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What the Illinois Healthcare Laws
  Will Mean to Your Business




                      Wirehead Technology 2013
What the Illinois Healthcare
Laws Will Mean to Your Business
      Howard Lee
      CIO
      Wirehead Technology
      312-286-8416
      wireheadtec@gmail.com




          Wirehead Technology 2013
Introduction
Wirehead Technology Mobile IT consulting company [started as
Technocrats Consulting 2001]. Headquarters in Chicago, IL
Mobile IT application software development MERP [Mobile
Enterprise Resource Planning] consulting services

 2009: Article Enterprise Management Quarterly "Is Your Mobile
Guru Costing You Money"

 2008: Article: Enterprise Management Quarterly "How to Plan a
MERP network

 2003: Member of VAR Business Magazine CMP Solution
Provider Board

 2002: Provided hybrid WIFI System to Chicago Public School.
This was used by Proxim Technology as Case Study and profiled
on CBS News and two technical publications.

 2002: National Medical Association: Speaker Using mobile
technology in Healthcare

 2001: DCI Wireless Expo: Speaker Using mobility in the
                                                                 “Looking Beyond the Mobile Device
enterprise                                                       To Create Solutions”

 2001: Co-authored Handheld Application Guide with
Synchrologic Inc.

 1998: Developed CE InSight mobile training application


                                                            Wirehead Technology 2013
Agenda

    Illinois Small Business
    Healthcare

    State Price Transparency
    Laws

    Small Business Call To Action




                                    Wirehead Technology 2013
Facts About Small Business Healthcare Laws


    Small business tax credits for eligible employers who enroll in health
    insurance coverage through the Small Business Health Options Program
    (SHOP).

    Illinois small business owners hear more about the healthcare law, their
    support for keeping it intact—either as is or with minor changes—rises to
    68%,while the desire for it to be overturned drops to 14%. Moreover,
    entrepreneurs strongly support most of its key provisions affecting small
    business owners.

     A strong 73% of owners say they would use their state exchange or at least
    consider using it, compared to only 5% who say they would not consider
    using it when they provide benefits. The majority of entrepreneurs find
    possible features of the exchange very appealing, and 70% support Illinois
    applying for federal funds to set one up.




                                                     Wirehead Technology 2013
Facts About Small Business Healthcare Laws

    Furthermore, a 52% majority of entrepreneurs report they’d be more likely to
    purchase insurance through the exchange if, in 2014, the small business tax
    credit is available only to those using the exchange. That’s more than three times
    the number (15%) who say they’d be less likely to purchase from the exchange.
    Of respondents who fall into the basic qualification parameters for the tax credit,
    39% are already taking advantage of it. Of eligible employers who aren’t claiming
    it, 35% say it’s because they’re not sure whether their business qualifies. And,
    64% of entrepreneurs say that if their company qualified for the credit, they would
    be more likely to provide or continue providing healthcare to employees.

    Nearly six in 10 owners who don’t offer coverage to employees say cost is the
    biggest barrier: Of small business owners who do not provide coverage for
    employees, 59% report their business cannot afford it. Another 31% of
    respondents say their employees get coverage elsewhere.




                                                        Wirehead Technology 2013
Facts About Small Business Healthcare Laws

    159,900 Illinois small businesses are eligible (78.5% of all IL businesses); 48,400
    businesses eligible for the maximum credit




    Requires insurers to spend at least 80% of small groups’ premium expenses on
    medical claims and quality improvement.• Limits administrative and profit costs to 20%
    of premiums collected.• If carriers exceed this, they must make up for it by giving back
    rebates for the difference.• An estimated $1.1B will be given back in 2012 (HHS)•
    Nationally:Average rebate per enrollee in a small group plan: $76 Total rebates:
    $377M in the small group market, 28% of all small employer plans• Illinois:Total
    rebates: $61M, an average of $380 for the 163,000 families in Illinois covered by a
    policy.
                                                              Wirehead Technology 2013
Healthcare Essential Benefits

    The Affordable Care Act
    ensures Americans have
    access to quality, affordable
    health insurance. To achieve
    this goal, the law ensures that
    health plans offered in the
    individual and small group
    markets, both inside and
    outside of Health Insurance
    Marketplaces, offer a core
    package of items and services,
    known as “essential health
    benefits.” Under the statute,
    EHB must include items and
    services within at least the
    following 10 categories:

                                      Wirehead Technology 2013
Healthcare Essential Benefits

    Ambulatory patient services

      Emergency services

      Hospitalization

      Maternity and newborn care

      Mental health and substance use disorder services, including
    behavioral health treatment

      Prescription drugs

      Rehabilitative and habilitative services and devices

      Laboratory services

      Preventive and wellness services and chronic disease
    management

      Pediatric services, including oral and vision care
                                                  Wirehead Technology 2013
State Price Transparency Laws

    Healthcare cost has been the major
    concern of business in Illinois. But
    containing healthcare has been difficult.
    When most healthcare providers prices are
    not known until service are done. Two new
    reports One from Catalyst for Payment
    Reform and the Health Care Incentives on
    State Laws on Healthcare Price
    Transparency Disclosures give most states
    a C- minus or below on providing healthcare
    prices.

    The next report from International
    Federation of Healthcare Plans compares
    the prices in the U.S. To that of other
    industrialized countries with U.S.
    Healthcare being higher than any other
    country.
                                                  Wirehead Technology 2013
Illinois Healthcare Cost




                  Wirehead Technology 2013
Illinois Healthcare Costs




                   Wirehead Technology 2013
Average Healthcare Cost




                Wirehead Technology 2013
Average Healthcare Cost




                 Wirehead Technology 2013
Average Healthcare Cost




                Wirehead Technology 2013
Average Healthcare Cost




                 Wirehead Technology 2013
Average Healthcare Cost




                 Wirehead Technology 2013
What Can I Do ?

    Educate Yourself and
    Your Employees
    About the new
    Healthcare Laws

    Support Illinois
    Healthcare SB 34

    Small Business
    Healthcare
    Consortium

                           Wirehead Technology 2013
HEALTH INSURANCE
      MARKETPLACE LAW of 2013

    Intent: establishment of an Illinois Health Insurance
    Marketplace (Exchange) to facilitate the purchase and
    sale of qualified health plans and dental plans in the
    individual market, and to provide for the establishment
    of a Small Business Health Options Program to assist
    qualified small employers in facilitating the enrollment
    of their employees in qualified health plans and dental
    plans offered in the small group market. It is estimated
    that more than one million Illinoisans will be eligible for
    the Illinois Marketplace.



                                          Wirehead Technology 2013
What is the Small Business Health Care Consortium?
We are a new, tax-exempt non-partisan coalition of small businesses that
serves to...

enable the collective voice of small businesses to



have a direct impact on controlling health care costs in Illinois.

 educate about the impact of health reform, control the excesses of the health
insurance industry and improve transparency.

 encourage small business friendly health reform legislation and regulations.

 represent the broad diversity of small businesses throughout the state.

 foster health reform changes that enable more small businesses and their
employees to access affordable health insurance.

                                                       Wirehead Technology 2013
Small Business IT Partners




                  Wirehead Technology 2013
What Illinois Healthcare Laws Will
    Mean to Your Business



       Q&A

                      Wirehead Technology 2013
Thank You

    Contact Us:

    Howard Lee

    Wirehead Technology

    Tel:312-286-8416

    Email:wireheadtec@gmail.com

    Web: www.wireheadtec.com



                               Wirehead Technology 2013

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What Illinois Healthcare Law Will Mean To Your Business

  • 1. What the Illinois Healthcare Laws Will Mean to Your Business Wirehead Technology 2013
  • 2. What the Illinois Healthcare Laws Will Mean to Your Business Howard Lee CIO Wirehead Technology 312-286-8416 wireheadtec@gmail.com Wirehead Technology 2013
  • 3. Introduction Wirehead Technology Mobile IT consulting company [started as Technocrats Consulting 2001]. Headquarters in Chicago, IL Mobile IT application software development MERP [Mobile Enterprise Resource Planning] consulting services  2009: Article Enterprise Management Quarterly "Is Your Mobile Guru Costing You Money"  2008: Article: Enterprise Management Quarterly "How to Plan a MERP network  2003: Member of VAR Business Magazine CMP Solution Provider Board  2002: Provided hybrid WIFI System to Chicago Public School. This was used by Proxim Technology as Case Study and profiled on CBS News and two technical publications.  2002: National Medical Association: Speaker Using mobile technology in Healthcare  2001: DCI Wireless Expo: Speaker Using mobility in the “Looking Beyond the Mobile Device enterprise To Create Solutions”  2001: Co-authored Handheld Application Guide with Synchrologic Inc.  1998: Developed CE InSight mobile training application Wirehead Technology 2013
  • 4. Agenda  Illinois Small Business Healthcare  State Price Transparency Laws  Small Business Call To Action Wirehead Technology 2013
  • 5. Facts About Small Business Healthcare Laws  Small business tax credits for eligible employers who enroll in health insurance coverage through the Small Business Health Options Program (SHOP).  Illinois small business owners hear more about the healthcare law, their support for keeping it intact—either as is or with minor changes—rises to 68%,while the desire for it to be overturned drops to 14%. Moreover, entrepreneurs strongly support most of its key provisions affecting small business owners.  A strong 73% of owners say they would use their state exchange or at least consider using it, compared to only 5% who say they would not consider using it when they provide benefits. The majority of entrepreneurs find possible features of the exchange very appealing, and 70% support Illinois applying for federal funds to set one up. Wirehead Technology 2013
  • 6. Facts About Small Business Healthcare Laws  Furthermore, a 52% majority of entrepreneurs report they’d be more likely to purchase insurance through the exchange if, in 2014, the small business tax credit is available only to those using the exchange. That’s more than three times the number (15%) who say they’d be less likely to purchase from the exchange. Of respondents who fall into the basic qualification parameters for the tax credit, 39% are already taking advantage of it. Of eligible employers who aren’t claiming it, 35% say it’s because they’re not sure whether their business qualifies. And, 64% of entrepreneurs say that if their company qualified for the credit, they would be more likely to provide or continue providing healthcare to employees.  Nearly six in 10 owners who don’t offer coverage to employees say cost is the biggest barrier: Of small business owners who do not provide coverage for employees, 59% report their business cannot afford it. Another 31% of respondents say their employees get coverage elsewhere. Wirehead Technology 2013
  • 7. Facts About Small Business Healthcare Laws  159,900 Illinois small businesses are eligible (78.5% of all IL businesses); 48,400 businesses eligible for the maximum credit Requires insurers to spend at least 80% of small groups’ premium expenses on medical claims and quality improvement.• Limits administrative and profit costs to 20% of premiums collected.• If carriers exceed this, they must make up for it by giving back rebates for the difference.• An estimated $1.1B will be given back in 2012 (HHS)• Nationally:Average rebate per enrollee in a small group plan: $76 Total rebates: $377M in the small group market, 28% of all small employer plans• Illinois:Total rebates: $61M, an average of $380 for the 163,000 families in Illinois covered by a policy. Wirehead Technology 2013
  • 8. Healthcare Essential Benefits  The Affordable Care Act ensures Americans have access to quality, affordable health insurance. To achieve this goal, the law ensures that health plans offered in the individual and small group markets, both inside and outside of Health Insurance Marketplaces, offer a core package of items and services, known as “essential health benefits.” Under the statute, EHB must include items and services within at least the following 10 categories: Wirehead Technology 2013
  • 9. Healthcare Essential Benefits  Ambulatory patient services  Emergency services  Hospitalization  Maternity and newborn care  Mental health and substance use disorder services, including behavioral health treatment  Prescription drugs  Rehabilitative and habilitative services and devices  Laboratory services  Preventive and wellness services and chronic disease management  Pediatric services, including oral and vision care Wirehead Technology 2013
  • 10. State Price Transparency Laws  Healthcare cost has been the major concern of business in Illinois. But containing healthcare has been difficult. When most healthcare providers prices are not known until service are done. Two new reports One from Catalyst for Payment Reform and the Health Care Incentives on State Laws on Healthcare Price Transparency Disclosures give most states a C- minus or below on providing healthcare prices.  The next report from International Federation of Healthcare Plans compares the prices in the U.S. To that of other industrialized countries with U.S. Healthcare being higher than any other country. Wirehead Technology 2013
  • 11. Illinois Healthcare Cost Wirehead Technology 2013
  • 12. Illinois Healthcare Costs Wirehead Technology 2013
  • 13. Average Healthcare Cost Wirehead Technology 2013
  • 14. Average Healthcare Cost Wirehead Technology 2013
  • 15. Average Healthcare Cost Wirehead Technology 2013
  • 16. Average Healthcare Cost Wirehead Technology 2013
  • 17. Average Healthcare Cost Wirehead Technology 2013
  • 18. What Can I Do ?  Educate Yourself and Your Employees About the new Healthcare Laws  Support Illinois Healthcare SB 34  Small Business Healthcare Consortium Wirehead Technology 2013
  • 19. HEALTH INSURANCE MARKETPLACE LAW of 2013  Intent: establishment of an Illinois Health Insurance Marketplace (Exchange) to facilitate the purchase and sale of qualified health plans and dental plans in the individual market, and to provide for the establishment of a Small Business Health Options Program to assist qualified small employers in facilitating the enrollment of their employees in qualified health plans and dental plans offered in the small group market. It is estimated that more than one million Illinoisans will be eligible for the Illinois Marketplace. Wirehead Technology 2013
  • 20. What is the Small Business Health Care Consortium? We are a new, tax-exempt non-partisan coalition of small businesses that serves to... enable the collective voice of small businesses to  have a direct impact on controlling health care costs in Illinois.  educate about the impact of health reform, control the excesses of the health insurance industry and improve transparency.  encourage small business friendly health reform legislation and regulations.  represent the broad diversity of small businesses throughout the state.  foster health reform changes that enable more small businesses and their employees to access affordable health insurance. Wirehead Technology 2013
  • 21. Small Business IT Partners Wirehead Technology 2013
  • 22. What Illinois Healthcare Laws Will Mean to Your Business Q&A Wirehead Technology 2013
  • 23. Thank You  Contact Us:  Howard Lee  Wirehead Technology  Tel:312-286-8416  Email:wireheadtec@gmail.com  Web: www.wireheadtec.com Wirehead Technology 2013