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Healthcare Reform: A Practical and Strategic
Look at the Impact
$76M in revenue in 2012
6,776 public and private sector clients
7,364 individual clients
153,882 square feet to serve clients
400+ total personnel
71 partners
1 collaborative and positive culture
About Sikich
» Multi-disciplinary: An accounting,
advisory, investment banking, technology
and managed services firm with clients in
the U.S. and internationally.
» Excellent reputation: With a reputation
for professional excellence, Sikich
provides unsurpassed client service as
well as timely and cost effective services.
» Strong talent: We employ more than
400 talented people including 71
partners, all of whom devote their
careers to a focused area.
» Award winning: Accounting Today
ranks the Firm 40th nationally among the
top 100 accounting firms and 12th in the
top 100 VARs.
Honors & Recognitions
Accounting
» #40 in Accounting Today’s
2013 Top 100 Accounting
Firms
» INSIDE Public Accounting’s
Top 50 Accounting Firms in
2012
» INSIDE Public Accounting’s
All-Star Firms in 2012
Technology
» Top 1% of all ERP solution
partners in the world
» 2012 Microsoft Dynamics
Inner Circle
» 2012 Microsoft Dynamics
President's Club
» #12 on Accounting Today's
Top 100 VARs in 2012
» #13 on Bob Scott's Top 100
VAR List for 2012
Tracing Our Roots
19821982
Sikich Gardner & Co. was
formed; takes up residence in
Aurora and Springfield
19981998
Merges with Intelligent Computer
Solutions LLC and starts its
technology practice
20122012
30th
Anniversary
4
Sikich Service Lines
Securities are offered through Sikich Corporate Finance LLC, a registered broker dealer with the Securities Exchange Commission and a member of FINRA/SIPC.
Advisory services offered through Sikich Financial, a Registered Investment Advisor. General securities offered through Triad Advisors, Member FINRA/SIPC.
Accounting, Audit & Tax
Financial Reporting
Employee Benefit Plan Audit
Accounting Services
Tax Planning
Advisory
Business Valuation
Dispute Advisory
Financial Advisory
Flex-Staff Solutions
Human Resources
Marketing & Public Relations
Supply Chain
Investment Banking
Acquisitions Advisory
Sales Advisory
Capital Raises
Strategic Advisory
Technology
Accounting & ERP Software
CRM Software
IT Infrastructure
Cloud & Hosting Solutions
Strategic IT Planning
Communication & Collaboration
IT Consulting
Managed Services
Outsourced Accounting
Managed IT
Outsourced Human Resources
Outsourced Marketing
& Public Relations
Industry Expertise, Tailored Approach
» Agriculture
» Manufacturing & Distribution
» Construction
» Professional Services
» Real Estate
» Retail
» Government
» Non Profit
» Healthcare
» Higher Education
Deep industry experience
and longevity.
Cross sectional teams with a depth
and breadth of experience to handle
the complete solution.
Solution centric and
product agnostic.
Healthcare Reform:
A Practical and Strategic Look
at the Impact
What Do We Know Today?
• Healthcare reform is here to stay
• Healthcare reform is very confusing
• Guidance is coming out regularly, but there are still many unknowns
• Administrative burden will likely be very significant
Healthcare Reform’s Impact on
Payroll/HR/Benefits
HR/Benefits Payroll
A Practical Look at Healthcare Reform:
What’s on My To-Do List?
Notice of Exchanges
• Must be provided to current and all newly hired employees starting
no later than October 1, 2013.
• Must inform employees of the following:
• The existence of the government-run health care exchanges
including a description of the services provided and instructions
for contacting an exchange to request assistance.
• If the employer plan’s share of the total allowed costs of benefits
provided under the plan is less than 60 percent of the costs,
employees may be eligible for a premium tax credit if they
purchase a qualified health plan through an exchange.
• If employees purchase a qualified health plan through an
exchange, they may lose the employer contribution (if any) to
any health benefits plan the employer offers. All or a portion of
this contribution may be excluded from income for federal
income tax purposes.
Updated COBRA Notice
• COBRA Model Election Notice revised to inform qualified
beneficiaries of coverage options available through government run
health care exchanges under PPACA
• Employers will now give employees the option of choosing COBRA
or going to Exchanges
• The updated Model notice can be found here:
http://www.dol.gov/ebsa/cobra.html
Who is a Large Employer?
• Employed 50 full-time employees on business days in the preceding
calendar year
• Add up total number of hours worked in a month by part-time
employees, divide by 120 and add to full-time employees
• Add up number of employees for each of the 12 months and divide
by 12 – if greater than 50, then you are considered a large employer
for the current year
• Transition relief is provided for the 2014 calendar year – employer
may choose a six-month period in 2013 only
Who is a Large Employer?
• Seasonal/variable worker exception:
• (1) an employer’s full-time employee workforce (including FTEs)
exceeded 50 employees on only 120 or fewer days, and
• (2) seasonal workers were the only reason the 50-employee
threshold was exceeded during this period. This exception may
also be applied on the basis of 4 or fewer calendar months.
Who is a Full-time Employee?
• Under healthcare reform and for determining the penalties, full-time
is defined as 30 hours per week or 130 hours per month
• More clarity may be needed when an employee is hired
regarding employment status
• Full-time
• Part-time
• Variable/Seasonal
• Organizations will have to closely monitor those hired to work
less than 30 hours
Employer Mandates
• Employers (with 50 or more full-time/full-time equivalents) must:
• Offer minimum essential coverage to at least 95% of full-time
employees and children under age 26 OR
• Pay $2,000 penalty per year per full time employee (minus up to
30 full-time employees)
Employer Mandates
• If an employer offered coverage and it is not both:
• Qualifying – offers minimum actuarial value of 60%
• Affordable – doesn’t cost employee more than 9.5% of income
• Employer pays $3,000 per year, per employee who:
• Doesn’t receive qualifying and affordable coverage AND
• Is not enrolled in minimum essential coverage AND
• Obtains insurance from the exchanges AND
• Obtains a subsidy
To “Play” or Not to “Play”?
• If your organization decides to “pay” the penalty:
• Penalties are not tax deductible
• Reporting requirements still exist
• Determining exact numbers of employees can be difficult
• Not offering benefits may affect recruitment and retention
Seasonal/Variable Employees
• Track hours over measurement period – 3 to 12 months
• Get things in order during brief administrative period
• Offer coverage to those emerging with at least 30 hours per week in
a stability period
The Payroll Perspective
• Each system is different and has varying capabilities
• Think about what you will need your system to do going forward
• Work with your current payroll system to make changes for tracking
and reporting
• Begin thinking about process to deal with administrative burdens
Questions to be Asking
• How will my payroll system handle:
• Tracking of hire dates (multiple hire dates,
rehires)
• Tracking of unpaid absences
• Documentation of employment status
• Reporting of hours worked
• Full-time equivalents
• Managing hours worked
• Tracking of measurement periods
and stability periods
• Automatic enrollment
Questions to be Asking
• What is the actuarial value of my current plan?
• Is my plan affordable under the affordable care act?
• What are my options to minimize the cost to my organization?
A Strategic Look at
Healthcare Reform
A Strategic Look at Benefits
• How do your benefits factor in to your total rewards package?
• How are your benefits used to attract/retain top talent?
• How do your benefits compare to the competition?
• How will benefit changes impact your total rewards/compensation?
• Do your employees understand the full value of the benefits you are
providing?
Planning/Workforce Analysis
• Staffing concerns – now and in the future
• Managing hours worked, particularly with part-time staff
• Impact of changes to work hours
Administrative Concerns
• How will your organization determine measurement periods,
administrative periods and stability periods?
• How will your organization track hours to determine eligibility for
part-time/variable employees?
• Who will be responsible for handling the additional administrative
responsibilities?
• Tracking hours/reporting requirements
• Enrollments
• Questions
Communication with Employees
• Ensure compliance with the various notifications and reporting
requirements
• Be able to communicate with employees about the various options
available
• Make employees better consumers
• Help them understand how to get the most from their benefits
• Be prepared to answer questions
• Your organization’s benefit plans
• Exchanges
Managing Rising Costs/Focus on
Wellness
• Promotes healthier lifestyles
• Helps recognize potential medical concerns earlier
• Keeps premium costs down
Your Focus: 2013 and Beyond
• Work with a trusted advisor
• Analyze workforce – today and in the future
• Determine measurement periods
• Consider plan design changes
• Make sure payroll systems are set up properly to handle the
additional administrative burdens
• Ensure compliance with various notifications and reporting
requirements
• Focus on employee communications
• Value of the benefits provided
• How to get the most from benefits
• Focus on wellness
• Healthier lifestyles = reduced costs
• Stay flexible
LinkedIn: www.linkedin.com/company/sikich
Facebook: www.facebook.com/sikichllp
Twitter: www.twitter.com/sikichllp
Blog: www.sikich.com/blog
Jennifer Lollino
Vice President
HR Consulting Services
630.566.8483
jlollino@sikich.com
www.sikich.com
Joyce Grenis
Senior Vice President
HR Consulting Services
630.566.8454
jgrenis@sikich.com
www.sikich.com
Questions?

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Healthcare Reform: A Practical and Strategic Look at the Impact

  • 1. Hot Topics in Employment Law Healthcare Reform: A Practical and Strategic Look at the Impact
  • 2. $76M in revenue in 2012 6,776 public and private sector clients 7,364 individual clients 153,882 square feet to serve clients 400+ total personnel 71 partners 1 collaborative and positive culture About Sikich » Multi-disciplinary: An accounting, advisory, investment banking, technology and managed services firm with clients in the U.S. and internationally. » Excellent reputation: With a reputation for professional excellence, Sikich provides unsurpassed client service as well as timely and cost effective services. » Strong talent: We employ more than 400 talented people including 71 partners, all of whom devote their careers to a focused area. » Award winning: Accounting Today ranks the Firm 40th nationally among the top 100 accounting firms and 12th in the top 100 VARs.
  • 3. Honors & Recognitions Accounting » #40 in Accounting Today’s 2013 Top 100 Accounting Firms » INSIDE Public Accounting’s Top 50 Accounting Firms in 2012 » INSIDE Public Accounting’s All-Star Firms in 2012 Technology » Top 1% of all ERP solution partners in the world » 2012 Microsoft Dynamics Inner Circle » 2012 Microsoft Dynamics President's Club » #12 on Accounting Today's Top 100 VARs in 2012 » #13 on Bob Scott's Top 100 VAR List for 2012
  • 4. Tracing Our Roots 19821982 Sikich Gardner & Co. was formed; takes up residence in Aurora and Springfield 19981998 Merges with Intelligent Computer Solutions LLC and starts its technology practice 20122012 30th Anniversary 4
  • 5. Sikich Service Lines Securities are offered through Sikich Corporate Finance LLC, a registered broker dealer with the Securities Exchange Commission and a member of FINRA/SIPC. Advisory services offered through Sikich Financial, a Registered Investment Advisor. General securities offered through Triad Advisors, Member FINRA/SIPC. Accounting, Audit & Tax Financial Reporting Employee Benefit Plan Audit Accounting Services Tax Planning Advisory Business Valuation Dispute Advisory Financial Advisory Flex-Staff Solutions Human Resources Marketing & Public Relations Supply Chain Investment Banking Acquisitions Advisory Sales Advisory Capital Raises Strategic Advisory Technology Accounting & ERP Software CRM Software IT Infrastructure Cloud & Hosting Solutions Strategic IT Planning Communication & Collaboration IT Consulting Managed Services Outsourced Accounting Managed IT Outsourced Human Resources Outsourced Marketing & Public Relations
  • 6. Industry Expertise, Tailored Approach » Agriculture » Manufacturing & Distribution » Construction » Professional Services » Real Estate » Retail » Government » Non Profit » Healthcare » Higher Education Deep industry experience and longevity. Cross sectional teams with a depth and breadth of experience to handle the complete solution. Solution centric and product agnostic.
  • 7. Healthcare Reform: A Practical and Strategic Look at the Impact
  • 8. What Do We Know Today? • Healthcare reform is here to stay • Healthcare reform is very confusing • Guidance is coming out regularly, but there are still many unknowns • Administrative burden will likely be very significant
  • 9. Healthcare Reform’s Impact on Payroll/HR/Benefits HR/Benefits Payroll
  • 10. A Practical Look at Healthcare Reform: What’s on My To-Do List?
  • 11. Notice of Exchanges • Must be provided to current and all newly hired employees starting no later than October 1, 2013. • Must inform employees of the following: • The existence of the government-run health care exchanges including a description of the services provided and instructions for contacting an exchange to request assistance. • If the employer plan’s share of the total allowed costs of benefits provided under the plan is less than 60 percent of the costs, employees may be eligible for a premium tax credit if they purchase a qualified health plan through an exchange. • If employees purchase a qualified health plan through an exchange, they may lose the employer contribution (if any) to any health benefits plan the employer offers. All or a portion of this contribution may be excluded from income for federal income tax purposes.
  • 12. Updated COBRA Notice • COBRA Model Election Notice revised to inform qualified beneficiaries of coverage options available through government run health care exchanges under PPACA • Employers will now give employees the option of choosing COBRA or going to Exchanges • The updated Model notice can be found here: http://www.dol.gov/ebsa/cobra.html
  • 13. Who is a Large Employer? • Employed 50 full-time employees on business days in the preceding calendar year • Add up total number of hours worked in a month by part-time employees, divide by 120 and add to full-time employees • Add up number of employees for each of the 12 months and divide by 12 – if greater than 50, then you are considered a large employer for the current year • Transition relief is provided for the 2014 calendar year – employer may choose a six-month period in 2013 only
  • 14. Who is a Large Employer? • Seasonal/variable worker exception: • (1) an employer’s full-time employee workforce (including FTEs) exceeded 50 employees on only 120 or fewer days, and • (2) seasonal workers were the only reason the 50-employee threshold was exceeded during this period. This exception may also be applied on the basis of 4 or fewer calendar months.
  • 15. Who is a Full-time Employee? • Under healthcare reform and for determining the penalties, full-time is defined as 30 hours per week or 130 hours per month • More clarity may be needed when an employee is hired regarding employment status • Full-time • Part-time • Variable/Seasonal • Organizations will have to closely monitor those hired to work less than 30 hours
  • 16. Employer Mandates • Employers (with 50 or more full-time/full-time equivalents) must: • Offer minimum essential coverage to at least 95% of full-time employees and children under age 26 OR • Pay $2,000 penalty per year per full time employee (minus up to 30 full-time employees)
  • 17. Employer Mandates • If an employer offered coverage and it is not both: • Qualifying – offers minimum actuarial value of 60% • Affordable – doesn’t cost employee more than 9.5% of income • Employer pays $3,000 per year, per employee who: • Doesn’t receive qualifying and affordable coverage AND • Is not enrolled in minimum essential coverage AND • Obtains insurance from the exchanges AND • Obtains a subsidy
  • 18. To “Play” or Not to “Play”? • If your organization decides to “pay” the penalty: • Penalties are not tax deductible • Reporting requirements still exist • Determining exact numbers of employees can be difficult • Not offering benefits may affect recruitment and retention
  • 19. Seasonal/Variable Employees • Track hours over measurement period – 3 to 12 months • Get things in order during brief administrative period • Offer coverage to those emerging with at least 30 hours per week in a stability period
  • 20. The Payroll Perspective • Each system is different and has varying capabilities • Think about what you will need your system to do going forward • Work with your current payroll system to make changes for tracking and reporting • Begin thinking about process to deal with administrative burdens
  • 21. Questions to be Asking • How will my payroll system handle: • Tracking of hire dates (multiple hire dates, rehires) • Tracking of unpaid absences • Documentation of employment status • Reporting of hours worked • Full-time equivalents • Managing hours worked • Tracking of measurement periods and stability periods • Automatic enrollment
  • 22. Questions to be Asking • What is the actuarial value of my current plan? • Is my plan affordable under the affordable care act? • What are my options to minimize the cost to my organization?
  • 23. A Strategic Look at Healthcare Reform
  • 24. A Strategic Look at Benefits • How do your benefits factor in to your total rewards package? • How are your benefits used to attract/retain top talent? • How do your benefits compare to the competition? • How will benefit changes impact your total rewards/compensation? • Do your employees understand the full value of the benefits you are providing?
  • 25. Planning/Workforce Analysis • Staffing concerns – now and in the future • Managing hours worked, particularly with part-time staff • Impact of changes to work hours
  • 26. Administrative Concerns • How will your organization determine measurement periods, administrative periods and stability periods? • How will your organization track hours to determine eligibility for part-time/variable employees? • Who will be responsible for handling the additional administrative responsibilities? • Tracking hours/reporting requirements • Enrollments • Questions
  • 27. Communication with Employees • Ensure compliance with the various notifications and reporting requirements • Be able to communicate with employees about the various options available • Make employees better consumers • Help them understand how to get the most from their benefits • Be prepared to answer questions • Your organization’s benefit plans • Exchanges
  • 28. Managing Rising Costs/Focus on Wellness • Promotes healthier lifestyles • Helps recognize potential medical concerns earlier • Keeps premium costs down
  • 29. Your Focus: 2013 and Beyond • Work with a trusted advisor • Analyze workforce – today and in the future • Determine measurement periods • Consider plan design changes • Make sure payroll systems are set up properly to handle the additional administrative burdens • Ensure compliance with various notifications and reporting requirements • Focus on employee communications • Value of the benefits provided • How to get the most from benefits • Focus on wellness • Healthier lifestyles = reduced costs • Stay flexible
  • 30. LinkedIn: www.linkedin.com/company/sikich Facebook: www.facebook.com/sikichllp Twitter: www.twitter.com/sikichllp Blog: www.sikich.com/blog Jennifer Lollino Vice President HR Consulting Services 630.566.8483 jlollino@sikich.com www.sikich.com Joyce Grenis Senior Vice President HR Consulting Services 630.566.8454 jgrenis@sikich.com www.sikich.com Questions?

Notas do Editor

  1. Additional Medicare taxes Medicare tax on unearned income
  2. FT=30 hours per week Term business days is not clear
  3. Seasonal worker exception: an employer having a large number of seasonal employees might be able to avoid the “large employer” label, and thus the play or pay rules, even if its average full-time workforce exceeded 50 over the course of the entire year. This exception applies if, during the prior calendar year, (1) an employer’s full-time employee workforce (including FTEs) exceeded 50 employees on only 120 or fewer days, and (2) seasonal workers were the only reason the 50-employee threshold was exceeded during this period. This exception may also be applied on the basis of 4 or fewer calendar months .
  4. Reminders to flag measurement period, admin, stability periods
  5. More employers link premiums to wellness Aon/Hewitt Study: 83 percent of employers offer their workers incentives for participating in wellness-improvement programs, including filling out a health-risk assessment and undergoing biometric screenings.