HealthCare Reform Breakdown CONT.

More from Mike Vogel's Florida Trend article:

"NEW REGULATIONS

Closed Counter
Before: Employees could use their health savings account, flex savings account or health reimbursement account money to pay for over-the-counter meds.

Now: If workers want to spend their money on over-the-counter purchases, they’ll need a doctor’s prescription.

Implication: Employees and doctors won’t bother with prescriptions for runny noses, so employees will ratchet down the money they park in accounts.

Class Distinctions
Before: Businesses could put their employees in different “classes” with different coverage for each class. A restaurant company, for instance, might put wait staff in one class and chefs, administrative staff and executives or owners in another.

Now: All are treated equally — or companies will pay significant penalties down the road if they “discriminate” in favor of highly paid employees. That raises concerns that some companies may drop coverage altogether rather than absorb the cost of adding dozens of employees, says Robert Pariseau, president of West Florida operations in Tampa for benefits company AGIS.

Exception: Companies can grandfather their existing plans — and avoid the penalties — provided they don’t make substantive changes to the plans such as increasing the share of the premium employees pay for coverage by more than 5%. That rule against major changes could force employers to give up grandfather status rather than absorb rising insurance costs. How many companies will seek or maintain grandfather status is unclear. The rules aren’t finished and the size of the penalties won’t be announced until the middle or later part of this year, giving companies a year to decide what to do. “Penalties could be huge,” Barber says. Some companies, if they can’t offer key talent a better plan or some healthcare perk, instead pay bonuses so high-value employees can obtain the coverage they want on their own. “They’re having to think outside the box to maintain their competitive advantage in recruiting talent,” Farmer says.

Care Standards
New: Small-business insurers must pay out 80 cents of every premium dollar for patient care. Insurers of larger employers have to pay out 85%.

Implication: Insurers will see margins pressured and so may cut back on broker commissioners, administrative costs or services to businesses and their employees. “I don’t see how the service gets better if they have to cut the administrative costs, maybe drastically,” Pariseau says. “It’s a low-margin business anyway.”

Tax Credit
New: A tax credit for small companies of up to 35% of their premium cost. “It’s a good deal. It’s better than a deduction,” Barber says. "