This “Small Business Owner’s Guide to Healthcare Reform” will help answer some of the biggest questions you’ll have with regard to the new law. It’ll provide a broad-based overview for you, so you can more easily navigate some of the new legislation’s most important components. This is healthcare reform for the small business owner “in a box.” Here we go.

1. Healthcare
Reform
Small Business
Owner’s Guide

2. This “Small Business Owner’s
Guide to Healthcare Reform” will
help answer some of the biggest
questions you’ll have with regard
to the new law.
It’ll provide a broad-based overview for you, so you
can more easily navigate some of the new legislation’s
most important components. This is healthcare reform
for the small business owner “in a box.”

3. Question #1:
Do I have to provide health
insurance to my employees as a
small business owner?

4. The answer to this is
You do not have to provide
health insurance to your
employees as a small
business owner. This leads
us right into our next
important question.

5. Question #2:
What is the definition of a
“small business” with regard
to the healthcare reform law?

6. businesses with less than 50 fulltime equivalent
employees for the previous calendar year.
Small businesses are
“Fulltime equivalent employee” is sometimes abbreviated “FTE.”
This is an important concept to understand, because your FTE
count does includepart-time employees.

7. A part-time employee is defined as working
less than 30 hours per week, and there’s a
calculation when determining their
“fulltime equivalency.”
If you’re a business that is on the cusp
of 50 FTE, you’ll want to make sure to
have this all squared away.

8. Why?Because there are costly tax penalties that may be
incurred if you’re over 50 FTE and don’t provide
health coverage. As it stands, employers with over
50 FTE will eventually be mandated to provide
coverage.

9. Question #3:
If I’m under 50 FTE and don’t
have to provide health
insurance, do my employees
and I have to find health
insurance somewhere
on our own?

10. YESThe Affordable Care Act requires that most
Americans need to carry a “minimum
essential coverage” health plan, or
pay a tax penalty (there are a few
exceptions: Alaska natives,
American Indians, exemptions
based on religious
affiliation, etc).

11. Question #4:
Where do my employees
and I find coverage on our
own?

12. If you’re not providing an employer sponsored health
plan, there are various places to look for coverage:
You can now purchase an individual or family insurance plan without regard
to health status (ie: preexisting conditions). In other words, if you apply for
coverage, you have to be accepted. It’s called "guaranteed issue” and it’s
easier now than ever before to “shop” for a health plan.
Individual Insurance Plans.

13. These new exchanges were a key part of the healthcare reform law. The
plans on the exchange are usually identical to the plans off of the exchange,
with one big exception: depending on income, you may be eligible for
substantial subsidies that can help you pay for premiums.
Public Health Insurance Exchanges.

14. If your spouse has access to a plan via their employer, you
may also be eligible to participate.
Spouses.
You may be able to find a plan through unions,
associations, or other “group like” arrangements.
Other.

15. Question #5:
As a small business owner, I’d
like to attract and retain quality
employees with a health benefit.
Are there some new strategies
that can help me do-so?

16. YESThere are some new strategies and
options that can help small business
owners offer their employees a health
benefit more affordably. Here are a
few of them:

17. The Small Business Health Options
Program (known as “SHOP”).
This is a new program that has been made available on both the federal
and state health insurance exchanges. It was specifically designed to help
small businesses (under 50 FTE) provide a group health plan to their
employees.

18. The Small Business Health Options
Program (known as “SHOP”).
Depending on the average income and size of your group, you may be
eligible for a sizeable tax credit (up to 50% of premiums).

19. A “Defined Contribution” Strategy.
The term “defined contribution” is a retirement planning phrase. You can
Google it and read all about it. Keeping it simple, it’s exactly what it says it
is: you “define a contribution” (ie: $200/month), and then employees
purchase their own individual plans on or off the exchange.

20. A “Defined Contribution” Strategy.
Effectively, it’s an after-tax stipend each month for health insurance. *Note:
one of the biggest questions benefits advisors have had over the past
couple of years has been whether-or-not this strategy can be carried
out on a pre-tax basis through payroll.

21. Consumer Directed Health Planning.
This can also be referred to as “account based” or “equity based”
planning. Small business owners can provide their employees access to a
high deductible plan, and then pair it up with an HRA (health
reimbursement arrangement) or HSA (health savings account).

22. Consumer Directed Health Planning.
The HRA or HSA becomes an asset that builds equity over time. You retain
funds that would normally go to the insurance companies in the form of
premiums, and ownership of the account is with either the employee or
business, depending on your strategy.

23. The #1 goal in health
benefits planning is always to
improve coverage and
save money.
Remember

24. Presentation Written By:
Tyson J. Lester, RHU, REBC
President, Policy Advantage Insurance Services
tyson@policyadvantage.com
(714) 512-8098
www.PolicyAdvantage.com

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