Preparing for change

Steven Plambeck

Small businesses with fewer than 50 full-time employees will not be required to provide health insurance, but may find it beneficial to do so anyways. That’s because those with fewer than 25 employees that opt to provide coverage could qualify for tax credit up to 35 percent or 25 percent for nonprofits. The tax credit incentive will increase to 50 percent for small businesses and 35 percent for nonprofits in 2014, helping curb costs associated with health care.

Businesses with fewer than 50 employees will have several options to purchase health insurance for their employees. These options include purchasing health insurance through the health insurance marketplace, an insurance broker or through “SHOP,” a new affordable insurance marketplace. Both the health insurance marketplace and SHOP are intended to offer individuals and small business increased leverage, increasing their purchasing power to that of large businesses. Self-employed individuals will also be able to purchase health insurance through the marketplace or insurance brokers. Start examining your options now; enrollment will open this October for coverage starting on January 2014.

Many large employers – those with 50 or more full-time equivalent employees – are already in compliance with the health care reform provisions. Under the law, federal/state governments and large employers will be required to provide a minimum level of health insurance coverage to full-time employees (those who work 30 or more hours per week) or potentially pay a penalty. Large employers that currently provide health insurance for their employees are unlikely to see major changes under the Affordable Care Act.

It’s important to understand how the new provisions might apply to your business and, if you employ more than 50 full-time equivalent employees, what might trigger employer shared responsibility payments. Find more information about employer responsibilities at

Examine your cost-saving options

Across the country, more and more businesses are implementing employee wellness programs focused on preventative health care. According to the Small Business Administration, the Affordable Care Act is only expected to make that trend more appealing. Under the new law, providing these wellness programs could save businesses up to 30 percent of coverage costs for plans beginning on or after January 1, 2014. Programs designed to prevent and/or reduce employees’ use of tobacco will be incentivized up to 50 percent.

Employer-based prevention and wellness programs not only improve the overall health and productivity of our workers, but also help control health care costs nationwide. The U.S. Department of Health and Human Services reported that 75 percent of our annual medical costs are spent on treatment for chronic conditions like heart disease, cancer, stroke and diabetes; these costs are reflected in higher premiums. Preventative health care strategies like employee wellness programs not only help your coverage costs with incentives, but could reduce the overall price of health care premiums. If you’re considering launching or expanding an employee wellness program for your organizations, be sure to review the Centers for Disease Control and Prevention’s resources at

As 2014 approaches, business owners should be aware of the provisions that will come into effect in the next year and beyond. The resources our out there; be proactive about it. Examine your options now and plan for how your organization will respond to the changes accompanying the Affordable Care Act.

Steven Plambeck is director of medical banking at Riverview Community Bank. He serves on four boards for St. Vincent Medical Center, including those for the Center’s Foundation, Heart and Vascular Institute, Brain and Spine Institute, and Donor Development.

{jathumbnail off}