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Aca healthcare options for 2013 public by michael chapman 073113 slideshare
1.
What You Need
to Know NOW & How to prepare for 2014 • What You Need to Know • What You Need to Decide • When You Need to Act • Plus, How It Affects You, Your Job, and Your Employer What? When? Healthcare Options for 2013 And how to prepare for 2014 © 2013 Michael Chapman, GroupBenefitsAdvisors.com
2.
Disclaimer: • The information
presented is subject to change, and will likely change in the future. • Subscribe to TheMedicalInsuranceExchange.com newsletter or contact us for latestupdates. • The information presented should not to be construed as offering legal or tax advice; consult with a lawyer or tax professional. • Some state variations may occur, the information presented is based on the laws of Texas. What? When? Healthcare Options for 2013 © 2013 Michael Chapman, GroupBenefitsAdvisors.com
3.
My Qualifications: • Former
CEO • Since 2003, Frequent Public Speaker on Healthcare and Insurance. • Employee Benefits Broker for Companies and Individuals. • Published Author, Blogger. • Helpful, pro bono resource to thousands of individuals and companies in DFW with benefits-related questions and concerns. • Mike Chapman, mtchapman@endeavorgroup.net • Linkedin.com/in/michaelchapman (14,000+) • 214-764-6315 tel, 214-732-3691 cell © 2013 Michael Chapman, GroupBenefitsAdvisors.com Healthcare Options for 2013
4.
© 2013 Michael
Chapman, GroupBenefitsAdvisors.com My Dilemma Healthcare Options for 2013
5.
Door # 2: •
Plunge head first towards opportunities created from PPACA • Mike Chapman, mtchapman@endeavorgroup.net • Linkedin.com/in/michaelchapman • 214-764-6315 tel., 214-732-3691 cell © 2013 Michael Chapman, GroupBenefitsAdvisors.com Healthcare Options for 2013
6.
Healthcare Options for
2013 Best Healthcare Advice for Anyone: © 2013 Michael Chapman, GroupBenefitsAdvisors.com
7.
Healthcare Options for
2013 Best Healthcare Advice for Anyone: • Stay Healthy • Don‟t Get Injured © 2013 Michael Chapman, GroupBenefitsAdvisors.com
8.
Healthcare Options for
2013 2nd-Best Healthcare Advice for Anyone: © 2013 Michael Chapman, GroupBenefitsAdvisors.com
9.
Healthcare Options for
2013 2nd-Best Healthcare Advice for Anyone: • Die Quickly • Die In Your Sleep! • Over 80% of lifetime healthcare expenses occur in last 18 months of life. • Medical is Leading Cause of Bankruptcies © 2013 Michael Chapman, GroupBenefitsAdvisors.com
10.
Healthcare Options for
2013 We Don‟t Get to Choose If, When, or How We Get Sick, Injured or© 2013 Michael Chapman, GroupBenefitsAdvisors.com
11.
Healthcare Options for
2013 The Choices We Make Determines How Much We Have to Spend If and When We Get Sick, Injured or Die © 2013 Michael Chapman, GroupBenefitsAdvisors.com
12.
Healthcare Options for
2013 A Healthy, “Hazard-Free „Lifestyle Reduces How Much We‟ll Eventually Pay When We Get Sick, Injured and Die, and Increases the Length and Quality of Life © 2013 Michael Chapman, GroupBenefitsAdvisors.com
13.
Healthcare Options for
2013 Insurance pools the $$ Risk of Sickness Accident, and Death © 2013 Michael Chapman, GroupBenefitsAdvisors.com
14.
Healthcare Options for
2013 Healthcare is Expensive • 30-35% of US GDP • For many families, #1 or 2 budget item. • For many Businesses, #2 Overhead item after salaries • High, uncontrollable inflation. © 2013 Michael Chapman, GroupBenefitsAdvisors.com
15.
Healthcare Options for
2013 Pre-2014 Options: • COBRA • Private Insurance • “Risk Pool” • VA/Tricare (Veterans/Active Duty) • Medicare (65+) • Medicaid/CHIP (Children) • Self-Insure © 2013 Michael Chapman, GroupBenefitsAdvisors.com
16.
Healthcare Options for
2013 Pre-2014 Options: • COBRA/State Continuation • Same plan, same $ as employer • 18 months/6 months • No exclusion of health conditions • Must elect within 60 days © 2013 Michael Chapman, GroupBenefitsAdvisors.com
17.
Healthcare Options for
2013 Pre-2014 Options: • Private Insurance • Can exclude conditions, increase rates based on health conditions during underwriting. © 2013 Michael Chapman, GroupBenefitsAdvisors.com
18.
Healthcare Options for
2013 Underwriting: • Evaluation of Risk of claims • Conditions • Age • Gender • Residence © 2013 Michael Chapman, GroupBenefitsAdvisors.com
19.
Healthcare Options for
2013 Pre-2014 Options: • Group Insurance • Guaranteed Issue • Same cost for every employee • Individual Insurance • Individually Underwritten © 2013 Michael Chapman, GroupBenefitsAdvisors.com
20.
Healthcare Options for
2013 Pre-2014 Options: • Individual Insurance • Individually Underwritten • Insuring a healthy, younger, male with no health conditions is less risk of a claim, so they will pay less for insurance. • Can reduce cost vs. COBRA by up to 60% © 2013 Michael Chapman, GroupBenefitsAdvisors.com
21.
Healthcare Options for
2013 Pre-2014 Options: • Individual Insurance • Short term plans • 0-6 months of coverage. • Easy, short application. • “Permanent” plans • Stay in force as long as you pay premium. • Lengthy application/underwriting. • Short term and permanent are both major medical plans. © 2013 Michael Chapman, GroupBenefitsAdvisors.com
22.
Healthcare Options for
2013 Pre-2014 Options: • “Risk Pool” • Option after COBRA and if either spouse is not eligible for group plan. • Covers individuals who are ineligible or excluded individual insurance because of health condition. © 2013 Michael Chapman, GroupBenefitsAdvisors.com
23.
Healthcare Options for
2013 Pre-2014 Options: • Medicare • Guaranteed issue coverage at age 65, can apply at 64 ½ • A+B+D plus medicare supplement or Medicare Advantage (HMO) plan in some areas. • Limitation of healthcare providers who accept. © 2013 Michael Chapman, GroupBenefitsAdvisors.com
24.
Healthcare Options for
2013 Pre-2014 Options: • Medicaid/CHIP (Children) • Children 0-18 • Income/Asset qualify • Waiting list • HMO • Affordable © 2013 Michael Chapman, GroupBenefitsAdvisors.com
25.
Healthcare Options for
2013 Pre-2014 Options: • Self-Insure • You assume risk of sickness/injury • Includes public health programs such as Parkland and John Peter Smith in DFW © 2013 Michael Chapman, GroupBenefitsAdvisors.com
26.
Whether you yet
know it or not… …ACA Impacts EVERYTHING • Every American faces healthcare decisions Beginning 10/1/2013 for 2014. • Every Business faces similar decisions in 2014 What? What? When? © 2013 Michael Chapman, GroupBenefitsAdvisors.com Healthcare Options for 2014
27.
When Must I
Make A Decision? • Huge Advertising Campaign. • Exchanges Open October 1, 2013 • ACA Coverage Begins January 1. • Best Time To Make A Decision is NOW! © 2013 Michael Chapman, GroupBenefitsAdvisors.com What? When ? Healthcare Options for 2014
28.
The Obamacare Clock Is
Ticking.. …The Sooner You Know WHAT to Do …The Longer You‟ll Have to Adjust! © 2013 Michael Chapman, GroupBenefitsAdvisors.com Healthcare Options for 2014
29.
Change = Opportunities © 2013
Michael Chapman, GroupBenefitsAdvisors.com Use Knowledge of Obamacare as Your Secret Advantage. Healthcare Options for 2014
30.
Brief Overview of
What it Is • Coverage Differences • How You Buy It • What It Costs You • Consequences to You and Employer © 2013 Michael Chapman, GroupBenefitsAdvisors.com What? When ? Healthcare Options for 2014
31.
Your Health Plan
will be Different © 2013 Michael Chapman, GroupBenefitsAdvisors.com 2013 2014 Healthcare Options for 2014
32.
© 2013 Michael
Chapman, GroupBenefitsAdvisors.com 98% of Today‟s Health Plans Will Be Replaced Just Kidding! Healthcare Options for 2014
33.
Some of the
Big Plan Differences: © 2013 Michael Chapman, GroupBenefitsAdvisors.com • Different Deductibles – • Max $2,000 Deductible. • $3,500 Max Out of Pocket. • “Guaranteed Issue,” Regardless of Your Health. • More Coverage, Examples: • Maternity Coverage, Dental Checkups to Age 6 Healthcare Options for 2014
34.
More Big Plan
Differences: © 2013 Michael Chapman, GroupBenefitsAdvisors.com • Guaranteed issue, No “Rate Ups” for Risk or Conditions • Except May Charge 50% More for Smoking • May Offer Discount for Wellness Plan Participation • 3 vs. 6 Age Bands • Community Rating. Healthcare Options for 2014
35.
Buzz Word: Essential
Benefits © 2013 Michael Chapman, GroupBenefitsAdvisors.com • Ambulatory patient services • Emergency services • Hospitalization • Maternity and newborn care • Mental health and substance use disorder services, including behavioral health treatment • Prescription drugs Healthcare Options for 2014
36.
Essential Benefits, continued: ©
2013 Michael Chapman, GroupBenefitsAdvisors.com • Rehabilitative and habilitative services and devices • Laboratory services • Preventive and wellness services; chronic disease management • Pediatric services, including oral and vision care Healthcare Options for 2014
37.
Essential Benefits, continued: ©
2013 Michael Chapman, GroupBenefitsAdvisors.com • Items or services that have an „A‟ or „B‟ rating • Immunizations for routine use in children, adolescents, & adults • Evidence‐informed preventive care and screenings • No cost sharing for preventive care services (in‐network) Healthcare Options for 2014
38.
Buzz Word: Actuarial
Value © 2013 Michael Chapman, GroupBenefitsAdvisors.com • Bronze plans = 60% of minimum of cost of healthcare • Silver plans = 70% of minimum of cost of healthcare • Gold plans = 80% of minimum of cost of healthcare • Platinum plans = 90% of minimum of cost of healthcare Healthcare Options for 2014
39.
Your Premiums Will
Be Different: © 2013 Michael Chapman, GroupBenefitsAdvisors.com 2013: $$$ 2014: ??? Healthcare Options for 2014
40.
Anybody Want to Guess
the Biggest Factor Whether You‟ll Pay More or Less? © 2013 Michael Chapman, GroupBenefitsAdvisors.com Healthcare Options for 2014
41.
How Much You
Earn! © 2013 Michael Chapman, GroupBenefitsAdvisors.com Healthcare Options for 2014
42.
Eligibility for Government
Subsidy Family of 4 Income Level Percent of Poverty Level Individual Can Get Coverage In: Government Subsidies Above $88,200 Above 400% Federal or State Health Ins Exchange No $88,200 400% Federal or State Health Ins Exchange Yes $29,327 $22,050 $0 133% 100% 0% Medicaid Yes © 2013 Michael Chapman, GroupBenefitsAdvisors.com Healthcare Options for 2014
43.
1. How Do
Find Out if I Qualify for a Subsidy for Obamacare? © 2013 Michael Chapman, GroupBenefitsAdvisors.com 2. Am I Sure I Really Want a Subsidy? 3. What‟s The Penalty If Uninsured? Healthcare Options for 2014
44.
Tax Credit or
Subsidy • Subsidies Only Available through Public and Private Exchanges. • Employee+ Dependents NOT ELIGIBLE for a Subsidy If: © 2013 Michael Chapman, GroupBenefitsAdvisors.com • The employer offers at least the actuarial equivalent of the Bronze Plan (60%) • The employee cost share is not more than 9.5% of their annual income (W‐2 Employee) (AGI) Healthcare Options for 2014
45.
Tax Credit or
Subsidy • If employer offers health insurance for employees, employee cannot apply for subsidy for themselves or for their dependents. • This means employee must purchase high cost, unsubsidized insurance for dependents or pay a tax penalty if they are uninsured. © 2013 Michael Chapman, GroupBenefitsAdvisors.com Healthcare Options for 2014
46.
© 2013 Michael
Chapman, GroupBenefitsAdvisors.com Subsidy Calculator: Healthcare Options for 2014
47.
Go to: http://TheMedicalInsuranceExchange.com/ obamacare-subsidy-calculator/ or http://goo.gl/LbldeU For
Subsidy Estimates © 2013 Michael Chapman, GroupBenefitsAdvisors.com Healthcare Options for 2014
48.
Go to: http://themedicalinsuranceexchange.com/apply- here-for-obamacare-subsidy-and-health-insurance/ or http://goo.gl/7QAx5y For
Final Draft Copy of ACA Paper Applications © 2013 Michael Chapman, GroupBenefitsAdvisors.com Healthcare Options for 2014
49.
If your Adjusted
Gross Income ends up exceeding your estimate, the IRS will assess and take back your subsidy. © 2013 Michael Chapman, GroupBenefitsAdvisors.com The IRS Giveth and Taketh Away: Examples: • Job Seekers • Y.E. Bonus • Unexpected Income Healthcare Options for 2014
50.
Where You‟ll Buy: ©
2013 Michael Chapman, GroupBenefitsAdvisors.com Employer Exchange • Employer • Federal or State Exchanges (Federal Only in TX) • Private Exchanges • 2015: SHOP for small biz (< 25) Healthcare Options for 2014
51.
Public Insurance Exchanges: ©
2013 Michael Chapman, GroupBenefitsAdvisors.com • State Run (23 states + DC) • Federal Exchange (26 states, including Texas) Healthcare Options for 2014
52.
“Pre-2014” Health Insurance
Transaction When? Healthcare Costs © 2013 Michael Chapman, GroupBenefitsAdvisors.com You and/or Your Employer Insurance Company Insurance Policy $$, Health Information Healthcare Options for 2014
53.
2014 Exchange Transaction What? Healthcare
Costs © 2013 Michael Chapman, GroupBenefitsAdvisors.com You and/or Your Employer Insurance Company Healthcare Options for 2014
54.
2014 Exchange Transaction What? Healthcare
Costs © 2013 Michael Chapman, GroupBenefitsAdvisors.com You and/or Your Employer Insurance Company Healthcare Options for 2014
55.
2014 Exchange Transaction What? Healthcare
Costs © 2013 Michael Chapman, GroupBenefitsAdvisors.com You and/or Your Employer Insurance Company $$ Premium Payment Health Insurance Policy Healthcare Options for 2014
56.
Where: © 2013 Michael
Chapman, GroupBenefitsAdvisors.com Marketplace.CMS.Gov Healthcare Options for 2014
57.
Downside of Public
Exchanges: • Self-serve, with little to no support • Expect LONGGGGGG Wait Times, • WRONGGGGG Answers. Healthcare Options for 2014 © 2013 Michael Chapman, GroupBenefitsAdvisors.com
58.
Downside of Public
Exchanges: • Inexperienced, minimally trained “Navigators” and “Assistors” • Navigator grant money awarded to organizations favoring Administration Healthcare Options for 2014 © 2013 Michael Chapman, GroupBenefitsAdvisors.com
59.
Downside of “Public
Exchanges” • Do you really want to share your personal health & tax information? Healthcare Options for 2014 © 2013 Michael Chapman, GroupBenefitsAdvisors.com
60.
Downside of “Public
Exchanges” • No support or assistance after purchase. Healthcare Options for 2014 © 2013 Michael Chapman, GroupBenefitsAdvisors.com
61.
What is a
“Private Exchange”?• Multiple carrier venue for insurance policies • Not just health insurance • Run by Experienced, Trained, Licensed Agents Healthcare Options for 2014 © 2013 Michael Chapman, GroupBenefitsAdvisors.com
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Example of Private Exchange: ©
2013 Michael Chapman, GroupBenefitsAdvisors.com TheMedicalInsuranceExchange.com Healthcare Options for 2014
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© 2013 Michael
Chapman, GroupBenefitsAdvisors.com • Out of pocket max greater than $3,500. • You don‟t have guaranteed issue or maternity coverage now. • You‟re younger than age 35 (approx.) • You live in an area with high healthcare utilization. • Your employer decreases contribution or drops group plan. You May Pay More in Premiums If in 2013: Healthcare Options for 2014
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You May Pay
Less in Premiums If in 2013: © 2013 Michael Chapman, GroupBenefitsAdvisors.com • Out of pocket max now less than $3,500. • You have guaranteed issue coverage (Risk Pool). • You‟re older than age 50 (approx.) • You live in an area with low healthcare utilization. • Your employer maintains/increases health plan contribution or improves health plan. Healthcare Options for 2014
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• 2014: $95
per Adult, $47.50 per Child up to $285 per family or 1% of income. © 2013 Michael Chapman, GroupBenefitsAdvisors.com Individual Tax Penalty If Uninsured: • 2015: $325 per Adult, $162.50 per Child up to $975 per family or 2% of income. • 2016: $695 per Adult, $347.50 per Child up to $2085 per family or 2.5% of income. Healthcare Options for 2014
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Your Choices: © 2013
Michael Chapman, GroupBenefitsAdvisors.com COBRA Private/Public Exchange Insurance Short-term plan + Tax Penalty Healthcare Options for 2014
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Whatever You Choose,
You‟ll Pay More: © 2013 Michael Chapman, GroupBenefitsAdvisors.com Taxes Goods & Services New Federal Tax on Insurer Premiums, 3.8% Tax on Unearned Income, dividend taxes. Healthcare Options for 2014
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Impact On Seniors: ©
2013 Michael Chapman, GroupBenefitsAdvisors.com • Harder to find doctors who accept Medicare (25% pay cut) • Gradual Closing of Donut Hole • Reduction In Medicare Budget • Likely: Medicare Premiums Based on Assets and Income Healthcare Options for 2014
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Employer Impact © 2013
Michael Chapman, GroupBenefitsAdvisors.com Healthcare Options for 2014
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Employer Penalties (delayed): ©
2013 Michael Chapman, GroupBenefitsAdvisors.com • $2,000 per Employee over 30 FTEs if Group Ins. or if no Essential Benefits • $3,000 per Employee that does not enroll in Employer‟s plan because it costs employee more than 9.5% of income or plan does not meet Bronze level. Healthcare Options for 2014
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Certain Industry Sectors
Will Get Hammered: • Staffing • Seasonal • Hospitality • Retail © 2013 Michael Chapman, GroupBenefitsAdvisors.com Healthcare Options for 2014
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Employer Impact © 2013
Michael Chapman, GroupBenefitsAdvisors.com Healthcare Options for 2014 • Increased cost, taxes and regulations/red tape for all businesses. • Employer tax penalties delayed until 2015 (50+ full time employees) • Uncertainty impacting permanent, full-time employment.
73.
Employer Impact © 2013
Michael Chapman, GroupBenefitsAdvisors.com Healthcare Options for 2014 • Increase in part-time employment. • Fewer employers will offer health insurance as an employee benefit. • Fewer employees will want an employer to offer health insurance so they can qualify for a subsidy for their whole family.
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In Many Cases,
It Benefits Employer to Drop Group Health Ins. Coverage © 2013 Michael Chapman, GroupBenefitsAdvisors.com Healthcare Options for 2014 • Cost of Tax Penalty for 50+ Employees Is Less than Health Insurance and is a Fixed Cost.
75.
In Many Cases,
It Benefits Employee for Employer to Drop Group Health Ins. Coverage © 2013 Michael Chapman, GroupBenefitsAdvisors.com Healthcare Options for 2014 • Subsidized Cost of Health Insurance for Employee + Dependents May Be Less for Employee than Employee Cost of Health Insurance for Employee Only
76.
In Many Cases,
It Benefits Employee for Employer to Drop Group Health Ins. Coverage © 2013 Michael Chapman, GroupBenefitsAdvisors.com Healthcare Options for 2014 • For Lower Wage Employees, Its Like Getting Dependents‟ Insurance for FREE!
77.
At This Point,
Which Are You? © 2013 Michael Chapman, GroupBenefitsAdvisors.com Dazed & Confused Bored Zombie Healthcare Options for 2014
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My Unique Solutions: ©
2013 Michael Chapman, GroupBenefitsAdvisors.com • Education, Expertise, Year-Round Service. • TheMedicalInsuranceExchange.com, a Private Health Insurance Exchange • Employer consultation • Partially Self-Funded Plans for employers Healthcare Options for 2014
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The Obamacare Clock Is
Ticking.. • Advertising for Fed. Exchanges Has Begun • Open Enrollment begins October, go to TheMedicalInsuranceExchange.com • You need to educate others what to do. © 2013 Michael Chapman, GroupBenefitsAdvisors.com Healthcare Options for 2014
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Decision-making Is Like Constipation ©
2013 Michael Chapman, GroupBenefitsAdvisors.com Taxes, Penalties, Higher Expenses, STRESS, Etc. …The Longer You Wait, the Worse It Gets Healthcare Options for 2014
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How I Help
Employers • Consulting expertise • Rapid assessment of options & impact • Educate top management • Develop plan of action • Employee education is critical for success. © 2013 Michael Chapman, GroupBenefitsAdvisors.com Healthcare Options for 2014
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© 2013 Michael
Chapman, GroupBenefitsAdvisors.com ACA Open Enrollment Preparation: “Black Tuesday”: October 1st, 61 Days Away • Schedule an appointment now for beginning October 1st. • Write down your Family SS #s, Dates of Birth. • If Insured, Make Copy of Your Insurance Card and Bill. • Go to http://TheMedicalInsuranceExchange.com/obamacare- subsidy-calculator or http://goo.gl/LbldeU; Print out an estimate of your subsidy. Healthcare Options for 2014
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© 2013 Michael
Chapman, GroupBenefitsAdvisors.com ACA Open Enrollment Preparation: • Subscribe to http://www.TheMedicalInsuranceExchange.com for updates and information as it becomes available. • Find a good PCP ASAP! Healthcare Options for 2014
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© 2013 Michael
Chapman, GroupBenefitsAdvisors.com If You‟re An Employer or Work for One: • Whether or not your employer offers health ins., An Employer Has An Obligation and Opportunity to Communicate ACA to Employees. • Schedule Me for an Employee Group Meeting • Schedule Me to Visit with Owner/CFO/CEO Healthcare Options for 2014
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How You Can
Help Me • Refer me to companies that need advice. • What Business Leadership Groups Could Use a Subject Matter Expert Speaker? • Bookmark/Share: TheMedicalInsuranceExchange.com © 2013 Michael Chapman, GroupBenefitsAdvisors.com How You Can Help Yourself & Your Company • Share This Information ASAP • ACT on This Information ASAP Healthcare Options for 2014
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© 2013 Michael
Chapman, GroupBenefitsAdvisors.com Remember: Use Your New Knowledge of Obamacare as Your Healthcare Advantage. (Know enough to raise the questions, then, “I know a guy…” Healthcare Options for 2014
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Please Comment/Forward Share/Like: • http://TheMedicalInsuranceExchange.com •
Facebook: • YouTube Channel: ObamacareInformation • LinkedIn.com/in/michaelchapman © 2013 Michael Chapman, GroupBenefitsAdvisors.com • Subscribe, Sign Up for Updates, Upcoming Presentation Schedule and Webinars! Healthcare Options for 2014
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