December 11, 2013 - Part 3 in a series
Daniel Russell discusses Obamacare during a presentation at Fountains Golf and Banquet. Photo by Andrea Beaudoin (click for larger version)
Shannon Saksewski, from Detroit Regional Chamber and Daniel Russell from DEM Group LLC agree the Affordable Care Act, "Obamacare," has not been easy to understand for anyone, least of all businesses.
"Employers must also offer affordable coverage, which means health care costs must not exceed 9.5 percent of wages for the lowest paid employee of your company," said Russell during a presentation at Fountain's in Independence Township.
During the presentation, brought to Fountain's by the Clarkston Chamber of Commerce, Saksewski and Russell addressed many questions being asked by businesses.
"We are just trying to clarify and help move people and businesses through the process," said Sakewski.
Michigan's biggest insurer Blue Cross Blue Shield went from offering 650 plans down to just 48, Russell said adding that he is running into the smartest business owners and employees who are confused by the ACA.
Insurance Agent Mark Davis from Waterford said he come to the presentation because health care is a hot topic for his clients and he wants to keep up on all the changes.
Changes are being made daily to the ACA, Russell and Sakewski told the group.
"The biggest scare for employers is being compliant with the ACA," said Russell. "Business owners now feel they have to become experts at healthcare," he said.
Russell clarified what employers have to provide health care coverage and who does not.
"Employers with 50 employees or less do not have to provide health care coverage to employees, but companies with over 50 must provide coverage," he said.
However, under the new law which defines a full-time employee as working 30 or more hours per week or 130 hour per month, several part-time employees can add up to a full-time employee.
Russell explained although a company with under 50 employees do not have to get health care-their employees must. Employers with under 50 employees will not be penalized for not providing health care.
Small companies that have fewer than 50 employees and choose to offer health care coverage will be eligible for tax credits to help fund the costs.
Russell said many employers are hiring agents and are finding answers to questions they didn't even know existed, adding some employers are giving employees and increase in salary and telling them to take care of their insurance needs and find a plan themselves.
"This releases the employer responsibility," said Russell.
Despite all the problems with the ACA rollout, by January 1, 2014 employers must offer health care to employees.
Russell explained that the government has declared by January 1 everyone must sign up for insurance, but no penalties will be imposed until 2015.
After that if employers have not offered healthcare to employees, the fines are steep-$2,000 a year, per employee steep.
Russell said many employees assume that a full-time employee works 40 hours a week, but that's not how it works under the ACA.
Employers must offer affordable coverage, not exceeding 9.5 percent, of income but employees must pay the rest.
Then you have employers that value their employees and want to provide health care coverage.
Recently, employers were required to send a letter to employees regarding the health care changes set to roll out. The government said if they employers did not send out the letter they could get a fine. Although the government has not checked to see if employers followed through with sending the letter Russell said, "That does not mean the government can not say tomorrow every employer who did not send out a letter will be fined."
Employers must also decide what type, and the level of quality health care they want to provide.
Russell said employers are concerned with how their employees will react to any insurance changes. No one wants an angry employee that hates them, he said.
Employers have many issues to address including compliance with the ACA, how to purchase and obtain health care coverage, choosing what type of benefit plan to offer, deciding of benefit packages fit in with business strategies and what and how to tell employees about the changes that will occur.
Health care plans offered by employers must meet certain standards. An "adequate" plan meeting minimum standards must cover at least 60 percent of health care expenses.
Some other issues to be considered
-The spouse of a covered employee is not eligible for subsides if health care coverage is provided trough their spouses' employer.
-Individuals can choose to enroll in many ways from exploring the heath care marketplace or insurance plans themselves, going directly off the marketplace to a carrier or hire an agent or a broker. Small groups can also hire an agent or broker, shop on health care marketplace or go through a private exchange to explore and obtain coverage.
-Employees who have been offered health coverage through and employer may be better off sticking with that coverage because they are not eligible for a subsidy if they choose to seek coverage on their own.
For more information visit www.mihealthanswers.com. More on the ACA next week in part 4
Staff writer covering Independence Township and Clarkston area.