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USA Benefits Group
“The State of Health Insurance”
• Patient Protection and Affordable Care Act
aka: Obama Care
Tom Koanui
541-914-8441
Shonna Butler
541-357-8751
• The information given within this presentation is
accurate as of May 2013 and comes directly from
the Cover Oregon Public Exchange. It is subject
to change.
• Note that ACA details shared informally by word
of mouth may not represent the state of Oregon.
A number of states around the country are
defaulting to the Federal Exchange program or
choosing the Co-op Exchange format.
Disclosure
Tom Koanui
541-914-8441
Shonna Butler
541-357-8751
Patient Protection Affordable Care Act
Changes for January 01, 2014
• All individuals MUST have M.E.C. (Minimum Essential
Coverage).
• Guaranteed acceptance
• No pre-existing condition exemptions
• NO RATING for health, gender, build & industry
• Essential Health Benefits as defined by program
• Metallic Levels: Bronze- Silver- Gold- Platinum
Tom Koanui
541-914-8441
Shonna Butler
541-357-8751
Affordable Care Act – Small Employers
Small Employers of <50 Employees:
• Employer is NOT required to provide group insurance in
2014
• NO tax penalty will be assessed to employers if group
insurance is not provided in 2014 or 2015
• A 35% to 50% tax credit will be available to employers
through 2015 who DO offer group insurance
• Metallic Plans currently available to employer:
Bronze, Silver, and Gold
Tom Koanui
541-914-8441
Shonna Butler
541-357-8751
• Oregon Zip Code
• 2-50* Employees
• Pay at least 50% of
employee only premiums
• At least 75% participation
*2016 up to 100 employees
2017 over 100 employees
• Have less than 25 FTEs (full-
time equivalent)
• Have average income of less
than $50K
• Contribute at least 50% of
employee only premiums
*Federal small business tax
credits for 2-yrs (2014 & 2015)
Small Employer Program
Requirements
To Qualify for Tax Credits:*To Shop Through Cover Oregon:
Tom Koanui
541-914-8441
Shonna Butler
541-357-8751
Four Options for Employers
• Option 1: Employer chooses plan and carrier
• Option 2: Employer chooses carrier but
employee chooses plan
• Option 3: Employer chooses plan but
employee chooses carrier
• Option 4: Employee chooses both plan and
carrier
Tom Koanui
541-914-8441
Shonna Butler
541-357-8751
Tom Koanui
541-914-8441
Shonna Butler
541-357-8751
Oregon Exchange Plan Design
Platinum Plan details are not yet available
Tom Koanui
541-914-8441
Shonna Butler
541-357-8751
Tom Koanui
541-914-8441
Shonna Butler
541-357-8751
Platinum Plan details are not yet available
Exchange Prescription Drug Plan
Tom Koanui
541-914-8441
Shonna Butler
541-357-8751
Platinum Plan details are not yet available
How the Exchange Will Work
Now What?
This is a confusing new health care act.
We would enjoy speaking with you and your organization about the
changes happening through the Oregon Exchange and what it means
for you and your company.
Please contact Shonna at: 541-357-8751 or Tom at: 541-914-8441 to
set up an appointment to discuss your health care options in greater
detail.
Thank you for your time and attention!
Where there is no vision the people perish, but he that keeps the law, happy is he. Proverbs 29:18
Tom Koanui
541-914-8441
Shonna Butler
541-357-8751

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ACA changes for small employers

  • 1. USA Benefits Group “The State of Health Insurance” • Patient Protection and Affordable Care Act aka: Obama Care Tom Koanui 541-914-8441 Shonna Butler 541-357-8751
  • 2. • The information given within this presentation is accurate as of May 2013 and comes directly from the Cover Oregon Public Exchange. It is subject to change. • Note that ACA details shared informally by word of mouth may not represent the state of Oregon. A number of states around the country are defaulting to the Federal Exchange program or choosing the Co-op Exchange format. Disclosure Tom Koanui 541-914-8441 Shonna Butler 541-357-8751
  • 3. Patient Protection Affordable Care Act Changes for January 01, 2014 • All individuals MUST have M.E.C. (Minimum Essential Coverage). • Guaranteed acceptance • No pre-existing condition exemptions • NO RATING for health, gender, build & industry • Essential Health Benefits as defined by program • Metallic Levels: Bronze- Silver- Gold- Platinum Tom Koanui 541-914-8441 Shonna Butler 541-357-8751
  • 4. Affordable Care Act – Small Employers Small Employers of <50 Employees: • Employer is NOT required to provide group insurance in 2014 • NO tax penalty will be assessed to employers if group insurance is not provided in 2014 or 2015 • A 35% to 50% tax credit will be available to employers through 2015 who DO offer group insurance • Metallic Plans currently available to employer: Bronze, Silver, and Gold Tom Koanui 541-914-8441 Shonna Butler 541-357-8751
  • 5. • Oregon Zip Code • 2-50* Employees • Pay at least 50% of employee only premiums • At least 75% participation *2016 up to 100 employees 2017 over 100 employees • Have less than 25 FTEs (full- time equivalent) • Have average income of less than $50K • Contribute at least 50% of employee only premiums *Federal small business tax credits for 2-yrs (2014 & 2015) Small Employer Program Requirements To Qualify for Tax Credits:*To Shop Through Cover Oregon: Tom Koanui 541-914-8441 Shonna Butler 541-357-8751
  • 6. Four Options for Employers • Option 1: Employer chooses plan and carrier • Option 2: Employer chooses carrier but employee chooses plan • Option 3: Employer chooses plan but employee chooses carrier • Option 4: Employee chooses both plan and carrier Tom Koanui 541-914-8441 Shonna Butler 541-357-8751
  • 8. Oregon Exchange Plan Design Platinum Plan details are not yet available Tom Koanui 541-914-8441 Shonna Butler 541-357-8751
  • 10. Exchange Prescription Drug Plan Tom Koanui 541-914-8441 Shonna Butler 541-357-8751 Platinum Plan details are not yet available
  • 11. How the Exchange Will Work
  • 12. Now What? This is a confusing new health care act. We would enjoy speaking with you and your organization about the changes happening through the Oregon Exchange and what it means for you and your company. Please contact Shonna at: 541-357-8751 or Tom at: 541-914-8441 to set up an appointment to discuss your health care options in greater detail. Thank you for your time and attention! Where there is no vision the people perish, but he that keeps the law, happy is he. Proverbs 29:18 Tom Koanui 541-914-8441 Shonna Butler 541-357-8751