Health Care Reform: Employer Mandate Delayed

The U.S. Government has announced that the employer mandate, one of the most significant portions of the Affordable Care Act (ACA), will not be required until 2015. Under this provision, businesses with 50 or more full-time employees would have faced fines up to $3,000 per employee if they didn’t offer their employees affordable health insurance.

The one year delay is designed to accomplish 2 goals:

  • Allow the Government to consider ways to simplify the new reporting requirements consistent with the law.
  • Provide time to adapt health coverage and reporting systems while employers are moving forward with offering affordable coverage to their employees.

For more information you can click here and be directed to the Treasury Department’s website. Sweeney & Sweeney Insurance will continue to send out any updates that come along! And as always, feel free to call to talk to one of our Health Care Reform Certified Agents or make an appointment to come in with any questions or concerns.

Health Care Reform: Young Adults

As the country prepares for implementation of
the Affordable Care Act (ACA), a recent poll examined different age groups,
including young adults. The poll showed that a large majority of Americans want, and value, health insurance. Among the public overall, 87 % say it is “very
important” to them personally, 88% describe health insurance as “something I
need,” and 68% say insurance is worth the cost. This includes young adults, who
say health insurance is very important to them and that cost remains the biggest
barrier. Many young adults want health insurance, but struggle from
unemployment, employers not offering insurance, or getting coverage is just too expensive. With
the ACA coming into effect, more opportunities will be opened for young adults
to obtain affordable coverage. Large employers are required to offer coverage
to their full-time employees and tax credits are available for individuals
based off their gross income. Sweeney & Sweeney hopes the Affordable Care
Act will give people of all ages a peace of mind. We are aware of the struggles
and the cost restraints it brings to many people, which is why we are here to
help you through it

Health Care Reform: Small Business Tax Credits

In regards to the Patient Protection and Affordable Care
Act, small employers (those who have less than 50 full-time equivalent employees
(FTE)) are not required to offer their employees health coverage. However, an
employer with 25 or fewer full-time equivalent employees may be eligible for
incentives from the federal government to provide their employees with health


Many small employers do not realize they have the
opportunity to claim a federal income tax credit on their annual tax returns.
Unfortunately, a very low percentage of qualified business owners are taking
advantage of this credit. Here are the IRS guidelines to be eligible.

  1. The expenses that an employer can count towards the tax
    credit includes the premiums that are paid for each employee. The employer must
    contribute at least 50% of the cost of the health care coverage for employees.
  2.  Must have less than 25 FTE workers when totaling all
    individuals’ hours of employment.
  3.  Employers must pay their workers an average of less
    than $50,000 per year to qualify. The smaller and lower wage employers will
    receive a larger tax credit.

If your business meets these requirements, we encourage you
to contact a Health Care Reform Agent (such as our Health Department here at Sweeney & Sweeney) to verify your options and help you
calculate your eligibility of a tax credit.


Health Care Reform: Individual Tax Credits

Tax credits are
available for individuals and families who meet certain income requirements and
don’t have access to affordable health coverage through their employer. Below
are some key points you should know about tax credits.

  • The size of the tax credit is
    based on a sliding scale, with those who make less money getting larger
    financial support to lower their cost of insurance.
  • Individuals and families who
    make between 138 percent and 400 percent of the federal poverty level- an
    individual making up to $44,680 and a family of four making up to $92,200,
    are those who are eligible for tax credits and subsidies.
  • Tax credits lower the cost of
    your premium and can be used when you enroll, you do not need to wait
    until you file a tax return at the end of the year.
  • Tax credits are paid to your health plan monthly
    by the federal government.

In addition, as always, with any questions you have about Health Care Reform and what that can mean for your family, yourself, or your business, please feel free to either call or set up a meeting at Sweeney & Sweeney and Cheryl, Jamie, Dan, Shannon, Ellen, and/or John would be more than happy to assist with any concerns.

Health Care Reform: Getting Covered

With the health care reform bill soon to take effect, many
people are worried about how they’re going to afford coverage. Fortunately,
there are many assistance programs available to make sure that your health care
is affordable. For more information, click here to read the full article. 

Cost-sharing subsidies help to reduce the amount of expenses
that an individual has to pay out of pocket (i.e. copayments). The assistance
programs are based on an individual/family’s income. The chart below shows some
examples of what you and your family could qualify for. 

Health Care Reform table

*Income levels are based on the year 2012

**California only 

Sweeney & Sweeney will be having more updates to
come. Please feel free to call us with any questions. Our amazing health team—
John, Jamie, Ellen, Dan, and Cheryl—are always ready and willing to help!

Health Care Reform: What Does it Mean for Your Small Business?

Many small business owners might be going in to panic mode as the new year gets closer. Sweeney & Sweeney Insurance wants you to know we are here to help you through this big transition. In this article we have outlined some key points that you as an owner need to start thinking about now. Below are some questions you can ask yourself to help you make the best choice for your business.

  • Do I have to offer coverage to my employees? If you have 50 or more
    full-time employees, you are required to offer affordable coverage to your
  • How many of my employees are considered full-time? According to the
    ACA regulations, full-time employees are 30 or more hours per week. If you are
    anywhere near 50 employees you need to be very clear who is considered a
    full-time or part-time equivalent. This can be a very confusing process, but
    Sweeney & Sweeney has trained professionals to help you walk through these
  • What coverage classification should I choose for my employees? The
    coverage’s will be tiered as, bronze, silver, gold, and platinum. Be sure to
    balance the best offerings with a plan your employees can afford (May not
    exceed 9.5% of the employee’s gross income).
  • Will I offer coverage for dependents? This is a tricky concept and
    you need to be extremely careful. Choose the best balance that your employee’s
    family can afford. If a dependent is offered affordable coverage through an
    employer they may NOT go to the individual exchange and receive a subsidy. If you
    decide to offer employee only coverage, then their dependents can go to the
    individual exchange to receive a subsidy. It is very important to balance what
    is best for your employees and we recommend speaking to a health care
    professional about this.
  • Should I handle these decisions on my own? It is highly recommended
    to choose an Agency who is Health Care Reform certified to walk you through these
    extremely important steps to insure your employees are getting the best deal
    and to avoid any penalties to your business. Sweeney & Sweeney Insurance is
    here to help. Give us a call for more information!

Health Care Reform: Health Insurance Plans at a Glance

What To Expect in 2014! 

Many of you are probably wondering what will change about your health insurance plans come January 2014. To get started, all Individual and Family Health Plans will disappear on January 1, 2014. If you have a Grand-Fathered plan that has been active and unchanged prior to March 23, 2010, then you are exempt from this requirement. The rest of us will be required to find a new plan that meets the required “Essential Health Benefits” law. Provided below is an image to show how the plans will be tiered.


You are now probably wondering what the plans must include
as “Essential Health Benefits”, as defined by the Health Care Reform.
Specifically, the plans must include these 10 categories of care:

  1. Ambulance Services
  2. Emergency Services
  3. Hospitalization
  4. Maternity and Newborn Care
  5. Mental Health, Substance Abuse, Behavioral Treatment
  6. Prescription Drugs
  7. Rehabilitative and Habilitative Services
  8. Laboratory Services
  9. Preventive and Wellness Services
  10. Pediatric

We are very excited to share with our community that
Sweeney & Sweeney will be offering health coverage inside and outside the
Exchange. Open Enrollment begins October 2013 and goes through March 2014.
Please be aware that this is the ONLY time you can obtain health coverage, and you must enroll by December 15, 2013 to have a January 1 start date for coverage. Call us for further information and stayed tuned for more to come! We still have appointments open for December!