This guest post is written by Brad Evans. Brad is a trusted resource when it comes to Healthcare Reform. His firm Fringe Benefit Analysts is an Employee Health Benefits Consulting Firm that is committed to simplifying benefits management and generating greater employee satisfaction. Feel free to reach out to Brad to learn more. Take it away Brad.....
There’s a lot being said concerning healthcare reform and how it will affect each of us. Probably one of the biggest issues is all of the misinformation floating around. Twice in the last couple weeks I’ve listened to our local news talk about some of the changes and either they have it flat out wrong or so convoluted it misses the mark by a mile. Now I can’t really blame people for making these errors as this law is extremely complicated, and the rules
change depending on whether you are a covered on an individual, small group, or large employer plan. Just to make this more interesting the definition of small and large employer are not always the same. Sometimes a large employer is considered an employer with 50 + employees, others define large employer as those with 100 + employees. The details on these new rules also keep changing almost on a weekly basis. One of our senators has stacked the law and subsequent regulations in the corner of his Office; it has now reached over 8 feet tall.
What should one do? First of all don’t get to wound up, this is going to take a lot of time to get fully implemented, not to mention the rules and regulations are still being defined. A lot of the reforms have already taken place and most people have not even noticed. The good/fluffy stuff has already occurred; 100% preventative care, dependents coverage until age 26, life time limits lifted, small business tax credits, among a handful of other laws. 2014 is getting the most attention because now comes the dark side….. not really, but it’s the year when the tougher side of reform begins. This is the time to start paying more attention to healthcare reform and how your situation will be affected. A lot of the reform is just going to happen without your involvement, but there will be steps you need to take. Your insurance broker and/or insurance company should be providing you with some guidance. There’s also pretty good, straightforward information on the government’s web site.
As an individual, 2014 brings the individual mandate. If you do not have coverage you are required to purchase a plan. The positive spin on this is you can’t be turned down, and there will be subsidies for many who do purchase plans. The negative side is if you don’t purchase coverage you will be penalized, not much the first year but it ratchets up over the next few years to a sizable fine. Our friends at the IRS will handle this. Small employers are not (at this time) going to see penalties for not offering coverage, but they will see additional taxes and fees on their existing plans. Their plans will also be required to offer “Essential Health Benefits”, and will be required to reach certain levels of coverage to be considered “creditable coverage”. Large employers, those with 50 or more full time equivalent employees will be subject to penalties if they don’t offer coverage. Without going into pages of details understand that these penalties can be substantial, $2-3,000 per employee per year.
The particulars on how this would happen are very involved; again one would need to get help
from a health insurance professional to guide you through this process.
At the end of the day it appears that healthcare reform is here to stay. It is not likely to be overturned, or rolled back. It is also probable to see many changes and revisions. The law that was passed was never meant to be the final draft. With politics not being a perfect science this is what we are left with, the good and the bad. It is a law we will have to adopt and live with, and like laws before, it will evolve and change. Hopefully progressing into a structure that better fits the American everyday life.