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Businesses tell us that one of their top areas of worry and uncertainty, if not THE #1 concern, involves changes in healthcare.  We're always interested in multiple points of view regarding this important topic, regardless of political leaning.  Like you, we're keenly attuned to the financial impact of healthcare policies on businesses. Thus we thought you might be interested in Dr. Elizabeth Lee Vliet's perspective, especially since "taxpayer" is often another way to say "businesses."

Now that businesses will not be required to offer health insurance until 2015, workers and their dependents will be eligible for taxpayer-funded subsidies to purchase health insurance on the exchanges.
This will cost taxpayers an estimated $60 billion dollars in 2014 alone to cover the increased costs of subsidies and the loss of revenue from employer penalties.
This $60 billion figure is before we take into account the "liar subsidies"that will invariably occur now that the administration has quietly removed eligibility verification for taxpayer-funded subsidies.
Community organizers are already being hired around the country to sign people up for the health exchanges. There are no penalties for failing to verify eligibility, and no penalties for signing up people who cannot afford to pay the monthly insurance premiums.

To read more, go to:
 
 10 Reasons Why Obamacare Is Going to Ruin Your Medical Care and Your Life

Q: Our office is overrun with paper! I have no idea what I have to keep, how I have to keep it, or for how long! We'd like to move our HR paperwork toward paperless, but I don't know what to do with our old stuff, or who can help me store things electronically. Basically, we're not sure where to start, and aren't even sure we currently have what we need. Help! 

Kandi's Reply: You bring up a number of good points, ones shared by many businesses.  Electronic storage is here to stay, but you’re correct in your concern about how you implement and maintain it.
 
The Employee Benefits Security Administration (part of the Dept. of Labor) is the governing body on this.  Check with the any firm that you’re thinking of hiring for your data storage needs to be sure they comply with the government’s standards on recordkeeping — they have to be kept:

• safe
• accessible
• and private. 

 
Reams could be written on each of those components, and either they or we can help you.
 
As you also point out, there’s the matter of knowing WHAT needs to be kept, for HOW LONG, and what needs to be kept SEPARATE.  This applies whether you use paper or electronic record keeping.  It’s easy to run afoul of the many different aspects, but we can help you audit, comply, and maintain.  We’re big on checklists as a means of simplifying what is far from simple.  You’re absolutely spot-on, though, to recognize your Achille’s heel in this area.  An audit in one area can, and often does, bring on audits in other areas, depending upon what the Auditor sees in the first audit.  Preparation and organization go a long way in mitigating potential fines that can snowball with each audit.

By: Mensing Consulting Solutions 

“DOMA” is the Defense of Marriage Act which defines marriage as a union between one man and one woman.  Recently, the Supreme Court found Section 3 of it (the section pertaining to the Federal government’s non-recognition of same sex marriage) to be unconstitutional.  Prior to DOMA’s passage in 1996, the Federal government had no definition of marriage.  The Federal government recognized any marriage that a State recognized, even if other states didn’t recognize the marriage.  i.e. if State A didn’t recognize a marriage from State B, the Feds still recognized State B’s marriage.

13 States and the District of Columbia recognize same-sex marriage.  Illinois recognizes legal unions between same sex partners.  What does this mean in terms of nuts and bolts for your business?  For one, employees may need or wish to change tax withholding.  Depending on the state, withholding for Federal taxes could be at the married rate for Federal, and single rate for State.  Thus if an employee now expects to file as married for Federal tax purposes, he or she may recalculate the expected tax bill and change withholding accordingly. However, remember that any employee can change withholding at any time for a variety of reasons, and can adjust their expected withholding by changing the withholding rate, or the withholding amount.  The desired final result is to end the year with the amount of tax withholding, both Federal and State, that meets the employee’s wishes.

Additionally, employers should review their plan documents and fringe benefits to include same sex spouses in such areas as FLMA, health insurance and COBRA.  Retirement plans are also affected since marriage affects spousal consent, beneficiaries, and rights upon divorce.  Ask your plan administrator if your plans are up to date with the new DOMA ruling.

By: Joel Harrison 

The clock is running… America is scrambling to get ready for one of the biggest social economic changes since the implementation of welfare, Medicare and Medicaid. Big changes mean big questions. With less than 6 months to go in 2013, people are anxious to see what healthcare is going to look like. Many people don’t want to make a move until everything is in place and working. For people who are currently denied coverage due to a pre-existing condition, the days are creeping by until they can purchase the care they need. Insurance carriers know that they will be paying more in claims in the future; this means that right now carriers are trying to collect as many healthy people as possible to help balance the scales. There big advantages to shopping this year that could greatly improve your healthcare situation in the future.

1.)    The healthy pool When you buy insurance you are often put into a “pool” – a group of people who are grouped by certain criteria.   Often this is done by your geographical location. Your “pool” also contains a group of people of  varying health status. The design is intended to strike a balance between premiums coming in and claims going out. If you are healthy, and purchase your healthcare before Jan 1st 2013, you meet the criteria to join a healthy pool. This means that the overall cost of your “pool” will be less, because healthier people cost less in claims.. The best news is the pool doesn't evict you later . Once you’re in… as long as you keep your policy, you can stay in the healthy pool. This will not avoid rate hikes in the future, however it will make your rate hikes more manageable than the healthy guy who buys in January and jumps into the “everybody pool.” The “everybody pool” will include any and all illnesses and have a very high claims cost.

2.)    Essential health benefits On January 1st 2013 every major medical plan must include certain coverage for EVERYONE. Are you a single 24 year old male, or a couple in their 50’s? Neither are planning on having children, however they will both be paying for maternity and fertility coverage… Haven’t taken a pill in years?  Sounds like you need prescription coverage. Don’t want it? Too bad, every single major medical plan sold in 2014 will have these, and other benefits mandated. These rich plans are great you’ll be covered for everything, however they will also be VERY expensive. If you don’t need all of these benefits then now is the time to shop. Each carrier handles the upgrading of current plans to new benefits differently. Blue Cross Blue Shield of Illinois will upgrade all plans on January 1st 2013. The new plans are defined by richness of benefits, and assigned a “metal” level – bronze, silver, gold or platinum.  When these plans get “upgraded” (aka ” metalicized”, meaning they will now fall into one of the newly defined metallic levels of benefits,) the price will skyrocket;  estimates are anywhere from 50% to 200% increased cost.  Some carriers will let you put off this upgrade until the one year anniversary of your plan, others even let you keep your current plan design until Dec 31st 2014… Postponing a huge rate hike a whole year sounds like a GREAT reason to shop now to me.

3.)    Cost as previously mentioned, healthcare premiums are about the skyrocket. Estimates are range from $350-$500 MORE PER PERSON. These plans will offer GREAT coverage and anyone can get them regardless of health status, location, medications, weight, or any other reason someone would be denied coverage today. But again, they will be hugely expensive.  Cost is the big ugly monkey on the back of healthcare reform. Paying more claims means premium costs must go up across the board.  Another new rule is that  no one person can pay more than 300% more than any other.  Currently a difference of 500% is allowed.,. Younger, healthier people will face much higher rates in order to subsidize rates for others. 

4.)    State Marketplace (the artist formerly known as the public exchange)GREAT COVERAGE FOR EVERYONE… if you can afford it. Yes the government will be subsidizing premiums for those under 400% of the poverty level (which starts out around $42,000 for an individual and increases based on family size.) The cost of healthcare purchased from the State Marketplace is the “unknown” factor that has most people waiting to shop. STOP WAITING. We have been doing extensive research on this topic all year. We now have the ability to estimate what subsidy you may be eligible for and what your premium will be on the public marketplace. These numbers will not be exact; however they will tell you whether or not waiting is a good idea.

Healthcare is and will remain to be one of the top expenses for families for a long time to come. How far do you drive to save a few pennies on gas? How long do you spend each week cutting coupons to save a few dollars on groceries? Could you stop wasting that time if you made one big cost-saving move? Shop around for healthcare, find an agent who you feel you trust to find the best plan and price for your family, and prepare for the future. Healthcare reform is coming whether you want it to or not. Stop ignoring it and make the best move for your family and your wallet.

By: Mensing Consulting Solutions 

Late in the afternoon before a holiday weekend, the Treasury Department made an announcement via the Treasury Notes blog that rocked the business community.  There will be a one year delay (until January 1, 2015) of a key mandate of the Affordable Care Act (ACA).  Simply stated, the provision mandates that employers with 50 or more full-time equivalent employees either provide health care coverage to their full-time employees, or pay penalties.  Hence the “play or pay” analogy --  provide insurance that meets certain government standards and implement the required data collection and reporting that goes along with it, or pay a substantial per employee fine.  On July 5 of 2013 the Department of Health and Human Services issued a 606-page regulation announcing that state health exchanges would not verify the eligibility of those applying for Obamacare health insurance subsidies.  That regulation is a subject for another discussion; for now, we address the delay in enforcement of play or pay.  

Speculation was rampant as to the reason(s) – even the legality – of the Administration unilaterally changing a provision codified in law.  Is it permissible for an Administration to dispense with compliance with some or all of a law, and if so, does that apply to any Administration and any law?  Do individuals have the same right?  Was it, as stated, that the Administration had listened to businesses and wanted to provide more time to comply?  Was it that the logistics of the ACA had not been thought through well before passing the law and the government itself was not prepared to enforce it?  Was it that Federal agency staffers, tasked with the interpretation and enforcement of the ACA,  and now also impacted by both the furlough and the herculean task of revamping regulations in the wake of the Supreme Court’s ruling on the Defense of Marriage Act (DOMA), simply completely overwhelmed?  Did delaying an unpopular mandate past the 2014 elections play any role?  The reach of the delay may or may not be enormous.  No one can say for sure, but here is what we do know:

·         At first blush, the small employer might think:  “Who cares?”  Small employers are not directly impacted by the delay in the mandate, since the mandate does not apply to them.  However as small business owners know, often what is implemented first for larger businesses is a preview of what is “coming to a theater near you.”  Legislation impacting business tends to be phased in from large to small business.   Also, small business cannot escape the impacts of costs in healthcare and healthcare insurance.  Changes to key components of healthcare (see below “What stays the same”) will impact costs to all, and the ability to offer healthcare coverage has a direct impact on the ability to remain competitive, and recruit and retain talent.

Small businesses should also beware the adverse impact of increased government fines as a result of the delay of the mandate. You see, the government was planning to partially fund the cost of operating the exchange with the revenue from fines imposed on those that failed to comply with the coverage mandate. Without the revenue from fines, other government agencies will inevitably need to ramp up their audits to generate revenue from imposing fines in other areas of non-compliance; ICE, DOL, EEOC, and more! 

·         There is still a tax credit available to small, “qualified” employers providing health insurance (with lots of qualifiers to meet first).

·         So what does the delay mean?  The delay applies to the mandate on “large” employers.  For purposes of the ACA only, “large” employers are those who employ 50 or more full-time equivalents.  The delay means employers have more time to figure out:

• What is “minimum essential coverage”?
  
• What is “minimum value”?
  
• What is the definition of “affordable” to the employees of this specific business?
  
• How many “full-time equivalents” does the business employ, and is that calculated correctly according to government definition and formula?
  
• How, when, and to whom is this reported?
  

What stays the same?

·         The delay applies to the reporting and penalty portion only --  other ACA provisions stay in place, including:

• Requirements for health plans to ban annual dollar limits on essential health benefits
  
• A 90-day limit on eligibility waiting periods
  
• New out-of-pocket maximums
  
• Elimination of preexisting condition exclusions for adults
  
• Coverage of clinical trial participant costs
  
• Health plan sponsors must still pay new fees, notably “PCORI” (Patient Centered Outcomes Research Institute) and reinsurance fees
  
• Coverage of recommended preventative care, including contraceptive services,  with no cost-share
  
• Certain wellness program requirements
  
• Employer mandate to provide written notices about the government run exchanges (“Exchange Notice”) by October 1, 2013
  
• Mandate to determine if the employer’s group health plans meet the 'minimum value' requirements under ACA for the 2014 plan year.  Why?   This information is required to be included on the summary of benefits and coverage (SBCs) that employers must provide for coverage beginning on Jan 1, 2014 or later.  Thus these SBCs must be provided during the fall 2013 open enrollment season.
  
• Reporting health care costs on the employee’s W-2, with certain exceptions
  
• Grandfathered plans must cover dependent children to age 26 even if the child has access to his/her own employer-provided coverage
  

Every company is unique – let us help you evaluate the impact of the ACA on your company and projected growth.

Part of the Affordable Care Act (ACA, also known as healthcare reform) is the employer mandate for businesses with over 50 FTEs (full-time equivalent employees) to provide healthcare coverage to their employees working 30 hours or more. The consequence for NOT providing healthcare to full-time employees is to face hefty government fines. Late yesterday, the Obama administration announced that the employer mandate portion of healthcare reform has been DELAYED UNTIL 2015! What does this mean for employers? It simply means they have another year to prepare. We have already been asked here at MCS what that means for individuals and W-2 reporting. We are being told that all other provisions of the ACA legislation will remain in effect. However, we are telling our clients that it is truly 'wait-and-see' at this point. The government sure does keep our jobs interesting!

We will continue to monitor this closely and keep you updated.

By: Kandi Mensing

I just put $4,800 directly into a business owner's pockets every year.  $4,800 is the direct premium savings I was able to find them by shopping their plan. For the last 5 years, they were paying $730 per month for their family coverage with a $6,000 family deductible and $15 prescription copays. Their NEW plan, which has a monthly premium of only $330, has only a $5,000 family deductible and their prescriptions are only $4. So, if we want to get technical, we also lowered their expense risk by $1,000 annually in terms of their deductible, and saved them $132 per year on their prescriptions (savings of $11 per month). So, over the course of the next 5 years (as long as they had their old plan) they will have saved nearly $30,000 ($4,800 x 5 = $24,000, $1,000 x 5 = $5,000, and $132 x 5 = $660)! I didn't even mention that for each year that they do not exhaust their deductible, their deductible decreases by 20% the following year, up to a 50% decrease!

How can we save business owners this type of money? That's easy; we are not an insurance agency. Our income is not dependent on the amount of premium we can get you to pay. We believe in small business. We support small business. We want you and your business to feel financially stable and protected. We care about "doing right" by our clients.
What would you do with your extra $30,000?

HST Post of the Week: 
By: [email protected]

How many times do you hear someone say to you “I never get sick?” Or maybe you say that yourself. Why get health insurance coverage if there is nothing wrong with me? As the clock ticks toward the 2014 launch of the Affordable Care Act, health leaders across the nation are embarking on a tough task: persuading young adults to enroll. Their participation will be critical to balance out older, sicker patients more likely to sign up for health insurance as soon as they are able.

This has been the battle that private insurers have faced in the past as well. If any plan regardless if it is a private carrier or the plans in “ObamaCare” the only way it would ever work is if there is a “balance” in the age of the people who apply. The success of the healthcare law depends on reaching everyone who is uninsured, but particularly young people who may feel like they don’t need insurance.

Beginning in 2014, nearly everyone will be required to have insurance or face a fine — $95 or 1% of their household income in the first year. Many young adults who are not covered through work or their parents may be eligible for Medicaid or the new state-based insurance market places known as exchanges.

Health officials worry that the fine, which increases over time isn’t high enough to convince people to sign up for coverage. The penalty itself will not convince a young person or any other person. Young people will need to understand the risks of not having health insurance. If there is a lack of young people signing up there is a concern that the older, sicker generation will use up all the money that is set aside for the “Obamacare” plans

So parents of the younger generation, please call us. We can insure your son or daughter so that you will not have the stress of trying to protect them and answering to the federal government all at the same time.

By Joel Harrison

The Affordable Care Act (ACA) has been stated by many to be the single most controversial and confusing piece of legislation in United States history. With so many different people and groups interested in healthcare in one form or another everyone has something to say and they are all saying something different.  Like it or not healthcare reform is coming FAST. The countdown is to less than 6 months left in 2013 and the exchanges open in October.   If you’re “just waiting to see what the ACA does” you’re going to be left in the dust and be scrambling to comply with regulations early next year.  This could end up costing you in the end. So here are a few tips to stop worrying and love the ACA.

Drop the politics

OK I’ll admit love is a bit of a stretch. My point is Healthcare reform is coming whether you like it or not.  Congress tried to overturn it… FAILED. The Supreme Court tried to say it was unconstitutional… FAILED. States said they would not participate… FAILED.  It’s time to face the facts… the healthcare reform is here to stay. So stop arguing about who is right and who is wrong and start having intelligent conversations about what solutions work best for your business. The number of businesses who will actually be severely hurt by the new laws is minimal.

Get educated (properly)

Healthcare reform is complex; there is no way around it. If you have not already begun to understand how the ACA will affect you, your time is running out. Now is the time to meet with professionals in the healthcare field. Search out and attend seminars that help you to navigate the pitfalls business owners will have to deal with. Have specific conversations about how reform will help or hurt your business and what strategies are available to make the transition as smooth as possible.  When doing research remember to pay attention to the political affiliations of your sources. Because everyone feels so strongly about healthcare reform there is A LOT of misinformation out there… be careful.

Relax… it’s just the ACA

Once you have made your peace with healthcare reform and found the best solutions for your business you can sit and watch the chaos happen around you. The “wait to see what happens” crowd will be forced to make last-minute, hasty decisions and pay costly fines because they have been too stubborn to just stop worrying and learn to apply and love the ACA.