One of the many components of the Patient Protection and Affordable Care Act (PPACA aka Health Care Reform) is each state must decide if they will implement the Medicaid expansion. The goal is to expand coverage to state residents that aren’t covered by or eligible for one of the many programs currently offered.

Indiana already has several program options in place, including the Healthy Indiana Plan (HIP), but eligibility can be complicated and varies based on the individual program guidelines. There is much disagreement between parties as to which program is the most cost-effective for the state and how to provide the coverage needed by over 400,000 low-income Hoosiers.

Businesses are getting into high gear figuring out how to deal with the new Healthcare Reform requirements that take effect in 2014.

Indiana does not want a state-run health insurance exchange.

For the 19^th consecutive year, Gibson has earned Best Practices status from Independent Insurance Agents & Brokers of America (IIABA).

The following table provides a timeline of effective dates for the primary healthcare reform provisions affecting employers.
 
Caution: PPACA is under constant review. Provisions could be adjusted, re-interpreted and even repealed in the future. This is a snapshot as of July, 2012.
 

Under the Patient Protection and Affordable Care Act (PPACA), aka Healthcare Reform, health insurance companies are required to spend a minimum of their premium dollars for health care. This percentage, called medical loss ratio (MLR), is 80% of premiums for groups under 100 employees or 85% for groups with 100 or more employees. If an insurer does not meet this standard, it is required to rebate the excess to employers by August 1, 2012. Employers need to become familiar with the MLR rebate rules and if receiving a rebate, know what needs to be done to be compliant with the law.

The Supreme Court affirmed the constitutionality of the Affordable Care Act. By a 5-4 vote, the individual mandate requiring most Americans to maintain "minimum essential" health insurance coverage, 26 U.S.C. 5000A, is affirmed as an exercise of Congress's taxing power.

There has been a lot of information in the news about health care reform and how it affects small businesses. We find many business owners scratching their heads trying to understand what it all means. To simplify matters, here are three things small employers must know about employee health benefits—especially in a post-health care reform environment:

1. You do need to claim your tax credit. Your business is eligible for the Small Business Health Care Tax Credit if you have fewer than 25 full-time employees, cover at least 50% of the cost of their coverage, and your employees have average wages of less than $50,000 a year. To determine the amount of your credit, talk to your accountant and complete IRS form 8941.
2. You don’t have to report benefits on your W-2′s. PPACA requires employers to report the cost of coverage under an employer-sponsored group health plan on employees’ Form W-2s. However, this requirement was optional for all employers for the 2011 tax year. And the reporting requirement is still optional for businesses filing fewer than 250 W-2 forms for 2012. Reporting will remain optional for smaller employers until further guidance is issued.
3. You must provide proper notice. Under COBRA, employers with 20 or more employees that provide health benefits must continue to provide coverage to an employee when he or she leaves. You can require the employee to pay the full cost of the coverage and a 2% administrative charge. However, you must notify your plan administrator within 30 days of the employee leaving so your administrator can provide the proper employee notice.

Health care reform is confusing. Speak with your attorney, accountant, and insurance advisor to make sure you know what your business is required to do.