Google it

and read all about it.

HEALTH BENEFITS PLANNERS ARE NOW USING THIS “DEFINED CONTRIBUTION” CONCEPT TO FUND HEALTHCARE.

JUST like an

allowance.

And it’s simple.

It’s EXACTLY what it says it is:

You “define a contribution” (ie:

$300/month), and employees

then purchase their own

individual insurance plans.

EMPLOYEES THEN PICK FROM INDIVIDUAL INSURANCE PLANS THAT ARE BOTH ON AND OFF THE PUBLIC HEALTH INSURANCE

EXCHANGES. THEY SIMPLY BUY THEIR OWN PLAN.

AND DEPENDING ON INCOME: they

might also receive SUBSTANTIAL

subsidies.

WHICH

PLAN?

THIS STRATEGY CAN ACCOMPLISH THREE BIG THINGS:

• Simplify. All it is, is an allowance.

• Budgetable. It’s easy

to decide on a fixed

amount to offer.

• Selection. It gets

business owners out of

the “insurance

business” and allows

employees to make

their own decisions.

OR… HERE’S ANOTHER SMALL BUSINESS STRATEGY:

“CONSUMER DIRECTED HEALTH PLANNING.”

IT’S ALSO REFERRED TO AS “ACCOUNT-BASED” OR “EQUITY BASED” PLANNING.

FIRST: SMALL BUSINESS OWNERS PROVIDE THEIR EMPLOYEES ACCESS TO A HIGH DEDUCTIBLE HEALTH PLAN.

SMART MONEY.

THEN:

They pair it up with a health

reimbursement arrangement

(HRA) or health savings

account (HSA).

The HRA or HSA becomes an

asset (account) that builds

equity over time.

YOU RETAIN FUNDS THAT WOULD NORMALLY GO TO THE INSURANCE COMPANIES IN THE FORM OF PREMIUMS.

And THAT.

Is rad.

AND, DEPENDING ON YOUR

STRATEGY, OWNERSHIP OF THE

ACCOUNT STAYS IN ONE OF TWO

PLACES:

• With your company.

• With your employee.

THERE YOU HAVE IT. A COUPLE OF EXAMPLES OF

STRATEGIES THAT CAN HELP SMALL BUSINESSES OFFER

HEALTH BENEFITS TO THEIR EMPLOYEES. NOW LET’S MOVE

ON TO THE LAST ITEM ON OUR CHECKLIST.

CHECK.

SIMPLY:

Know where you

can find help.

#5: KNOW WHERE YOU HAVE ACCESS TO

PRODUCTS, ADVICE, CUSTOMER SERVICE,

AND CONSULTATION.

FIND EFFECTIVE ADVISORS THAT CAN HELP YOU SORT EVERYTHING OUT.

JUST like having your

own HR Department.

A “ONE-STOP-SHOP” CAN

HELP YOU SAVE TIME, MONEY,

AND A LOT OF HASTLE BY

“OUTSOURCING” YOUR

SMALL BUSINESS HEALTH

BENEFITS PLANNING.

And the good news: brokers are compensated by the insurance companies.

Done.

So you don’t have to worry

about broker fees, etc.

Compensation is built into

every single health

insurance plan regardless of

whether-or-not you decide to

work with an adviser.

ADDITIONALLY, A BROKER WILL KEEP YOU “IN THE KNOW” ABOUT NEW PRODUCTS, STRATEGIES, AND REFORMS.

THEY SHOULD OFFER A BROAD RANGE OF PRODUCTS AND SERVICES THAT WILL MAKE YOUR PLANNING CONVENIENT.

HERE ARE SOME OF THE QUALITIES THAT YOU SHOULD LOOK FOR IN A BROKER/CONSULTANT.

Look for

quality folks.

LICENSED, ACCREDITED,

ETHICAL.

Find consultants that are licensed by

the Department of Insurance to do

business in your state.

Take it a step further and find advisers

who have professional designations.

People with these designations will

provide advanced knowledge, and

adhere to strict ethical standards.

FIND A BROKERAGE WITH A STRONG SELECTION OF REPUTABLE PRODUCTS.

Gotta’ have

choice.

Your broker/consultant

should offer you a wide

variety of choices from

reputable insurance

companies like those to

the right… plus others.

SEARCH FOR AN ADVISER THAT OFFERS CONSULTATION IN “NON-INSURANCE” AREAS TOO.

MORE than just

insurance policies.

Your broker/consultant

should also be offering

products and services

that are considered

“non-insurance”

products.

Things like: HSAs (health savings accounts), HRAs (health reimbursement arrangements), COBRA

administration, knowledge of tax incentives, etc.

Find a well rounded

broker.

After-all, the goal is to fund

healthcare as efficiently

as possible. There are

other tools that help

accomplish this besides

just insurance plans.

AND THAT’S IT. THAT’S YOUR HEALTHCARE REFORM CHECKLIST

FOR SMALL BUSINESS. BY UNDERSTANDING THE POINTS WE’VE

MADE, YOU’LL BE ON THE RIGHT PATH TO DRAFTING A HEALTH

BENEFITS PROGRAM THAT FITS YOU OR YOUR BUSINESS BEST.

TYSON J LESTER, RHU, REBC

President, Policy Advantage Insurance Services

Toll Free: (800) 617-0089

Los Angeles Area: (424) 442-0170

Email: info@policyadvantage.com

www.policyadvantage.com | CA Insurance License #0F22799

ARTICLE WRITTEN BY

We help individuals and businesses sort out all of the aspects

when designing an individual or business health plan.

Please contact us if you have questions. We share high-value

information and look forward to working with you. Thanks for

stopping by.

Toll Free: (800) 617-0089

Los Angeles Area: (424) 442-0170

Email: info@policyadvantage.com

www.policyadvantage.com | CA Insurance License #0F22799

WE HELP INDIVIDUALS AND BUSINESSES

Nearly 10,000 Followers at Twitter: www.twitter.com/policyadvantage

Catch up at Facebook: www.facebook.com/policyadvantage

We’re also at Pinterest: www.pinterest.com/policyadvantage

www.policyadvantage.com

WE’RE SOCIAL