HEALTH CARE REFORM PREPAREDNESS 106:Where Do We Go From Here?

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What Have We Learned?Recap of Previous Sessions

2

Health Care

Reform Preparedness 102:

An Employer’s

Pocket Guide

• Health Care Cost Trends• Small Employer Tax Credits• Grandfathered Plans• No Pre-ex for Children• Kids covered up to age 26• Preventative care provided with no cost sharing

including free contraceptives• Must report value of health coverage on W2• New SBC format for easier plan comparisons• Health FSA now limited to $2,500

What Have We Learned?Recap of Previous Sessions

3

Health Care

Reform Preparedness 103:

Post Election Direction

• Health insurance mandate• Medicaid expansion• Release of preventive care guidelines (FAQ’s)• 90 day waiting period clarified• Aggregation rules apply• Safe harbor definition for seasonal / variable

workers • $2000 deductible limit will be imposed

What Have We Learned?Recap of Previous Sessions

4

Health Care

Reform Preparedness 104: State of

the Exchange

• 18 states with state based exchanges, 26 with federal exchanges, 7 with partnership exchanges

• Colorado exchange marketplace- Connect for Health Colorado- Open enrollment starts 10/1 for 1/1/14

• For individuals and small businesses with 2-50 employees

• Can use the assistance of a licensed/ certified broker or a certified navigator

• Subsidies, cost sharing assistance, tax credits• Multiple carrier choice• Consolidated administration for small businesses• Comprehensive coverage- Metal Tiers• Penalties

What Have We Learned?Recap of Previous Sessions

5

Health Care

Reform Preparedness 105: Reducing

Health Care Costs in a post-

reform world

• Health care spending and cost trends• Getting strategic about your plan designs• Alternate funding arrangements and consumer

directed health plans (self-funding, HSA, HRA)• Wellness strategy• Proactive planning

• Wellness Incentive Regs– Effective 1/1/2014

• Two Types– Participatory– Health Contingent

• Activity Only• Outcome-based

• Require some minimum design qualifications so as to not violate HIPAA

• Need proactive plan designs before 2014

Regulatory Updates

• Annual Reporting• Impact of sequestration on tax

credits• Are you large or not?– Control Group Rules– Variable and PT Employees

• Affordability and Minimum Value–Whose job is it?

Reminders

Group Break Out Sessions

1. Introduce yourself

2. Share best practices

3. Take notes

4. Share out

QUESTION 1

What is the largest impact of health care reform on your business?

QUESTION 2What is your health care strategy?

• Health benefits are going to change, but YOU are an expert!

• You have been armed with the knowledge to take control of your health care costs and be successful in this new world of employee benefits!

• You have trusted advisors and resources at your fingertips– Your broker, your carrier partners, the SBDC

Wrap Up

Brought to you by:

QUESTIONS?

Eden Ripingill Kaiser Permanente Colorado

(303) 306-2561 eden.m.ripingill@kp.org

Tonya KimreyFall River Employee Benefits

(303) 369-3200 tonya@fallriverbenefits.com

Dean HeizerHeizer | Paul | Grueskin LLP

(303) 376-3705dheizer@hpgfirm.com