Group Insurance Orange County Solana Insurance Service located in Newport Beach in Orange County, CA is one of the leading small business consultants in the realm of Group health insurance and small business employee benefits. We have been helping small businesses navigate the ever-changing world of health insurance for over 12 years and our clients include some of the most dynamic small businesses in California. With the implementation of Obamacare, employers are facing changes to their employee’s group health insurance rates on a scale not seen in history. The regulations are changing and the penalties for not providing health insurance are still being debated. The bottom line is that many small business do not know what is actually coming down the pipe for 2014 and beyond. Solana Insurance Services has its finger on the pulse of what is going on now with respect to group health insurance and is committed to keeping its clients notified of these changes. We make sure that our customers group insurance is set up in an optimum way so that the burden to the employer is minimized, and so the employees are getting the best insurance plans. There are many changes that will take effect over the coming years with respect to Obamacare and the Affordable Care Act (ACA) and Solana Insurance Services will be able to guide your company through this changing landscape as a sherpa guides a climber to the top of a mountain. While some of these changes will have a tremendous impact for local businesses, knowing what is coming and being prepared for the changes will be an advantage that companies will need in order to minimize the increase in costs that are inevitable with the looming changes. Employer Mandate Penalties Delayed Until 2015 The Obama Administration has postponed the Affordable Care Act (ACA) employer mandate penalties for one year, until 2015. The Department of the Treasury announced the delay on July 2, 2013, along with a similar delay for information reporting by employers, health insurance issuers and self-funded plan sponsors. The delay does not affect any other provision of the ACA, including individuals’ access to premium tax credits for coverage through an Exchange. The Treasury plans to issue more formal information about the delay within a week. What you need to know right now: ONE-YEAR IMPLEMENTATION DELAY The employer mandate provisions of the ACA are also known as the employer shared responsibility or pay or play rules. These rules impose penalties on large employers that do not offer affordable, minimum value coverage to their full-time employees and dependents. They were set to take effect on Jan. 1, 2014. According to the Treasury, the delay of the employer mandate was required because of issues related to the reporting requirement. With the reporting rules delayed, it would be nearly impossible to determine which employers owed penalties under the shared responsibility provisions. Therefore, these payments will not apply for 2014. The now-delayed reporting requirements are found in Internal Revenue Code sections 6055 and 6056. These rules apply to insurers, self-insuring employers and other parties that provide health coverage, along with certain employers with respect to health coverage offered to their full-time employees. The Administration’s decision is based on concerns voiced by businesses about the complexity of the requirements and the need for more time to implement them effectively. Effects of the Delay The additional year will give employers time to understand the employer mandate rules, to make decisions about providing health coverage and to adapt their reporting systems, without worrying about potentially significant penalties. It is unclear how the new deadline will impact guidance that has already been issued, such as the transition relief for non-calendar year plans and the optional safe harbor for determining full-time status. Future Guidance The administration plans to use the additional implementation time to consider ways to simplify the new reporting requirements consistent with ACA. The Treasury also plans to discuss the rules with stakeholders, including employers that currently provide health coverage to employees, and then publish proposed rules implementing these provisions later this summer. It is the Treasury’s intention to minimize the reporting requirements. The pay or play regulations issued earlier this year left many unanswered questions for employers. The IRS had highlighted several areas where it would be issuing more guidance. Presumably, the additional time will give the IRS and Treasury the opportunity to provide more comprehensive guidance on implementing these requirements. Solana Insurance Services will continue to monitor developments and will keep you informed of the latest updates. Don’t get caught without a plan. Contact Solana Insurance today to ask how your company can stay ahead of the curve in small business group health insurance and we will schedule a consultation to show you what you can do to minimize the impact these changes will have for your small business. We help large companies as well as small groups so don’t hesitate to contact us regardless of the size of your business. For more information call Solana Insurance at 949-675-1920.
Solana Insurance Services, Inc.
Health insurance companies orange county ca – Solana Insurance Services
I am writing this letter to inform you of some of the changes that are coming starting January, 1 of 2014 because of Obamacare.
All of our information is based on what we know right now and is subject to change.
All the carriers will be changing their plan designs to comply with the mandates of Obamacare. These plans are called the “medal” plans. Bronze, Silver, Gold and Platinum.
The Bronze plan will be the least expensive and the Platinum will be the most expensive. The Bronze plan will require the individual to pay for 40% of the medical cost up to $6,350, $12,700 for a family and the Platinum plan, 10% of cost up to $4,000/$8,000 family. California will be implementing their exchange called Covered California. You will be able to purchase your medal plans in or out of the exchange, however, the exchange is for those individuals and small groups that qualify for financial assistance.
Obamacare Employer Mandate Penalties Delayed Until 2015
By Hubie Laugharn
The Obama Administration has postponed the Affordable Care Act (ACA) employer mandate penalties for one year, until 2015. The Department of the Treasury announced the delay on July 2, 2013, along with a similar delay for information reporting by employers, health insurance issuers and self-funded plan sponsors.
The delay does not affect any other provision of the ACA, including individuals’ access to premium tax credits for coverage through an Exchange. The Treasury plans to issue more formal information about the delay within a week.
ONE-YEAR IMPLEMENTATION DELAY
Self Insured Program California for small businesses
by Hubie Laugharn
Solana Insurance Services
This is what we know as of 5-13-13
Partial-Self Funding- Self insured program california– Do you want to pay for a whole loaf of bread when you know you will only eat half of it?
How do you value your Company Healthcare?
A percent of compensation or a percent of profitability?
Large Group (LG); 51 employees or more:
Equivalent employees: It is important to understand that hours of part-time employees will count towards the total amount of credited full-time employees a company has for Obama Care. Understand the formula. For example, a company my think they 35 full-time employees and 20 part-time employees keeping them in the 50 or less category, but adding the total number of hours the part-time employees work and using the “formula”, the same company might have to count their full-time employees with an additional 16 employees for a total of 51 full-time equivalent employees thus putting then in the 51 + category rules!
You can plan on 2 classes of employees:
Class 1—Full time employees 30+ hrs per week
Class 2—Part time employees 29 hrs max per week
Employer’s Mandate in Obama Care will require coverage at the required “Minimum Essential Value” (MEV) for all full time employees. In addition, the “Mandate” requires the Single / Employee Only Contribution to be NO MORE than 9.5% of their W-2 wages. This means most employers will have to move their contribution for an employee to 100%.
Affordable Care Act large group
By Hubie Laugharn
Below is a bullet point list of the most important aspects of the Affordable Care Act for large employer groups over 50 employees.
This is what we know as of 2-18-13
- Starting Jan. 1, 2014 or a company’s open enrollment for 2014.
- The Employer Shared Responsibility provisions apply to an employer with 51 or more employees. Employer will be required to offer healthcare insurance to all full-time employees or pay a tax/fine (Pay or Play).
- Play: an employer must offer a minimum of the Bronze plan and contribute toward the premium of the employee so the employee does not pay more than 9.5% of their wage. If the employer complies with both the “minimum value” and the “minimum employer’s contribution” 9.5%, the employer cannot be taxed/fined, if an employee goes to the exchange for financial help!
- Play: Plans must cover minimum benefit package: The “Medal” plans: Bronze, Silver, Gold, and Platinum. Bronze / 60% plan (least expensive) individuals will be responsible for 40% of the medical cost. Silver / 70% plan, the insured will be responsible for 30% of the medical cost. Gold / 80% plan and the Platinum / 90% plan.
- Pay: if an employer does not offer healthcare insurance and no employee receives assistance from the exchange, there is No Tax/Fine.
- Pay: if an employer does not offer healthcare insurance but one employee gets assistance from the exchange, the employer will pay $2,000 per employee excluding the first 30 employees.
- Pay: if the employer offers healthcare insurance, but their plans are not equivalent to the minimum Bronze plan or the premium paid by the employee exceeds 9.5% of their pay, and one employee gets assistance from the exchange, the tax/fine will be $3,000 per employee getting financial help from the exchange. However, the max tax/fine is the lower of the $2,000 or the $3,000 tax/fine.
- The employer is not taxed/fined for part time employees (29 hrs or less).
- The max deductible on all plans will be $2,000.
- HSA health plans will still be able to continue with their high deductibles over $2,000, however, we feel that they may be deemed “Cadillac” plans and as such, will be taxed 40% starting in 2018. In 2012, the tax for non-prescription drugs was raised from 10% to 20%.
- Increase medical expense deduction from 7.5% to 10% to employees.
- W-2 filing is required after Jan. 31, 2013 for companies that issue more than 250 W-2s annually. The amount of the total premium is divided by the total W-2s issued and entered in the appropriate boxes.
- Must provide notice regarding “Covered California” the name of the exchange in California.
- Max waiting period may not exceed 90 days. 30-60 day waiting period will have a $400 tax/fine.
- Incentives for wellness participation increases to 30% from 20% deductions.
- Special payroll tax of .9% for employees with incomes over $200K.
Obama Care summary for small business (Less than 50 employees)
By Hubie Laugharn
This is what we know as of 2-18-13 about Obama Care for Small Business
Employer does not have to provide health insurance and cannot be penalized.
- Small groups will be able to purchase group health insurance through the exchange. The exchange for small group is called S.H.O.P. within “Covered California” (the name of the California exchange).
Affordable Care Act Small Business
By Hubie Laugharn
Is Insurance Required?
There is no law requiring small business owners to provide health insurance, however the Affordable Care Act makes critical changes that small business owners need to know of when deciding if they are going to purchase insurance for their staff. If you do choose to offer coverage, there are regulations you will have to follow—the most important of which we explain here or in person during one of our consultations.
Though large companies may face penalties if they do not offer coverage under the Affordable Care Act, small businesses with fewer than 50 full-time-equivalent employees will not be penalized if they do not provide coverage. If you have at least 50 full-time-equivalent employees but none receive an individual premium tax credit or cost-sharing reductions (both based on income), there’s no penalty—whether or not you offer health insurance.
To learn more about what the Affordable Care Act requires of small business and to find out how penalties are calculated see “Shared Responsibility Requirement.”
Is Your Business Eligible for Group Coverage?
Under California law AB1672, small employers are guaranteed group coverage should they choose to purchase it, regardless of the employees’ health status. A “small employer” is defined as a business with 2 to 50 full-time employees. Owners are generally counted as employees, so sole proprietorships with one employee fall into this category, as do partnerships without any employees (by definition partnerships have two or more partners).
California state law AB1672 says that small employers cannot be denied coverage as long as they:
- Pay their premiums.
- Have been in business longer than two months.
- Offer medical insurance coverage to all eligible full- and part-time employees.
- Comply with insurer requirements regarding employer contribution and employee participation.
- Have not committed fraud against the insurer.
For more information on small business healthcare and employee benefits, call Solana Insurance Services (949) 675-1920.
Solana Insurance Employee Benefits
3700 Newport Blvd. #309
Newport Beach, CA 92663
Obamacare Tax Penalty-” The facts you need to know.”
Solana Insurance Service 949-675-1920
Many Americans are furious that Obamacare will require them to buy health insurance.
Most of these folks seem to hate the idea that Obama is forcing them to do something more and they hate the idea of shelling out money.
Partially Self-Funded Health Plan
With a partially self-funded health plan, an extremely small portion of the claim risk is shifted from the insurance company to the employer in exchange for potential significant savings. The company enrolls in a High Deductible Group Health Plan, which instantly drops the premium drastically. A small amount of the funds saved by the reduction in premium are set aside to cover employees who exceed their max out of pocket. A Third Party Administrator (or TPA) is used to manage those funds, administer the medical plan, process and adjudicate claims and act as a service center and resource for employees.
Orange County Employee Benefits
From Solana Insurance Service Employee Benefits, Newport Beach
A partially “self-insured” group health insurance program is an approach that typically saves businesses on average between 20- 40% on their annual health care costs without lowering benefits or changing carriers. This is the way large businesses have been approaching group health care for the last 30 years.