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Solutions for a Superior Workplace
Health Care Reform
What are my options?
Presented by:
Patrick Pennefather, CLU, ChFC, CEBS, LUTCF
Client Manager
David Gangi
Account Executive
Solutions for a Superior Workplace
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Happening Right Now!
The United States Supreme Court
Ruling expected by the end of June, 2012
Potential Outcomes
 Entire law is unconstitutional: individual mandate is NOT severable
 Individual mandate is unconstitutional, but severable – all other PPACA
provisions remain the law to be implemented
 Entire law is constitutional
Regardless which outcome occurs: employers must
deal with massive changes in the industry.
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In Addition to the Supreme Court Ruling
Defining Full-Time Employees:
 PPACA currently defines full-time employees as working “30
hours per week”
 Impact on determination of “large employer” status and
corresponding coverage and penalty requirements
 Impact on future automatic enrollment requirements
 DOL Department of Treasury and HHS have asked for comments
on determining “full-time employees”
 Look back provision
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In Addition to the Supreme Court Ruling
We are one renewal away
from full implementation of
Health Care Reform
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Massive Changes for Employers
Now
2014 and Beyond

Health care obtained through employers

Health care obtained through employers,
government, and direct

Group coverage

Individual coverage is an option: employer,
state, free market

“Buy” insurance through employer

Buy insurance through exchanges (public
and private), and through employer

Coverage regulated by states, but
doesn’t apply to all plans

Federal government regulates coverage
levels and mandates affordability

No premium regulation

Mandate how much of premium must be
spent on medical care

No federal taxes or fees

Taxes/Fees

Employers regularly provide coverage

Employers have to decide whether to “pay or
play”
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What are my Options?
 The prudent course of action is to plan to implement
those changes
 However:
 Still anticipate a significant amount of future regulations
and/or guidance
 Difficult to predict what will be included
 Difficult to predict law changes
 Difficult to predict outcome of the US Supreme Court case
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What is the Best Strategy?
2014 Options
 Play by PPACA rules
 Play and reduce coverage
 Play and pay unaffordability penalty
 Pay and drop coverage
 Pay and increase salaries
 Pay geographically
 Pay via private exchanges
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What Employers Need to Do...
 All employers need to decide whether to “pay or play”
 Develop a solid multi-year health care strategy
 Re-evaluate frequently as landscape continues to change
 Employee communication is critical
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Solutions for a Superior Workplace
| Health Care Reform. What are the Options?
Questions???
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