There are requirements that the employer is responsible for:

• A summary of benefits, which began in September 2012, should be received by each employee at the time of renewal, new hire or any changes in the health plan.
• The waiting period for a new hire cannot be greater than 90 days beginning January 1, 2014.
• Insurance companies cannot deny coverage due to pre-existing conditions.
• There is an exchange and subsidy notice to employees that must provide written notice of exchange and subsidies – proposed in fall 2013.
• FSA (flexible spending accounts) will be capped at $2,500.
• Employers are required to report the premium cost of the health insurance on the W-2s effective in the 2012 tax year.

There are essential and minimum benefits that must be offered at affordable premiums. The employee contribution cannot be more than 9.5% of the employee’s household income. This list of essential benefits is not as difficult to read and understand as it is to locate! Please refer to this link and read through what is required.

This link outlines affordability, minimum essential coverage, must include benefits, the cost sharing – deductibles and maximum out of pocket expenses AND mandatory coverage…

Our trusted carriers will be sure to be compliant and be our guide through our state insurance commissioners.

As an employer, you need to determine how many full time equivalents you have. From that, you will know whether you have to offer coverage or not to be compliant.

Another question that you may have is, should I offer the coverage. Offering coverage to employees is always good. First of all, the morale and the productivity of the employees that you spend more dollars than you think to recruit, train, and retain, will be easily pulled from your grips if you do not make health insurance part of your culture. Don’t forget that you may be eligible for federal tax credits. You will be more competitive in your industry. It will allow your company to grow.

In Wellmark’s recent Blue Spring 2013 publication, there is a health care reform article that caught my eye. If you do not receive these in your mail, or possibly it’s made its way to the recycling bin, please refer to this link. At the bottom, if you want to click on the link WeKnowReform.com, there are more interactive tools for your reference…

I was always raised with the concept that you had to go to school, you had to get decent grades and you were expected to work. And then, when you were in the “real world”, you obviously had to have a job, and whatever you brought home was what you had to live with. This, of course, was before credit cards were popular, before 110% mortgages were fashionable and before auto leasing was an option. And life seemed quite “real”.

Then the boundaries continually moved and became reset. Anything goes. If you see it, and you want it, you’re on it. Then, welfare became fashionable and mom and dad both worked, so the $99 question became, “What does it really cost me to go to work, versus to stay home.” and the trend to live beyond one’s means flourished.

So, as you watch this video, I hope you understand the concept of health care reform. What this means is, without any regard, do as you please. If you want prime rib, order prime rib. The cost is the same. What incentive has this created for making healthier choices. It appears to me, after 35 years in the business, that we are focusing strictly on dollars.

As this progresses forward, what I see happening is comprable to how medicare originally started in the 1960s. There is an “essential benefit platform”. That’s what we all get. If you want the A-team that has spent 8-18 years of education, time and dollars, plus their experience, you probably won’t get them for dime-store prices.

I feel, going forward, in an effort to be able to access the QUALITY of health care professionals, that we want, we will probably be buying insurance on top of what the government provides.