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How will it Impact You?healthcare_bannerFROMsanders.senate.gov

Beginning October 1, 2013 the healthcare exchange program is scheduled to be available to individuals and employers to help search for group coverage across multiple carriers.  Although most individuals and large businesses have been managing their health insurance coverage for some time, this has a potentially large impact on the small business owner with less than 50 employees. While we wait to see what types of plans are available and the cost associated, here are some key points for small business owners:

  • Employers with fewer than 50 full-time equivalent employees are NOT required to provide health insurance for employees.
  • Employer tax credits are available through the exchange if a small business meets the following criteria:
    • 25 or fewer full-time equivalent employees who are paid an average annual salary of less than 50k.
    • 10 or fewer full-time equivalent employees paying an annual wage of 25k or less.
    • To qualify for the tax credit the employer must also contribute at least 50% towards the employees premium cost.

In addition, there are also some major changes related to the actual how benefit plans are structured.  Below are the most significant of those changes related to small group plans:

  • New reform rule will limit benefit waiting periods to 90 days
  • Plan Deductibles may not exceed $2,000 (individual) or $4,000 (family)
  • Pre-existing condition exclusions must be removed from all plans
  • New rating structures will be implemented which eliminates traditional age bands and creates three new bands:
    • Children (ages 0-20)
    • Adult (ages 21-63)
    • Older Adult (age 64 and older)

We will continue to share more information as it becomes available and have resources on hand to assist both individuals and businesses who have questions regarding health insurance.