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SEK&Co, Strickler Agency and Capital Blue Cross Presented a Seminar on Affordable Care Act Compliance Issues for Employers and Individuals.
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SMITH ELLIOTT KEARNS & COMPANY, LLC WWW.SEK.COM
An overview of the administrative and tax requirements of the Law…
2010…2011…2012…2013…2014…2015…2016…2017…2018…
» The Patient Protection and Affordable Care Act
Joel A. Flinchbaugh, CPAMember of the FirmSmith Elliott Kearns & Company, LLCJflinchbaugh@sek.comwww.SEK.com
SMITH ELLIOTT KEARNS & COMPANY, LLC WWW.SEK.COM
2010
SMITH ELLIOTT KEARNS & COMPANY, LLC WWW.SEK.COM
President Obama Signs law March 23, 2010
now what???
SMITH ELLIOTT KEARNS & COMPANY, LLC WWW.SEK.COM
35% tax credit applicable for:• Businesses with less than 25 FTE employees & average wages less than $50,000.• Credit reduced as # of employees exceeds 10 and average wage exceeds $25K.
Small Business Health Insurance Credits Begin
Click icon to add picture 2010
SMITH ELLIOTT KEARNS & COMPANY, LLC WWW.SEK.COM
Tax applicable for services rendered after July 1, 2010.
10% Excise Tax on Indoor Tanning Services
2010
SMITH ELLIOTT KEARNS & COMPANY, LLC WWW.SEK.COM
2011
SMITH ELLIOTT KEARNS & COMPANY, LLC WWW.SEK.COM
• Over the counter drugs NO LONGER qualify.
• Non-qualified distributions subject to 20% penalty vs. 10% under old law.
Modifications to qualified expenses from FSA’s, HSA’s, and HRA’s and increased penalties.
2011
SMITH ELLIOTT KEARNS & COMPANY, LLC WWW.SEK.COM
Medical Loss Ratio Limits Begin • Small group and individual insurers-80%.• Large group-85%.• Excess premiums must be refunded.
2011
SMITH ELLIOTT KEARNS & COMPANY, LLC WWW.SEK.COM
2012
SMITH ELLIOTT KEARNS & COMPANY, LLC WWW.SEK.COM
Reporting of Health Insurance on W-2• Employers issuing more than 250 W-2’s required
to report health benefits on W-2• Still waiting for final regulations regarding
companies with less than 250• Not taxable – just information
2012
SMITH ELLIOTT KEARNS & COMPANY, LLC WWW.SEK.COM
Summary of Benefits Required• Renewals on or after 9/23/12• Notice of change in benefits must be provided 60
days before change• Insurance company should be providing this
reporting for employers
2012
SMITH ELLIOTT KEARNS & COMPANY, LLC WWW.SEK.COM
Employers Begin to Receive MLR rebates• Can be used to offset future premiums.• If employees contribute to premiums, they must
receive proportionate share of rebate.
2012
SMITH ELLIOTT KEARNS & COMPANY, LLC WWW.SEK.COM
2013
SMITH ELLIOTT KEARNS & COMPANY, LLC WWW.SEK.COM
Increased Medicare Tax (Hospital Insurance Tax)• .9% of wages in excess of…
• $200,000 if single.• $250,000 MFJ.
• Employers MUST withhold on wages paid in excess of $200,000 to individual.
2013
SMITH ELLIOTT KEARNS & COMPANY, LLC WWW.SEK.COM
Unearned Income Medicare Contribution Surtax • 3.8% on lessor of:
• Net investment income or• Excess of modified AGI over $200/S, $250/MFJ.
• Investment income (interest, dividends, royalties, rents, sale of passive activity, passive activity).
2013
SMITH ELLIOTT KEARNS & COMPANY, LLC WWW.SEK.COM
Increased Threshold for Deducting Medical Expenses• Threshold raised to 10% of AGI.• If over 65 - 7.5% limit still applies through
December 31, 2017.
2013
SMITH ELLIOTT KEARNS & COMPANY, LLC WWW.SEK.COM
Flexible Spending Account Limits• Annual limit of $2,500 for contributions to
flexible spending accounts.• No impact on premium or dependent care.
2013
SMITH ELLIOTT KEARNS & COMPANY, LLC WWW.SEK.COM
2.3% Excise Tax on Medical Device Manufacturers• Exemptions
• Eyeglasses.• Contacts.• Any device generally purchased by the public at
retail.
2013
SMITH ELLIOTT KEARNS & COMPANY, LLC WWW.SEK.COM
Patient Centered Outcomes Research Institute Fee - PCOR• Assessed on medical plans – usually paid by
carrier.• Employer may be subject with any type of self
insurance.• $1 per covered life, increasing to $2 than indexed
with inflation.
2013
SMITH ELLIOTT KEARNS & COMPANY, LLC WWW.SEK.COM
Notice of Coverage- Due 10/1/13• Employers required to provide• Must include:
• Description of services offered on Exchange• Potential eligibility for premium credit• Info about impact of purchasing through
Exchange
2013
SMITH ELLIOTT KEARNS & COMPANY, LLC WWW.SEK.COM
2014
SMITH ELLIOTT KEARNS & COMPANY, LLC WWW.SEK.COM
Individual Mandate• Maintain “minimum essential coverage” or:
• 2014 - Penalty (Tax) greater of 1% of household income OR $95 per uninsured
• 2015 – Penalty (Tax) greater of 2% of household income or $325 per uninsured
• Penalty Cap of $2,250 per household• There are some exceptions to the penalty
2014
SMITH ELLIOTT KEARNS & COMPANY, LLC WWW.SEK.COM
“Tax Credits” for Individuals Purchasing Through Exchange• A subsidy for purchasing insurance through the
Exchange. • For people with income above Medicaid limits,
but below 400% of federal poverty level.
2014
SMITH ELLIOTT KEARNS & COMPANY, LLC WWW.SEK.COM
Expansion of small business Health Insurance Credit to a 50% credit for small businesses who purchase insurance through SHOP (Exchange).
Small Business Health Insurance Credits
Click icon to add picture 2014
SMITH ELLIOTT KEARNS & COMPANY, LLC WWW.SEK.COM
2015
SMITH ELLIOTT KEARNS & COMPANY, LLC WWW.SEK.COM
Pay or Play Employer MandateEmployers with 50 or more FTE employees must either offer health insurance, or pay a penalty• $2,000/employee, but first 30 are not counted• Still subject to penalty even if coverage is offered,
but employee receives tax credit
2015
SMITH ELLIOTT KEARNS & COMPANY, LLC WWW.SEK.COM
2017
SMITH ELLIOTT KEARNS & COMPANY, LLC WWW.SEK.COM
States May Allow Larger Employers to buy on Exchange• Businesses with more than 100 employees may
be able to purchase insurance in the SHOP
2017
SMITH ELLIOTT KEARNS & COMPANY, LLC WWW.SEK.COM
2018
SMITH ELLIOTT KEARNS & COMPANY, LLC WWW.SEK.COM
Excise Tax on “Cadillac” Plans • 40% Excise tax on plans with costs exceeding:
• $10,700 for individuals• $27,500 for family
2018
SMITH ELLIOTT KEARNS & COMPANY, LLC WWW.SEK.COM
That was Easy!!!!
2018
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