Smart Benefits: Next Steps in Healthcare Reform for Employers
Monday, January 13, 2014
While many employers enjoyed a temporary reprieve thanks to delays of some rules, 2015 is just around the corner and the first of four important requirements will kick in then. And the time to prepare is now.
1. 30 is the new 40
Starting in 2015, large employers will face penalties if they don't offer coverage to employees who average 30 or more hours per week. That means, if employers previously only covered employees who worked 40 hours, they will likely have to incur the cost of covering more employees. And if they can't afford to offer coverage to more employees? They may have to cut back workers' hours and risk losing valuable employees.
2. Pay or Play
Not only must large employers offer coverage to employees who average 30 or more hours per week or face penalties, it must be affordable, minimum plan value coverage. If minimum essential coverage is not offered to at least 95% of full-time employees and children to age 26, employers will pay a penalty based on the number
of full-time employees. So, for example, 30 employees x $166.67 month. If coverage is offered but it's unaffordable or below minimum value, the penalty is $250 per month for each full-time employee who gets a premium credit subsidy through a healthcare exchange.
3. IRS Reporting Kicks In
In 2016, insurers will need to report information on minimum essential coverage it provides and covered individuals, while large employers subject to the pay or play rules must report on its affordable, minimum plan value coverage offered to full-time employees. Penalties for both are $50 per failure.
4. Cadillac Tax
Effective January 1, 2018, large and small employers will pay an excise tax if the total cost of medical benefits (including employer and employee contributions) exceeds $10,200 for single plans or $27,500 for family plans. This is indexed for
medical, HRA and Section 125 plans (pre-tax and FSA). The penalty is steep: a 40% non-deductible excise tax on the value of the benefits. Employers will need to determine if their plan designs falls below the threshold and, if not, they should consider plan design changes to avoid the tax -- sooner versus later.
Related Slideshow: 13 Biggest Healthcare Stories in RI in 2013
The most import stories from one of the most historic years in memory for Rhode Island healthcare.
13 Doctors Behaving Badly
Rhode Island Doctors Behaving Badly
Doctors, having professed in their professional lives to "do no harm," are typically looked at in their personal lives as upstanding citizens. But 2013 proved that not all doctors are cut from the same cloth.
With charges ranging from unprofessional behavior in the office to giving morphine to babies to breaking into a residence without permission at 3 in the morning and being in possession of marijuana, this breakdown of reprimanded doctors in 2013 is simply a must see.
12 Staying Healthy + Fit
10 Ways To Stay Healthy + Fit This Summer—Miriam Experts
Summer brings soaring temperatures, family cookouts and tempting warm-weather treats like ice cream and margaritas, and can easily sabotage your fitness and diet plans. That’s why leading nutrition and exercise experts at The Miriam Hospital shared their timeless top tips for staying fit and eating healthy while still having fun in the sun.
Summer fitness never goes out of style. Click here for tips you can use every year to maintain that beach body!
11 Well-Being Index
How Happy Is Rhode Island—Latest Gallup Well-Being Index
Rhode Island may need an attitude adjustment, according to the latest Well-Being Index numbers from Gallup-Healthways. The state's latest ranking for happiness is #37 in the nation, a drop of 2 spots from last year. And that ranking was a drop from the year before.
10 Retail Insurance
Smart Benefits: Health Insurers Go Retail
Healthcare reform has brought about lots of changes to the procurement of individual and family plans. Now, when you head to the mall, you'll be able to buy health insurance in addition to shopping for clothes. In a move that continues to gain steady momentum, leading health insurers across the country are opening retail stores to cater to individuals who now have to purchase health insurance on their own because of healthcare reform.
9 A Healthier You in 2013
13 Ways To Be Healthier in RI in 2013
As we embarked on 2013, Rhode Island's Director of Health, Michael Fine, MD, encouraged Rhode Islanders to make health and wellness a priority in the new year. Check out the 13 steps he recommended Rhode Islanders take to get and stay well in the new year. Whether you stuck to them or not in 2013, we find ourselves at another time for goal-setting and resolutions. Brush up on your healthy living and put your knowledge to good use in 2014!
8 RI’s Sexual Health
Rhode Island’s Sexual Health Worst In New England—New Ranking
Rhode Island's abysmal showing in the 2013 Sexual Health Rankings landed them at last place in New England.
The first-ever assessment of state-by-state data on 26 comprehensive health and services measures that speak to sexual health put the Ocean State at #19 overall in the US, and #6 among New England states.
7 Deloitte's Big Contract
Deloitte Awarded $105 Million Contract to Create New Healthcare System
Last January, Governor Lincoln Chafee announced that the State had awarded a $105 million contract to Deloitte Consulting to create the technology infrastructure to modernize the way the state administers Medicaid and other human service programs, and, most importantly, to create Rhode Island’s Health Benefits Exchange in compliance with the Affordable Care Act. Do you think Deloitte was the right choice? Read on for a breakdown of why Deloitte was chosen and the outlook on the exchange - who's rollout was not without its hiccups - while it was in just the conception phase.
6 Non-Profit Hospital CEO
Rhode Island Non-Profit Hospital CEOs Criticized For Big Paychecks
The American healthcare system may be quite deathly ill. But the paychecks CEOs of Rhode Island non-profit hospitals are quite healthy.
Because of the trend of for-profit chains buying non-profit hospitals, which has swept the nation over the last decade or so, only eight non-profit hospital groups remain in the Ocean State. Together, they control a total of 11 hospitals.
And you won't believe how handsomely the CEOs of these hospitals are paid.
5 Healthiest Counties
Rankings: Where the Healthiest Rhode Islanders Live
Where do the healthiest residents in Rhode Island live? According to 2013 rankings by the Robert Wood Johnson Foundation, a national foundation focused on improving public health, Bristol County took top honors -- while Providence County was the bottom of the list of the five counties in the state.
4 Health Exchange Rebrand
Rhode Island’s First Health Benefits Exchange Launches
In July, The Rhode Island Health Benefits Exchange announced a number of important updates and initiatives – including a new name and the creation of 70-100 new jobs – in preparation to enroll Rhode Islanders in quality affordable health insurance plans starting on October 1, 2013.
Dubbing the Health Exchange HealthSource RI and announcing the state's new contact center in Providence, the exchange announced it would employ 70-100 Rhode Islanders when fully operational who would be accessible to individuals and small employers to talk in-person or over the phone with engagement specialists who would provide personalized assistance in finding, comparing, and purchasing health insurance options available through HealthSource RI.
3 Heart Health
RI’s Go Red Day 2013: 10 Ways Women Can Keep Their Hearts Healthy
According to the AHA, nearly half of American women do not know that heart disease is their No. 1 killer, and less than half know the best blood pressure and cholesterol levels for cardiovascular health. Making red visible on Mondays could help sound the alarm and keep heart health ever present in the lives of American women.
2 Health Exchange Launch
Healthsource RI Announces Health Benefits Exchange Rates
In late August, HealthSource RI announced the plans and rates that were to be offered through the state's health benefits exchange when open enrollment began on October 1 for individuals and small businesses. Blue Cross & Blue Shield of Rhode Island, United HealthCare, and Neighborhood Health Plan of Rhode Island all signed on to offer 28 plans through the exchange.
The exchange launched on October 1st with no shortage of hiccups, but the launch was relatively smooth by comparison to those in states whose exchanges were facilitated federally. By November, the exchange had processed over 4500 applicants. And by December the New York Times noted that the RI exchange was the second-best performing in the country with enrollment exceeding target rates by a sizeable margin.
1 Patients Rank Hospitals
New England’s Best Hospitals Rated By Patients
Traditionally, hospitals are rated and ranked on a combination of sound technical care, adequate resources, and impressive statistics. But an increasing emphasis is being placed on perhaps one of the more important measures: the patient’s perspective. With that in mind, GoLocal has sifted through and analyzed the results from a government-sponsored survey of more than 50,000 patients in 176 hospitals in New England (full chart here), and emerged with the first-ever patient-based ranking of the region’s top hospitals.
GoLocal consulted with patients, experts, and hospital administrators for their take to contextualize the rankings- click here to read the story.
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