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The Affordable Care Act

The Affordable Care Act. Can Employers Afford It?. • Jason Altmire, Senior Vice President, Florida Blue

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The Affordable Care Act

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  1. The Affordable Care Act Can Employers Afford It?

  2. • Jason Altmire, Senior Vice President, Florida Blue • Jason is a former three term US Congressman who was a key participant in the debate on healthcare reform. He is currently responsible for public policy, government and community affairs at Florida Blue. • • Randy Jouben, Director Risk Management, • FIVE GUYS Enterprises, LLC • Randy is responsible for leading the mission of protecting the tangible and intangible assets of Five Guys in the areas of risk management, safety, security, business continuity and compliance. • Chris Williams, 2nd Vice President, TravelersChris is responsible for fiduciary underwriting strategy, marketing, training, and consultation on complex fiduciary accounts. In this capacity, Chris has a deep understanding of the ACA and its exposures to ensure that he is properly training underwriters on the ACA and its related risks.

  3. What to Expect • Develop an understanding of legislative accommodations made to ensure enactment of ACA, and the impact thereof. • Illustrate the Potential Benefits to Employers of the ACA. • Recognize ACA litigation exposures, penalty exposures, and mitigation techniques.

  4. Do Employers Understand Their Risks? • What Percentage of Employers are not at all or not very familiar with the overall requirements of the ACA? • a. 10% • b. 23% • c. 36% • d. 42%

  5. Employers Obligation Under the ACA • For 2015, employers with more than 100 employees who do not to provide health insurance coverage to 70% of their full time employees (those working more than 30 hours per week) may be subjected to the following penalty: • (Number of Full Time Employees – 80) x $2000. • For 2016: • The employee threshold is reduced to 50 from 100 • The percentage increases to 95% from 70% • The penalty is calculated using the following formula: • (Number of Full Time Employees – 30) x $2000.

  6. Potential ACA Fiduciary Litigation Exposures • Section 510 of ERISA prohibits discrimination or discharge of a participant solely for the purpose of interfering with the attainment of a benefit right under a plan. • Reduction in Hours • Misclassification of Employees as Independent Contractors • Wrongful Termination

  7. Do Employers Understand Their Risks? • Of those employers that are familiar with the ACA’s mandate, what percentage are concerned about employee lawsuits? • a. 5% • b. 17% • c. 31% • d. 45%

  8. ACA Penalty Exposures Are Real • -Section 1104 of the PPACA requires health plans to file a statement with the Secretary of Health and Human Services certifying data and information systems are in compliance with applicable standards. A $1 per covered life penalty may be imposed until certification is complete. • -Section 1511 requires employers with more than 200 employees to automatically enroll their employees in health insurance. The penalty amount has not yet been determined. • -Section 1514 of the ACA requires large employers (50 or more) to report to the Secretary of Health and Human Services whether full time employees are offered minimum essential coverage. A $100 per person penalty is imposed for the failure to file information regarding health insurance coverage.

  9. Getting Prepared: Mitigation Techniques • Develop Understanding of Requirements under ACA. • Consult outside counsel prior to changes in employment structure. • Talk to an independent agent to consider risk transfer mechanisms and options.

  10. Questions, Final Comments and Contact Information Thank You for Joining us Today!

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