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Affordable Care Act Seminar for Small Nonprofits Delivers Insights

by Brenda Peluso

On Tuesday, May 13th, the Maine Health Access Foundation (MeHAF), MANP and Healey & Associates co-sponsored a seminar in Augusta for small nonprofit businesses titled “The Affordable Care Act (ACA): What’s in it for my Nonprofit?

Thanks to our panel of experts and session moderator!

The event featured a panel of five ACA experts: Mitchell Stein, Health Policy Consultant; Roger Prince, Senior Manager in the BerryDunn Tax Group; Eric Jermyn, Director of Sales for Anthem; Scott Taggersell, Director of Business Development at Maine Community Health Options; and Brian Staples, Senior Sales Executive at Northeast Delta Dental. Dr. Wendy Wolf, President & CEO of MeHAF moderated.

Dr. Wolf noted that for the first open enrollment period for individuals that ended April 15th, Maine had one of the highest rates of participation in the country for a federally-run Marketplace state, with over 44,000 enrolling. This high rate of participation signals the interest Maine people have obtaining affordable health care for themselves and their families.

The five panelists spoke about different aspects of the ACA with special attention to the Small Business Health Options Program (SHOP). SHOP is available for both small (under 50 FTEs) for-profit and nonprofit employers. Small businesses are not required to offer health insurance to their employees, but for those that do, purchasing a group plan through the SHOP Marketplace may entitle the nonprofit employer to a Small Business Tax Credit.

Other key takeaways included:

  • The ACA works within the current system of private insurance to ultimately provide universal access to health coverage, using an online Marketplace to spur competition and financial subsidies to individuals and families making up to 400% of the Federal Poverty Level to make premiums more affordable. As with any major system change, there are winners and losers in terms of the financial impact.
  • The ACA is the most extensive tax law change since the 1986 Tax Act and employs a classic “carrot + stick” approach to compliance.
  • Small businesses have the option of purchasing plans off or on the SHOP, or may decide not to offer group insurance and let their employees go to the individual Marketplace. Whichever way is chosen, panelists strongly recommended using a broker who is well-versed in the ACA and SHOP since the law is complicated and the decision can be very fact-specific. Small businesses enroll through the SHOP using a broker, agent or insurance company.
  • The law as currently drafted includes what is known as “the family glitch,” which can have an unintended adverse impact on how “affordability” is determined for spouses of covered employees – another reason to consult a knowledgeable broker to sort out the best course for your organization and employees!
  • There are good tools on healthcare.gov to help small businesses make some of these complicated decisions.
  • There are plenty of people marketing ACA ‘workarounds’ for individuals and businesses, which may or may not be legal – yet another reason for nonprofits to seek advice from a reputable broker (can you spot a recurring theme?)

Presenters from the three insurers on the Maine Marketplace – Anthem, Maine Community Health Options, and Northeast Delta Dental – gave an overview and specifics on plan designs, including pediatric dental coverage requirement.

Slides from all of the presentations below are available on MeHAF’s website.

  • Mitchell Stein’s Presentation (Overview of ACA, Affordability, Subsidies, SHOP specifics)
  • Roger Princes’ Presentation (ACA Tax Provisions, Small Business Health Care Credit)
  • Scott Taggersell’s Presentation (About Maine Community Health Options’ Plans)
  • Eric Jermyn’s Presentation (About Anthem’s Plans)
  • Brian Staples’ Presentation (About Northeast Delta Dental Plans and the Pediatric Dental Requirement)

Open enrollment for 2015 for individuals begins November 15. MeHAF and MANP hope to bring another free seminar on the ACA to you later this year. Please watch our blog and e-newsletters for future dates.

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