Date post: | 18-Dec-2015 |
Category: |
Documents |
Upload: | abraham-miles |
View: | 213 times |
Download: | 1 times |
Annual Meeting
February 12th 2015
Issues Facing Small Employers
Employer Attitudes Toward Health Insurance
Most companies with less than 50 employees will continue to offer health insurance.
68% strongly agree they will continue coverage, 28% most likely will offer coverage, 4% will stop all together.
Employer health insurance related concerns
77% how to control escalating cost
10% helping employees make best choices
8% avoiding ACA penalties
* Source: NFIB Research Foundation
Employers Source of ACA Information
42% General News
15% Health Insurer
12% Trade Association
10% Business/Advisor/Broker
8% Healthcare Provider
5% Other
4% Government
4% No useful information
Employers Offering Coverage
84% of employers offer health insurance
14% of those not offering insurance provide some type of reimbursement for insurance
13% plan to cut hours of part-time next year, however only half of these cuts are associated with ACA
Employer Plan offerings & cost*
Average premium for single employees is $503 and $1,403 for family
Average employer contributions are $86 per month single, and $459 for family
Copays for office visits average $23 for PCP and $35 for specialist
Average prescription copays are $11 for 1st tier, $31 2nd tier, and $53 for 3rd tier.
Average deductibles are now $1032 for single coverage, with the deductible increasing to $1,797 for employers less than 200.
*Kaiser Family Foundation 2014
Employer Actions taken to contain cost
Took lower profit 66%
Became more efficient 48%
Delayed postpone business investment 40%
Wage freeze or reduction 37%
Raised prices 30%
Increase employee cost 30%
Reduced hours 17%
Took health tax credit 17%
Reduced non-health employee benefits 12%
Where do Employers go from here
Current ER Sponsored Group
Plans• High employer
engagement• Less employee
choice• Group based model• Single or limited
multi-carrier models• Employer subsidies
with Defined Benefit approach
Private Exchanges
• 3rd party or insurer host
• Insured or self insured
• Employer subsidizes through Defined Contribution
• Employer determined plan offering but less involved
Public Exchanges
• Governmental subsidies included
• Various attributes/types which differ by state model
• Employer has no control
• Insured individual products
Employer Involvement LowHigh
Advantages of Private Exchanges
Employer still maintains programs which helps attract and retain employees
Defined contribution model provides employees with fixed pre-tax dollar amount so that they choose how much to spend
Employer decides the defined contribution amount
Reduces Administration, eliminates paperwork
Allows Employer to set budget and control annual cost increases
Distances employer from plan design selection
Advantages (cont)
Promote employee choice, engagement, and consumerism.
Employees select plan designs that are customized to individual needs
Consumers are going to trade off benefits and consider
Higher deductibles
Less network flexibility
Create cost sharing
Ancillary products
Disadvantage Of Private exchanges
Does nothing to contain costs, future costs shift to employee
What does a Private Exchangelook like?
Employee Log In Main Page
Employee Open Enrollment – Employee Information
Employee Open Enrollment – Medical Selection
Employee Open Enrollment – Decision Support
Employee Open Enrollment – Decision Support
Employee Open Enrollment – Enrollment Summary
Overview of Public Exchanges
IRS/DOL/HHS prohibits employer arrangements that reimburse employees for individual insurance.
Must be integrated with group health coverage to comply with ACA
Rules apply to pre and post tax arrangements
Guidance does not prohibit increasing raises or salary
Increase can not be conditioned on obtaining individual coverage
Public Exchange, Employer no longer provides insurances
Compliance and administrative costs eliminated
John Smith
Employer ConcernsACA
Determining if they are an applicable large employer
Aggregation
Waiting Periods
6055/6056 reporting
Under 50 carrier responsibility
Over 50 employer must file 1094c/1095c
General Compliance
Summary plan documents
Premium only plan documents
Medicare Part D Notice
Marketplace Notice