An Employer's Guide to Health Care Reform

Table of Contents

Minimum Essential Coverage

4

Essential Health Benefits (EHB)

4

Actuarial Value Standards (Metal Levels)

4

Affordable Minimum Value Coverage

5

Health Insurance Portability and Accountability Act (HIPAA) Excepted Benefits

5

Grandfathering 6

2. Implementation Timeline 8

2013: Preparing for Reform

9

2014: Putting the Law into Practice

10

2015-2018: Solidifying Health Care Reform and Future Implementation

14

Delayed or Still to be Determined Provisions

16

3. Fundamental "Play-or-Pay" Considerations 17

1. Cost 18

2. Employer Size

20

3. Guaranteed Issue in the Individual Market

21

4. Federal Premium Tax Credits

21

5. Recruiting, Retention, and Productivity

22

6. Workforce Demographics and Preparedness

22

4. Employer-Sponsored Benefits Strategy 24

Small Business Health Options Program (SHOP) Marketplace

25

Self-Insured 27

Private Marketplace

28

Maintain Grandfathered Status

29

Hybrid Approach

31

Adjust Current Plan

32

Discontinue Coverage

33

Play or Pay Strategies Summary Chart

34

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