Healthcare:•What's Next?

5/26/2010 | By Marlene Colucci
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On March 21, the House of Representatives passed the Patient Protection and Affordable Care Act (H.R. 3590) by the narrow margin of 219-212. Two days later, President Obama signed it into law, unleashing one of the most momentous changes in decades into the American workplace: universal healthcare coverage for nearly every employee.

As a hotelier who runs a successful business, this new law creates a new and awkward relationship between your employees and the U.S. government. While the fight for further healthcare reform—or repeal of this law—continues in the political world, as a prudent business owner or general manager you should prepare for these new changes in your everyday conduct of operations.

Most of the big changes in the law will reach full force in 2014. This includes establishment of new state-based exchanges, individual mandates to obtain coverage or face a penalty increasing to $750, and new employer taxes based on company size if they do not offer minimum coverage to their employees. 2014 will also be the year when the federal government defines an essential benefits package, with all qualified healthcare plans required to offer it as part of their coverage. Insurance companies will also begin paying fees in 2014 to support the program, starting at $8 billion.

Congress recognized that businesses would require a lot of time to become compliant, so it phased in the law’s requirements over several years. However, hoteliers should begin planning this year to become compliant with the law’s demands by 2014. Hoteliers should also note that 2010 contains some mandates that they need to begin following immediately.

Mandates for Minimum Coverage
Since the law requires only individuals to obtain healthcare coverage, the new law does not contain an employer mandate. However, starting in 2014 the law does levy a tax on businesses with more than 50 employees that do not offer a minimum level of coverage. But the law’s requirements affecting businesses begin almost immediately.

Employers should note that all grandfathered group health or individual plans in existence on March 23, 2010, which are used by a company for new employees, are now required to provide minimum coverage that satisfies the individual mandate. 

Insurance plans for existing employees must be in similar coverage compliance by Sept. 23, 2010. 

Effective that date, existing plans must have at a minimum:
  • No lifetime dollar limits on essential benefits
  • No annual limits of value of “essential health benefits” except as permitted by the Department of Health and Human Services
  • No revocation of coverage (except for fraud or intentional misrepresentation)
  • Coverage of dependent children up to age 26
  • No pre-existing condition exclusions for enrollees under 19
Healthcare coverage under collectively bargained plans are exempt from the Sept. 23 deadline.

Small Business Relief
Small hotel businesses can look forward to some quick relief in 2010: a tax credit to offset insurance premiums took effect immediately. Small businesses are defined as ones with 25 or fewer full-time employees and that pay an average annual wage of $50,000 or less.  
To get the credit, the small business must already cover at least half the cost of health insurance premiums for its workers. There are a few additional restrictions, including caps on how high qualifying premiums can be, and the credit works on a sliding scale. Hotels with fewer than 10 employees and average wages less than $25,000 can take the maximum credit, while larger businesses with bigger payrolls collect a smaller credit.

For example, a hotel with 10 employees that has a total payroll of $250,000—meaning each worker averages $25,000—and spends $70,000 annually on health insurance premiums would max out the benefit, collecting a credit of $24,500 on its 2010 taxes.

2011: Get Ready For Changes
More aspects of the law will be introduced on New Year’s Day 2011, so hoteliers should prepare over the next six months for these additional requirements. Employers will be required to report the value of employees’ health benefits on W-2 forms. Also, employees will no longer be able to use Health Savings Accounts (HSA) or Flexible Spending Accounts to purchase certain items, including most over-the-counter medications unless prescribed by a physician. The penalty for making non-qualified healthcare purchases with an HSA increases to 20 percent.

An employer will face full taxation on a retiree’s drug subsidy. Voluntary payroll deductions will begin for the subsidized CLASS long-term care program, with working adults automatically enrolled unless they choose to opt out.

That year will also see the first medical manufacturer taxes, which will extract at least $2.5 billion from drug manufacturers and importers. This cost will be passed onto consumers in the form of higher costs for drugs and medicine.

Seasonal or Temporary Employees
As noted earlier, a full-time employee will be required by 2014 to purchase insurance.  However, a “full-time” employee is defined as one who works at least 30 hours a week for the employer. Employers will be required to offer these employees coverage no longer than 90 days after hiring them. 

Hotel businesses of a certain size that depend on seasonal or temporary employees will have to factor in these new health care expenses into their labor costs. Employers who have more than 50 employees will also have to decide how to handle scheduling these employees for work assignments if they want to avoid up to $2,000 in fines for not offering coverage if the employee exceeds a 30-hour work week. However, if a company does not exceed 50 full-time employees, there is no penalty.

More Information
AH&LA is committed to keeping its membership up-to-date about the new healthcare law and what changes it will deliver to their lodging businesses and their employees. For the latest information, or for a quick background review of the new law and its schedule between now and 2014, please visit www.ahla.com/healthcare.


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