Zane Benefits Publishes New Information on Health Care Reform for Small Businesses

All Small Businesses Need to Know About Individual Mandate, Employer Mandate and Health Insurance Exchanges

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Park City, Utah (PRWEB) May 04, 2013

Today, Zane Benefits, Inc. published new information on health care reform and small businesses. Zane Benefits, which provides comprehensive and flexible alternatives to traditional employer sponsored health benefits, is the leader in defined contribution health plans and health reimbursement arrangements.

According to Zane Benefits’ website, employers, human resource departments, and business consultants of all sizes are still trying to wrap their heads around the Affordable Care Act (ACA) and what health care reform means for their business and employees. Zane Benefits provided three key regulations every employer should know about health care reform:

1. Individual Mandate
2. Employer Mandate
3. Health Insurance Exchanges

Individual Mandate

According to Zane Benefits’ website, ACA requires everyone to obtain minimum essential coverage for themselves (and their dependents) or pay a penalty starting in January 2014. The penalty is phased-in starting in 2014 at $95, to $395 in 2015, to $695 in 2016 per calendar year, or up to 2.5% of income.

Minimum essential coverage includes coverage under government sponsored programs (e.g. Medicare, Medicaid), an eligible employer-sponsored plan, health plan offered in the individual market, grandfathered health plans, and certain other coverage, such as state health benefits risk pool.

Minimum essential coverage does not include coverage consisting of excepted benefits, such as dental-only coverage, and employer-based coverage that is not offered through an "eligible employer-sponsored plan", such as a Health Reimbursement Arrangement.

Employer Mandate for Applicable Large Employers

According to Zane Benefits’ website, beginning in 2014, all "applicable large employers" must offer "minimum essential coverage" that is "affordable" to their employees. Applicable large employers who fail to offer minimum essential coverage that is affordable will be required to pay a "penalty" on their tax return.

Applicable Large Employers – If a company employed an average of 50 or more full-time equivalent employees during the previous calendar year, it is considered an applicable large employer for the current year.

Minimum Essential Health Benefits (EHB) – Minimum EHB is a set of health care service categories that must be covered by certain plans starting in 2014. These will vary by state, and will be finalized by each state’s Department of Insurance.

Employer Tax Penalty - If an applicable employer decides not to offer the minimum EHB by 2014, the employer may have to pay a penalty. Read how to calculate the business tax penalty here.

Small Businesses with under 50 FTEs? If the company has less than 50 FTE employees, the mandate and tax penalties do not apply.

Exchanges ("Marketplaces")

According to Zane Benefits’ website, health insurance coverage for individuals and small businesses will become available through new state Health Insurance Exchanges (aka "Marketplaces") starting in January 2014. Each state Health Insurance Exchange will be operated in one of three ways: state-operated, state-federal partnership or federally-facilitated.

ACA requires all states to create two types of Exchanges:

  • American Health Benefit Exchange "AHBE": An individual Exchange
  • Small Business Health Options Program ("SHOP"): A group Exchange for employers with 100 or less employees (eligibility will vary by state)

Under the statute, only Qualified Health Plans (QHP) can be offered on the Exchanges. A QHP provides essential health benefits, follows established limits on cost-sharing (like deductibles, co-payments, and out-of-pocket maximum amounts), and meets other ACA requirements. Additionally, all plans will be guaranteed issue.

Most importantly, the key tax credits (e.g. the small business healthcare tax credits) and tax subsidies (e.g. individual health insurance tax subsidies) will only be available for coverage purchased via a state health insurance Exchange.

Click here to read full article.

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About Zane Benefits
Zane Benefits was founded in 2006 to provide a revolutionized SaaS (Software-as-a-Service) administration platform ("ZaneHRA") for Health Reimbursement Arrangements (HRAs) and defined contribution health care. The flagship software provides a 100% paperless administration experience to employers and insurance professionals that want to offer better health benefits without a traditional group health insurance plan at lower costs. For more information about ZaneHRA, visit http://www.zanebenefits.com.


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