Obamacare: Are You Ready to "Play or Pay"?

May 23, 2013


Get Prepared, Big Obamacre Mandates are Coming:

On January 1, 2014 many key provisions of the Patient Protection and Affordable Cara Act (aka “PPACA”, “ACA” or simply “Obamacare”) will come into effect.  It is predicted that the economic impact and the regulatory issues from the ACA will be the largest impact of any piece of legislation ever passed into law in the US.  At the same time, per Docstoc.com, polls taken of small business owners show that 56% of small businesses with less than 50 employees mistakenly believe that they must provide employees with health insurance coverage.  32% say that this coverage is ‘absolutely required’ and 24% believe they will be required to pay a penalty if they don’t.  The reality is that businesses with less than 50 employees do not have to provide employee health insurance coverage.

Every Picture Tells a Story

I have more than 10 years experience in healthcare in both physical and behavioral health with payments arising from the Medicare/Medicaid reimbursement system.  Due to the confusion with the ACA, I decided to ‘summarize and explain’ the Affordable Care Act in straight-forward, easy to understand language.  My presentation is titled:  "Obamacare:  What Here Applies to Me?"   My approach was to follow the old adage:  “A picture is worth a thousand words”.  Therefore my presentation is a Graphical Lay-out of the ACA  --  now with just 2 or 3 "flow-charted" slides, a business owner can determine what parts of the ACA applies to them.  This allows for a quick understanding and assessment of how the ACA will affect his business so they can begin to plan for the massive changes about to take place.    One CPA who’s seen my presentation called it the "The best, clearest explanation  I have seen of the provisions of the Affordable Care Act!".  Another CPA simply said:  “This is awesome”.   

Why is this Important to Understand the ACA?

The individual mandate and the employer’s mandate will go into effect on January 1, 2014.  This will affect the way millions of Americans obtain health insurance.  If a company is in the “Pay or Play” arena (the Employer Mandate), they must provide AFFORDABLE health Insurance with the 10 mandated ESSENTIAL HEALTH BENEFITS and meet MINIMUM ESSENTIAL COVERAGES for SUBSTANTIALLY ALL of their employees, or pay the Employer Penalty/Tax.  A business owner should know if Pay or Play applies and how it may affect his business.

Also, According to the General Accountability Office (GAO), in 2010 170,300 businesses claimed $468 million in tax credits for health insurance.  The 170,300 is about 3.9% of the 4.4 million businesses that the White House had argued were potentially eligible for the tax credits.  Also, the $468 million is about 23% of the $2 billion of tax credit originally forecasted by the Congressional Budget office.  The real question how many businesses and tax preparers simply did not file for the tax credits due to the complexity of the calculation and/or due to the uncertainty surrounding Obamacare.  Remember that it was not until June 27, 2012 that the Supreme Court upheld the key provisions of the ACA.  It seems that there may literally billions of dollars of unclaimed tax credits still available to small businesses for the years 2010 through 2012.


What’s the Next Step?

Do understand what “Pay or Play” means?   Or are you a small business (less than 25 employees and employees have an average salary of less than 50,000 per year) and wondering if you could be due a tax credit?  Do you have other questions or concerns about the ACA?  If any of these are true, please request a copy of "Obamacare:  What Here Applies to Me?" --  I’ll be happy to send it to you.  Please make a request to me at:  jimmerski@b2bcfo.com, or call me at 814.397.2645.

I’d also be happy to sit down and go through the Obamacare presentation so you understand “What Here Applies to Me”.  You just may be eligible to receive a tax credit, and like GEICO commercial says, in 15 minutes could save you have up to 35% per year in tax savings!

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