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December 5, 2012

Although the new health care law, the Patient Protection and Affordable Health Care Act (“PPACA”), is still a full year away from almost full implementation, many small companies are beginning to show concern. With the Presidential elections behind us now almost a month, it’s solidly understood that the PPACA is here to stay which means it’s time for “Plan B” for lots of people who may have been thinking the new law would be trashed with a Romney presidential win.  However, we all know that didn’t happen and the PPACA will be so strongly established within a few years that anyone trying to disengage it in the future will have a slim to no chance of doing so.

In most cases, the biggest concerns and complaints about the PPACA are coming from low wage industries that include retail and hospitality which may not be offering any healthcare coverage to their workers. Actually, most employers, even small ones, already offer health insurance to their workers, and the PPACA is not expected to have a significant impact on what they do from 2014 onward. However, business that rely heavily on low-wage workers are now forced to rethink their business models.

According to recent surveys, almost half of retail and hospitality  employers do not offer coverage to all of their full-time workers. Thus, with PPACA implementation, these industries will need to rethink how to deploy their costs or push the costs to the customer. With the average cost of health insurance premiums at $6,000 per year for an indivudual plan and about $15,000 per year for family (data from Kaiser Family Foundation), adding insurance costs will be quite considerable for businesses that typically pay workers $12/hour or less.  According to the Kaiser Family Foundation’s most recent survey of health insurance, about 28% of companies that employ large numbers of low-income workers offer health benefits.

From 2014, any business with 50 or more full-time employees will be expected to offer a set health insurance coverage. Failing to do so brings a penalty of $2,000 per worker, excluding the initial 30 employees.  The recent potential response to getting around the law has been to consider converting some full-time employees to part-time status to reduce their hours below 30 hours per week which is the PPACA’s threshold for the definition of a full-time worker.

Despite all the complaints and rhetoric from employers, there is still quite a bit of confusion concerning many of the more critical aspects of the PPACA such as how the government will determine whether an employee meets the 30-hour threshold and what is the set of benefits that an employer must provide.  The answers to these questions should start to be flushed out as we move into 2013.    12.05.2012


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