WIPP's legislative strategy is to have the greatest possible impact for small business owners. We focus on our economic principles and craft a succinct small business message that we bring directly to members of Congress, the White House and Federal Agencies. Your guidance and advocacy efforts together with political reality allows us to move our agenda forward effectively.
The SBA Office of Advocacy research shows that insurers of small business health plans have higher administrative expenses than their larger counterparts. It is no surprise that more than one third of uninsured Americans work in small businesses with fewer than 500 employees. With the enactment of the Affordable Care Act, state-based health insurance exchanges will be established for small businesses effective in 2014.
1) Ensure Health Insurance Exchanges Provide More Choices and Better Prices for Small Businesses
Rules and regulations that are adopted by federal and state governments to create and implement health insurance exchanges should be structured to maximize health insurance choices for small businesses. In order for the exchanges to be successful, health insurance premiums for small businesses must fall in line with other segments of the marketplace. Regulators should learn from past exchange successes and failures at the state level.
2) Cost Containment Measures Should Address Increased Healthcare Costs
One of the major drivers behind healthcare reform was the need to control increasing healthcare costs. According to the Kaiser Family Foundation, healthcare spending has grown at an average annual rate of 9.6%, 2.4 percentage points faster than nominal GDP since 1970. The federal government projects that by the year 2018, health spending will be one-fifth of the GDP.
Cost containment measures are needed to address increased healthcare costs such as medical malpractice. Furthermore, wellness and preventive care should be a priority of the providers as well as the consumers of healthcare.
of February 2014 Changes to Employer Mandate
On February 10, 2014, the Treasury Department and the
Internal Revenue Service released rules on the "employer mandate” provision of
the Affordable Care Act. The mandate requires all employers with 50 or more
employees to provide an affordable coverage option to employees or possibly
face penalties. As a reminder, no business with fewer than 50 employees will
ever face penalties. WIPP invites you to join a webinar
on the final rule and what you need to know.
The following major changes were made:
Businesses with 50-99 Employees Exempted
Until 2016. For businesses with 50-99 employees, penalties are waived until
2016. Previously, penalties for all businesses, regardless of size, were
delayed until 2015.
Relaxed Coverage Requirement for Businesses with
100+ Employees. For businesses with 100+ employees, penalties slated to
begin in 2015 will now only be imposed on employers failing to cover a minimum
of 70% of their employees—a decrease from the original 95%. This transitional
policy is only applicable to 2015 and returns to the required 95% in 2016.
Safe Harbor and "Look back” Provisions
Extended/Expanded. Certain health-insurance safe harbors (preventing
penalties) have been extended/expanded for 2014 and 2015. These include methods
of counting employees and determining if offered coverage is affordable.
Categories of Certain Employees Are Further
Defined. Some employers received special direction for totaling employees
including the counting of: volunteers, educational employees, seasonal employees,
and work-study programs. A frequent example is the exemption of volunteer
The final rules are extensive and this summary does not
cover all policy changes. The final
rule and a fact
sheet from the Treasury Department are available online. Keep an eye out
for upcoming regulations that include how employers can report their coverage
and employee totals.
WIPP is hosting a webinar to detail these changes and take
questions on February 27th at 2pm EST (register here).
To remain up to date on all healthcare policy issues, join the WIPP healthcare committee.
Online Enrollment in Small Business
Insurance Marketplace Unavailable Until November 2014
Small businesses choosing to
shop in the federal Health Insurance Marketplace will have to do so over the
phone, through a broker, or directly with an insurer. The online enrollment
option will not be ready until November 2014. This delay of the online
enrollment option only applies to the 36 states participating in the federal
insurance exchange. Many states, operating their own exchanges, have online
enrollment as an option. You can find out if your state participates in
the federal marketplace or if it operates a statewide exchange here.
The Small Business Marketplace,
also called the federal SHOP exchange, serves small businesses with up to 50
employees. While the exchange is functioning, and plans are available, the
enrollment process—specifically, enrolling online—has faced
challenges.According to the Administration, the one-year delay is necessary
to address technical issues as well as include the previously delayed employee
choice and premium aggregation functions. The Department of Health and Human
Services, overseeing health care reform changes in the Affordable Care Act,
originally said that technical problems with the website would be fixed by Dec.
Instead the Administration
recommends employers to consider "direct enrollment" -- enrolling
over the phone, through a broker, or with the insurer directly.The option
to enroll directly with the insurance company is a new option, in response to
the unavailable online option. The Small Business Administration provided the
following with regard to the enrollment process: "Specifically, for 2014,
small employers will enroll their employees in coverage through an agent,
broker, or insurer that offers a certified SHOP plan and has agreed to conduct
enrollment according to HHS standards." For the more on enrollment
options, visit the SBA.
Employees of businesses not
offering health insurance plans can purchase individual insurance. The deadline
to purchase individual plans with coverage beginning January 1, 2014 on the
federal exchange (through healthcare.gov) has been extended to Dec. 23, 2014.
To learn about all the recent changes in healthcare reform, be sure to register
for the final WIPP healthcare webinar of the yearhere.
In a briefing for health insurance exchange
stakeholders, the Centers for Medicare and Medicaid Services (CMS), the
department overseeing the health insurance exchanges for the federal
government, announced it would be extending the purchasing deadline for
insurance plans with coverage beginning January 1, 2014.
The new deadline to purchase a plan with
coverage that begins January 1, 2014 is now December 23, 2013 (previous
deadline was December 15th), giving applicants an additional week to secure
The following is a list of legislation that WIPP is actively following:
S. 1188 - Forty Hours is Full Time Act of 2013
H.R. 886 - America's Small Business Tax Relief Act of 2013
WIPP submitted comments for the record on proposed SHOP delays - 3/1/13
HEALTHCARE NEWS & POLICY UPDATES
The following is a list of presentations, statements and letters that WIPP has released:
Healthcare Policy, Trends
and Business Opportunities - 9/26/2013
ADD YOUR VOICE
WELLNESS STRATEGIES FOR THE WORKPLACE
Pfizer Medicine Safety Education Website:
How much do you know about the medicine you are taking? Do you know what information to provide to your doctor? Are there risks associated with the medicine you are taking? Click here to visit a comprehensive medicine safety website which will help you understand your medicines. Click here to see the Pfizer Medicine Safety Education Website logo
The Challenges and Rewards of Promoting Wellness in the Workplace, click here.
Department of Health and Human Services released new Physical Activity Guidelines for Americans, a roadmap encouraging individuals to incorporate physical activity into their daily routines. This is based on the fact that regular physical activity over months and years produces long-term health benefits and reduces the risk of many diseases such as early death for adults; coronary heart disease, stroke, high blood pressure, type 2 diabetes, colon and breast cancer, and depression. As we know, small businesses struggle to afford the rising costs of health insurance premiums. Promoting healthy living for employees directly correlates with long term health costs.
The Physical Activity Guidelines are based on a review of scientific research about physical activity and health. A 13-member advisory committee appointed in April 2007 by Secretary Leavitt reviewed research and produced an extensive report.
Key Guidelines for adults include:
Adults -- Adults gain substantial health benefits from two and one half hours a week of moderate intensity aerobic physical activity, or one hour and 15 minutes of vigorous physical activity. Walking briskly, water aerobics, ballroom dancing and general gardening are examples of moderate intensity aerobic activities. Vigorous intensity aerobic activities include racewalking, jogging or running, swimming laps, jumping rope and hiking uphill or with a heavy backpack. Aerobic activity should be performed in episodes of at least 10 minutes. For more extensive health benefits, adults should increase their aerobic physical activity to five hours a week moderate-intensity or two and one half hours a week of vigorous-intensity aerobic physical activity. Adults should incorporate muscle strengthening activities, such as weight training, push-ups, sit-ups and carrying heavy loads or heavy gardening, at least two days a week.
Women during pregnancy -- Healthy women should get at least two and one half hours of moderate-intensity aerobic activity a week during pregnancy and the time after delivery, preferably spread through the week. Pregnant women who habitually engage in vigorous aerobic activity or who are highly active can continue during pregnancy and the time after delivery, provided they remain healthy and discuss with their health care provider how and when activity should be adjusted over time.
Click to View the Guidelines: http://www.health.gov/paguidelines/pdf/paguide.pdf
As more resources regarding the Affordable Care Act are provided by the federal government as well as the states, WIPP wants to make sure you are aware of all that is available. The resources listed below can also be found on WIPP's healthcare page. Here are three resources important to small businesses:
1. What is Your State Doing To Put a Small Business Marketplace in Place
Following the February 15th deadline for states to file exchange plans with the Department of Health and Human Services (HHS), the state-by-state picture has been finalized. The breakdown of the fifty states and District of Columbia are: 18 states have declared their own exchanges, 7 have partnered with the federal government and 26 states defaulted to the federal exchange. To see what your state decided, click here.
2. SBA Myth vs. Fact blog on the Affordable Care Act and Small Businesses
The SBA just launched a new blog on their website aimed at tackling common misconceptions regarding the Affordable Care Act and small business obligations. The blog can be found here.
3. YouTube on the Affordable Care Act
The Centers for Medicare and Medicaid Services (CMS) at HHS have released a video of the application process for an individual (not a small business) in the health insurance marketplace. You can view that video, and find the comment submission process for review here.
Healthcare: Policy, Trends and Opportunities Regional Series - Sponsored by Pfizer
PowerPoint Presentations from the Raleigh/Durham, NC Event on 4/7/2011
- The New Healthcare Law: Where Small Businesses Fit - Ann Sullivan, WIPP Government Relations
- Trends, Your Key to Opportunity - Sherrie Aycock, All Points Research
Healthy Weight Resource Guide
Fact Sheet: The Affordable Care Act’s New Rules on Preventive Care
HHS website for consumer information on the healthcare law: http://www.healthcare.gov
Calculation of Subsidy by the Kaiser Family Foundation: http://healthreform.kff.org/SubsidyCalculator.aspx
Click here to watch Lisa Gable, the executive director of the Healthy Weight Commitment Foundation, comment on the effects of obesity on families, and the important work the HWCF is doing to address this problem
A Caregiver's Guide to Alzheimer's Disease
"Maybe It's Fibro?" Treatment and Management article
Check out these websites:
· Business Owners Can Take Lead Role in Smoking Cessation, click here.
· Switching Medications: Cost-effective for insurers or risky for patients – or both? Click here.
· Fibromyalgia: Chronic Pain That Packs a Punch to You and Your Employee <click here>
· Pfizer Helpful Answers, assistance for the uninsured: http://www.pfizerhelpfulanswers.com/
· Smarxt Disposal: this is a campaign called SMARxT DISPOSAL, sponsored by PhRMA, (the American Pharmacists Association), and the U.S. Fish and Wildlife Service, introduced a campaign called SMARxT DISPOSAL which gives tips for methods of proper disposal of unused or expired pharmaceuticals. You can visit the campaign's website at http://www.smarxtdisposal.net/