Replacement Option for HCSO HRA in 2014

Transcription

1 Replacement Option for HCSO HRA in 2014 Presented by: Mark Schmersahl Vice President BeneFLEX HR Resources Inc. & Brad Billik Regional Business Development Director The Boon Group Agenda Highlight recent FAQs released by the City regarding HCSO HRAs. Discuss Health Care Reform changes to HCSO & HRAs in Review how BeneFLEX will help employers remain compliant. A go forward option for HCSO in BeneFLEX HR Services Health Reimbursement Arrangements (HRA) and Limited HRA San Francisco HCSO HRA (Spend down option effective: 1/1/14) New Exchange Notice Services Flexible Spending Accounts (FSA) and Limited FSA (LFSA) Premium Only Plan (POP) Health Savings Accounts (HSA) Transportation Management Account (TMA) Benny Card (Debit Card) COBRA/HIPAA Administration, Exchange Notices Retiree Billing 3 1

2 The Impact of Health Care Reform POP Lost the ability to pay individual health insurance premiums pre tax FSA Lost the ability to pay individual id lhealth hinsurance premiums pre tax $2,500 cap Must have a Health Insurance Plan to offer $500 Carryover Option with no Grace Period 4 The Impact of Health Care Reform COBRA Exchange Notice obligations COBRA added language to include Exchange Notice HRA No standalone HRAs in 2014 Lost ability to pay individual health insurance premiums pre tax 5 San Francisco HCSO HRA In 2007 you had 3 options to be compliant with the ordinance: 1. Insurance 2. Standalone HRA 3. City Option 6 2

3 IRS Notice On Friday September 13 th, the IRS released IRS Notice This guidance forecloses the ability of employers to offer: stand alone HRAs, stand alone MERPs, and limited dollar HRAs Forecloses privately sponsored San Francisco HCSO HRAs beginning with plan years starting on or after January 1, What Does That Mean for My BeneFLEX Administered HCSO HRA? 1. The Health Care Security Ordinance (HCSO), is still in effect. 2. BeneFLEX s HCSO HRA will keep you in compliance. 3. Health Care Reform allows for existing HRA accounts with a balance to roll forward. 8 BeneFLEX s Run Down for Current HCSO HRAs Fourth quarter contributions Ordinance requires that funds be available for 24 months BeneFLEX administer a 24 month spend down period 9 3

4 BeneFLEX s Run Down for Current HCSO HRAs Plan Docs Summary Plan Descriptions (SPDs) Summary of Benefits and Coverage (SBCs) HCSO Quarterly Statements Proof of Delivery 10 BeneFLEX s Run Down for Current HCSO HRAs All customer service in English and Spanish will be available for the run down HRAs December 31, 2015 will be the last day to turn in HCSO HRA Run Down claims Any unused HRA funds will revert back to the employer 11 BeneFLEX s HCSO HRA Run Down Timeline 12/31/13 1/30/14 7/30/14 1/30/15 7/30/15 A B C D D D D D D D 1/15/14 4/30/14 10/30/15 4/30/15 10/30/15 A. Date 4 th quarter reward for 2013 posted B. Due date for 4 th quarter reward for 2013 to BeneFLEX C. 4 th quarter statements will be sent for BeneFLEX HCSO HRA D. HCSO HRA run down statements sent each quarter for 24 months 12 4

5 BeneFLEX s HCSO HRA Run Down Timeline 12/31/15 E F 1/30/16 E. Last day to submit HCSO HRA run down claims F. No quarterly report due to end of plan year 13 HCSO HRAs and the Affordable Care Act: FAQs from the City Q: Is the HCSO Employer Spending Requirement scheduled to expire or go away when the ACA takes effect in 2014? A: No. The HCSO Employer Spending Requirement is not scheduled to expire or go away when federal health reform takes effect in HCSO HRAs and the Affordable Care Act: FAQs from the City Q: Since my business can elect not to make HRA contributions commencing in 2014, what happens to existing HRA balances at the end of 2013? A: The HCSO establishes that an HRA, must remain available to an employee for twenty four months from the date of the allocation. 15 5

6 HCSO HRAs and the Affordable Care Act: FAQs from the City Q: If my business elects to no longer allocates funds to HRAs, what are my options to satisfy the HCSO's Employer Spending Requirement in 2014? A: The options available to your business for satisfying the HCSO s Employer Spending Requirement in 2014 and beyond remain. Insurance City Option 16 History of the Boon Group In business for 30 years Government Contractors Both laws require an hourly health and welfare benefit be provided to employees. Subject to: Service Contract & Davis Bacon Acts 17 Broker Friendly BBB ACCREDITED BUSINESS On a scale of A+ to F 18 6

7 Boon Group & Transamerica The Boon Group is exclusively marketing hourly based plans in San Francisco for Transamerica The Boon Group pays the claims, handles customer service, enrollment, etc. for Transamerica 19 $2.44 San Francisco Employee Only Benefit Overview 20 $2.44 San Francisco Employee Only Benefit Overview Continued 21 7

8 How the Benefits Work City Option = No PP0 network Dr visit $200 & Rx $50 Hospital $4,000 for 1 night stay With First Health PPO Network Dr Visit $50 & Rx $10 Transamerica plan $3,100 for 1 st night 22 California Approves FAQ 7 Guidelines On October 16 th, 2013 Transamerica received approval from the State of CA to market the Trans Advance fixed indemnity plan under the provisions of the Affordable Care Act. The Trans Advance plan meets FAQ 7 guidelines and can be sold in 2014 and going forward. 23 Approval From City Meets the spending requirement of HCSO No minimum benefit required under HCSO 24 8

9 Who is Eligible Employer Mandate vs Individual Mandate & Part Time & Full Time Employees 2015 & Beyond Part time Employees and Full Time that Opt Out Out of the Corporate Plan 26 Requesting a Quote In order to obtain a quote, we need the following information: Must have a minimum of 50 total employees and 15 eligible under HCSO Companyname name, address, phone number, contact person & title Total number of employees in the company Census & Hours report just list the eligible employees (DOB & zip code) NAICS Code 27 9

10 Reporting Spreadsheet enrollment Monthly Reports Sent to The Boon Group Name, SS#, Hours Self Reporting The Boon Group sends to the Business Audit Trail Reports 28 The Boon Group vs. City Option Better Benefits for the Same Cost Reduce HRA Run Down exposure City Option = No PP0 network Dr visit iit$200 & Rx $50 Hospital $4,000 for 1 night stay With First Health PPO Network Dr Visit $50 & Rx $10 Transamerica plan $3,100 for 1 st night 29 FAQs Timing to get a quote? If the HCSO changes cancel anytime? Customer Service calls and benefit questions? 30 10

11 Q & A Audience Questions We are now taking questions from the audience. Please submit your questions via the text message box. Any questions we do not get to address on this call will be addressed afterwards. A Q & A document will be posted with the recording of this webinar to: francisco hcso hra/ Contact Us Brad Billik of The Boon Group bbillik@boongroup.com or Mark Schmersahl of BeneFLEX HR Resources Inc