This health insurance reform video that is being sent out over the internet does a good job identifying the current problems facing small business owners.
While it is a good overview, it lacks the necessary details to explain how the current reform will help small business owners. Missing are specifics on health reform tax credits and mandatory coverage.
We just got this in today from Anthem regarding their small business coverage:
The following benefit changes have gone into effect based on the new federal health care reform provisions effective on or after September 23, 2010. This is regardless of whether the plan is or is not “grandfathered”:
Dependents are eligible to retain or enroll in coverage under their parent’s plan until they turn 26.
We removed some yearly dollar limits on certain plans:
*Durable medical equipment
*Smoking cessation program
*Removed annual maximum on physical exam benefit
*Removed limitations on office visits, diagnostic X-rays and labs for Elements Hospital Plus and Elements Hospital Preferred plans only
*We removed limitations on office visits, diagnostic X-rays and labs for Elements Hospital Plus and Elements Hospital Preferred plans only
*We removed the $5 million lifetime maximum from PPO plans.
*We removed pre-existing exclusions for members younger than 19 from plans in which such exclusions existed.
*In-network preventive care is now covered at 100% on all plans.
We will continue to update this blog as more information comes in -Mike
Michigan- U.S. Secretary of Health and Human Services Kathleen Sebelius states that our current method of providing health care is unsustainable and can learn from some of the advances of the private sector. According to Sebelius, without intervention, Health care costs in the next ten years are expected to increase to an average of $30,000 per employee. It is up to business to assist in providing solutions for affordable health insurance for small business.
One area that can benefit from the business sector’s experience, says Sebelius, is in the implementation of electronic medical records systems. A>?,?_"We’re still at a place in America where only 10 percent of hospitals and 20 percent of physicians’ practices use electronic records,A>?,?A_ she said.
She then asked an audience of business leaders from Detroit. A>?,?_"Think of any other business model… it’s not only inefficient, but also prone to errors.” According to the Secretary, “there’s a huge overhead in transferring paper from person to person, and it’s almost impossible to measure quality outcomes.A>?,?A_
She claims there there is evidence that switching to electronic records does make a difference.
A>?,?_"What we know from systems using electronic records is that it works. It works to lower costs, it works to reduce errors… and every physician I’ve talked to who uses electronic records says they would never go back to a paper file.A>?,?A_
By learning from the successes of the business sector will, in turn, help the business sector. Small businesses cannot afford health care for their employees and those that can end up paying 20% more than large companies.
A>?,?_"Warren Buffett has been quoted as saying that heath care costs are eating America’s competitiveness like a tapeworm,A>?,?A_ she said. A>?,?_"Health inflation well exceeds consumer price inflation, and was continuing at a pace that is simply unsustainable…A>?,?A_
The Patient Protection and Affordable Care Act approved by Congress last month offers up to 35% tax credits to small companies that offer health care for their employees. The credit, effective in 2010, can be used by both small businesses who have previously never offered health insurance as well as those who are currently offering health coverage to their employees.
Qualifications for the health care tax credit:
The tax credit is designed for small business employers who pay at least 1/2 their employees health care cost. The largest tax credits (35% of the annual premiums) go to small companies with less than 10 employes who make less that $25K per year on average. The credit is not available for employers that have 25 full time equivilent employees or more or that pay average wages of $50,000 per year or more.
These tax credits are mentioned in brief in the MSNBC health care overview below:
Next Steps:
Visit the IRS site on the new health insurance tax credit then consult your tax professional to see if you qualify.
The State Children’s Health Insurance Program (SCHIP) was recently extended for four and a half more years. As part of the Children’s Health Insurance Program Reauthorization Act of 2009 there are two new special enrollment opportunities that affect small group coverage.
A 60-day enrollment period will be allowed if:
A) A member or dependent becomes eligible for premium assistance under a state Medicaid or SCHIP plan; or
A) A member or dependent’s coverage under Medicaid or the SCHIP is terminated due to loss of eligibility.
The new enrollment rules begin for group plans that began after April 1, 2009. Check with your HR manager or group insurance agent if these rules apply to you.
