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Passion for Pizza - Columbia Business Times

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24 September 18, 2010 <strong>Columbia</strong> <strong>Business</strong> <strong>Times</strong> | <strong>Columbia</strong><strong>Business</strong><strong>Times</strong>.com<br />

SPECIAL SECTION | insurance<br />

CBT Q&A: The Pulse of Local <strong>Business</strong><br />

Calculating health care re<strong>for</strong>m’s<br />

impact on insurance costs<br />

The CBT asked Philip Naught<br />

with the Naught-Naught Agency<br />

in <strong>Columbia</strong> and Debra K. Mathes,<br />

a CPA and partner at Williams-<br />

Keepers LLC, about trends in the<br />

health insurance market and the<br />

impact of the new health care law.<br />

The cost of employee health insurance <strong>for</strong><br />

small businesses in <strong>Columbia</strong> has been<br />

steadily rising <strong>for</strong> years now. How does<br />

the cost this year, and the estimate <strong>for</strong> next<br />

year, compare with past years in your experience<br />

with clients?<br />

NAUGHT: This has been a fairly typical year<br />

<strong>for</strong> rate increases. We’ve seen groups that have<br />

double-digit increases as well as low singledigit<br />

increases. This is likely to continue into<br />

the future as premiums are closely tied to health<br />

care costs, which continue to rise.<br />

MATHES: Our clients continue to<br />

see increases in their overall health<br />

plan costs. We typically have seen<br />

increases of 6 percent and more,<br />

depending on the size of the plan.<br />

I estimate that the general trend<br />

<strong>for</strong> 2011 will continue upward, but<br />

more factors enter into the overall<br />

equation, including whether<br />

an employer is going to try, if<br />

allowed by their insurance carrier,<br />

to “grandfather” their plan from<br />

certain provisions of the Patient<br />

Protection and Af<strong>for</strong>dable Care Act.<br />

Do you predict that that costs<br />

will increase under the new<br />

health care law because it will<br />

require them to provide more<br />

benefits, such as coverage <strong>for</strong><br />

preventive care?<br />

mathes<br />

NAUGHT: The new health care<br />

re<strong>for</strong>m law requires a high level of<br />

services <strong>for</strong> preventive care. In the<br />

past, many health insurance plans<br />

included preventive care subject Naught<br />

to a deductible, co-insurance or<br />

a co-pay. Under the new law these services are<br />

required to be covered at no additional cost to<br />

the insured. Improved benefits <strong>for</strong> employees<br />

and higher expenses <strong>for</strong> the insurance company<br />

will likely push premiums higher.<br />

MATHES: I believe that overall costs will<br />

increase as a result of the new health care<br />

bill, but it might be <strong>for</strong> reasons other than<br />

enhancement of coverage changes. The Centers<br />

<strong>for</strong> Medicare and Medicaid Services actuaries<br />

per<strong>for</strong>med an analysis of the overall impact of<br />

health re<strong>for</strong>m on national health spending, and<br />

it showed a relative small increase in overall<br />

health expenditures as a share of gross domestic<br />

product by 2019.<br />

I anticipate an increase in premium costs to<br />

small businesses that historically have had relatively<br />

healthy employees and favorable claims<br />

experience, while others who have had unfavorable<br />

claims experience or difficulty finding<br />

coverage <strong>for</strong> employees might find their insurance<br />

premiums more af<strong>for</strong>dable. I also believe<br />

the compliance cost <strong>for</strong> small employers will<br />

increase significantly.<br />

A number of new reporting requirements that<br />

are a part of the PPACA could become a considerable<br />

burden on small employers. For example,<br />

the new law requires employers to report the<br />

“aggregate cost” of employer-sponsored group<br />

health insurance coverage, excluding any salary<br />

reductions deferred to a flexible spending<br />

account on the employees’ 2011 Form W-2s. We<br />

are expecting further guidance from the Internal<br />

Revenue Service on the factors to be used to<br />

determine this aggregate cost. This is just one<br />

example of numerous new reporting<br />

mandates that are a part of the<br />

new health care bill.<br />

A study sponsored by Families<br />

USA and Small <strong>Business</strong><br />

Majority, nonprofit organizations<br />

that describe themselves<br />

as nonpartisan, found that<br />

about 92 percent of Missouri’s<br />

small businesses (less than<br />

25 employees) are eligible to<br />

receive a federal tax credit this<br />

year if they purchase health<br />

care <strong>for</strong> their workers. Are<br />

small businesses in <strong>Columbia</strong><br />

applying <strong>for</strong> the federal tax<br />

credit?<br />

NAUGHT: We believe that qualified<br />

businesses will apply <strong>for</strong> the<br />

tax credit. Many health insurance<br />

company websites and the IRS<br />

website are offering detailed in<strong>for</strong>mation<br />

and calculators to help<br />

businesses estimate their potential<br />

credit. Due to some restrictions,<br />

businesses should work with their<br />

tax preparer to make sure they are<br />

calculating the credit properly.<br />

MATHES: Although we have had a number of<br />

inquiries regarding the credit, it’s impossible<br />

at this time to determine the credit <strong>for</strong> anyone<br />

whose taxable year has not ended because it is<br />

dependent on average annual wages. There are<br />

numerous eligibility provisions that must be<br />

met to qualify <strong>for</strong> the credit, and the premiums<br />

paid on behalf of the business owners are not<br />

counted in determining the amount of the credit.<br />

Additionally, businesses with the same owners<br />

are treated as a single employer <strong>for</strong> purposes of

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