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Health care plan studied

By LINDA HARRIS

February 10, 2013
Staff writer (lharris@heraldstaronline.com) , The Herald-Star

STEUBENVILLE - Those who've studied it say the Affordable Care Act has the potential to be anything but affordable for business owners as well as workers.

Affordable Care - also known as "Obamacare" or, more formally, the "Patient Protection and Affordable Care Act" - requires every American to have health insurance by Jan. 1, and every employer with 50 or more employees on the books to offer them health coverage. It's called "pay-or-play:" Companies with 50-plus workers that don't offer health coverage also will be fined and the money used to help finance subsidies for those who don't have access to an affordable plan.

While that "50 employee" trigger seems straight forward enough, in reality it's anything but: The government could count two part-time workers, for instance, as a full-time equivalent. Or, if you own two or more small businesses, the powers-that-be could opt to use something called "common ownership" and count it as one business. And going forward, full-time will mean anyone working 30 hours or more.

On the other side of the ledger, 11 months from now Americans will have to prove to the Internal Revenue Service that they have insurance. Those who have the resources but don't have coverage will be fined - a small amount, initially, but by 2016 the law will be in full force and the fines will be hefty.

And, while coverage will be subsidized for people who don't have access to a qualified health plan, how much each pays will be based on how much they make.

With so much at stake, the Jefferson County Chamber of Commerce is teaming with the Ohio Small Business Development Center to offer a two-hour program, "The Patient Protection & Affordable Care Act" from 9 a.m. to 11 a.m. Wednesday at Froehlich's Classic Corner, 501 Washington St.

Leading the discussion will be Scott Pipes, CEO and co-owner of Pipes Insurance Services, and Mark Fearon, principal in Rea & Associates, who will focus on employer responsibilities as they relate to the new requirements as well as the subsequent tax impact.

Both men say the new regulations have all sorts of twists and turns, and employers who don't educate themselves about the new rules could pay a steep price.

"It's definitely going to change the way we do business," Fearon said. "Business owners will be forced to make decisions. Businesses need to learn, first of all, do they qualify or not for the (50 employee or less) cutoff. Some businesses won't, some will. And if they are going to be affected, they need to know what their options are."

The goal, Fearon said, should be to "learn the rules and make an informed decision."

"Employers need to understand the employer responsibility portion, how the fees will work, how administration of the plans will work," Pipes added. "They also have to understand what it will do to their labor force, regardless of whether they're in pay-or-play status. This will change the labor market over the next several years more than anything we've seen in our lifetime."

Pipes said the changes might fly under the radar until tax time, when people actually feel the sting in their pockets.

"The burden of proof falls on the taxpayer, not the IRS," he added. "I'm really anticipating the buzz will start about April 2015 when they file taxes ... the fine won't be real big then, but by 2016 it will be pretty substantial. If you don't have coverage, you're going to be unhappy."

While many people think it's going to be "new, free health care," he said the reality is that it will be anything but free, and employee turnover could become a factor at companies that don't provide a qualified plan if their employees can't qualify for a substantial subsidy.

Fearon said he's actually had employers tell him they're thinking about cancelling their plan and paying the fine, which he said also could backfire.

"It may sound like a good idea, they think it will be cheaper to pay the penalty, but they could lose their employees to another employer who offers insurance," he said. "It's not a decision you want to rush into."

Admission to the seminar is $10 for chamber members and $15 for non-members. Space is limited, and those planning to attend are encouraged to reserve a spot by calling the chamber offices at (740) 282-6226 or by e-mailing dconrad@jeffersoncountychamber.com.

 
 

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