Offering Attractive Employer Provided Health Benefits in This Changing Environment

Transcription

1 Offering Attractive Employer Provided Health Benefits in This Changing Environment Presented by First Franchise Capital and Michael Haffey - Sales Leadership - Gravie

2 Today s Presenter: Michael Haffey Michael has helped employers of all sizes for over 25 years find the best solutions to provide health coverage for their employees. His roles include founder and principal of successful insurance agencies and leadership for a top national independent brokerage firm. He and the team at Gravie are assisting employers in providing innovative health plan solutions that: control spend provide more choice eliminate hassles Copyright Gravie 2017

3 Today s Agenda Review the options available for providing a health plan today What might the future hold The AHCA Review real success stories - 3 Case studies A new option the Small Employer HRA

4 Some of the questions we will answer What are my options other than group health insurance if it really doesn t work for my business? How can we mitigate or eliminate the employer mandate penalties and will they be around in the future? How can we help our employees access subsidies and/or tax friendly employer provided dollars to buy individual health insurance plans? How does a defined contribution health plan work?

5 How are employees offering health benefits? TODAY S ENVIRONMENT Traditional Group Health Insurance Model Common approach for many employers where the executive team works with an advisor to determine the plans that will be offered as well as the premium price point for the employees. Employees then opt in or waive coverage during their enrollment. PERCENT OF PRIVATE- SECTOR ESTABLISHMENTS THAT OFFER HEALTH INSURANCE Copyright Gravie 2017

6 Legislative update as of Now that the House has passed the AHCA, what might the future hold for employers? Eliminates the Employer and Individual Mandate Penalties Subsidies will continue Gives states more control in what is covered in health plans, Essential Health Benefits Gives states a say in how to cover pre-existing conditions Continuous Coverage rules Opens up HSA and FSA contributions

7 What the ACA continues to provide and most likely the AHCA 1. Cover pre-existing conditions 2. Guarantee availability and renewability 3. Cover adult children up to age Cap out-of-pocket expenditures 5. No health status underwriting 6. No lifetime and annual limits

8 What are my options today to provide competitive employer provided health benefits? A. Provide a plan, you have 3 options: 1. Fully Insured Group Health Plan 2. Partially Self-Funded Group Health Plan 3. Fully Insured Individual Market Health Plan B. Don t provide a plan; 1. < 50 EES no penalty, not so happy employees 2. > 50 EES pay the penalty or use a strategy to mitigate or eliminate the penalty

9 Case Study #1 Restaurant with 40 employees Fact Pattern: Currently providing a group plan Can't afford the premiums anymore Can't meet the insurance companies participation requirements Just 10 of 40 employees on the plan Solution: Provide a Defined Contribution approach using the Individual market private exchange Taxable and Discriminatory Contributions

10 Case Study #1 Restaurant with 40 employees

11 Defined Contribution Strategy Advantages of defined contribution health benefits: Employers set their own budget Employers get out of choosing one-size-fits-all group plans that fit few employees needs Employees get more options than they would with traditional group benefits and are able to choose benefits that fit their unique needs In some cases, employees may be eligible to receive tax credits, which could lower the cost of benefits or use the new Small Employer Health reimbursement Arrangement HRA to provide tax friendly dollars

12 Case Study #2 Home Health Agency with 200 full time employees and 100 on their plan Fact Pattern: Currently providing a self funded group plan Can t afford the claims cost anymore Want to offer a plan that allows them to provide more choice and control their spend Solution: Provide a Defined Contribution approach using the Individual market private exchange Taxable and Discriminatory Contributions with a MEC Minimum Essential Coverage plan to reduce the employer mandate penalty

13 Individual Market Case Study #2 FINANCIAL ANALYSIS DETAIL-197 Employees, PSF 15 years

14 Actual Enrollment Results

15 When Given a Choice

16 The Value of Choice

17 Case Study #3 56 Employee Hair Care Franchise Fact Pattern: Currently don't provide any form of a health benefit Would like to, but can't afford it Facing the employer mandate penalty for not offering a group plan and can t afford the penalty Solution: Offer a MEC plan Minimum Essential Coverage to reduce penalties Offer key employees a defined contribution

18 Case Study #3 56 Employee Hair Care Franchise

19 A New Option the SEHRA Defined Contribution Individual market plan Taxable or Tax friendly Employer dollars Two options for providing employees with $$$: 1. Supplemental Wage Taxable Subsidies Discriminate 2. Small Employer Health Reimbursement Arrangement SEHRA - Tax Friendly - No Subsidies - Limited Discrimination

20 21 st Century Cures Act & Small Employer HRA Passed into Law December 13, 2016

21 New Law Eases Small Business Health Care Burden Forbes Dec 14, 2016 Beginning on January 1 st 2017, a company with fewer than the equivalent of 50 full-time employees can reimburse employees for purchasing individual health insurance as if it were directly paying the premiums on a group health policy: the employee won t have to pay taxes on the company s premium contribution, and the company won t owe payroll taxes on it either. Qualified Small Employer Health Reimbursement Arrangement

22 QSEHRA - Qualified Small Employer Health Reimbursement Arrangement A new type of HRA that provides tax free benefits to Small Employers <50 and does not offer a group plan To get the tax advantage, an employee must have an individual market plan funded solely by the employer and they can be FT or PT No ERISA or Cobra requirements The contribution can vary by Family status or age and the 2017 Max amounts are Single - $4950 annual or $ monthly Family - $10,000 annually or $ Monthly If the employer wants to provide dollar in excess of the limits, they can it is just taxable as normal income

23 The Growth and Acceptance of the Private Benefit Exchange PBE Index enters 2017 with impressive numbers Employee Benefit News February ,800 employers moved workers to an exchange 2.8 million employees signed up for benefits through one of the online marketplaces 5.6 million people covered by benefit plans sold through the sites

24 What is GRAVIE? Provides next generation health plans combining 3 key ingredients: 1) A Private Marketplace for Health Plans Smart Technology 2) A New World Third Party Administrator A Complete Scope of Services 3) Human Involvement using GravieCare Member Advisors and Account Managers Advocacy, support, guidance

25 Launched in November 2013 Founders also established leading companies like Bloom Health, RedBrick Health and Definity Health WHO IS GRAVIE? Over 1000 employers representing 50,000+ employees have registered on Gravie as their health benefit. Featured in:

26 You choose the dollar amount to give each employee HOW IT WORKS. We check if your employees are eligible for government tax credits (and help them apply if they are) We help employees choose a plan in the individual market We provide year-round service and health insurance advice to all your employees

27 How does Gravie Help Employers? 1. Control Spend Defined Contribution Next Generation Health Plan 2. Eliminate Hassles New World Third Party Administrator 3. Provide More Choice Private Marketplace (Exchange) for all Individual Health Plans

28 THANK YOU! Questions or comments? Michael Haffey Copyright Gravie 2017