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Health spending a priority for local businesses


With the dawning of November, most people’s attentions are turning toward the holidays, but for business owners, there’s the standard end-of-the-year checklist that must be addressed. From financial statements to plans for the new year, this time of the year can become a season of tying up loose ends. One thing you shouldn’t forget is health insurance plans for 2018.

This year all businesses will see some changes in the new year, particularly in regards to cost-sharing limits and healthcare flexible spending account contribution limits. Cost-sharing limits, or out-of-pocket maximums, will increase from $6,600 to $6,850 for self-only plans and from $13,200 to $13,700 for all other plans. FSA limits will increase from $2,600 to $2,650. The good news is that Pam Files, senior vice president and employee benefits insurance consultant at Fisher Brown Bottrell Insurance, said there is not expected to be cost increases for employers.

Businesses with more than 50 employees, referred to as applicable large employees in the Patient Protection and Affordable Care Act, will be subject to coverage affordability percentages, maximum penalties for failure to comply with the ACA, and reporting violations.

“Under the ACA’s employer-shared responsibility rules, applicable large employers are required to offer affordable, minimum value health coverage to their full-time employees — and dependent children — or pay a penalty,” Files said. “Employer-shared responsibility requirements are also known as the ‘employer mandate’ or ‘pay or play’ rules.”

Large employers will be subject to penalties if one or more full-time employees receive a subsidy for purchasing health coverage through the ACA Exchange. An individual may be eligible for an Exchange subsidy if the applicable large employers: does not offer coverage to that individual; or offers coverage that is “unaffordable” or does not provide “minimum value.” Files said there are many steps and methods for the employer penalty calculation, offering of coverage to full-time employees, determination of a full-time employee, assessing affordability and reporting of coverage.

Another major change comes from the IRS for the upcoming tax season for those without health insurance. For the 2018 tax filing season, where 2017 tax returns are being filed, the IRS won’t accept electronically filed tax returns where the taxpayer does not certify whether the individual had health insurance for the year. Paper returns in which the taxpayer does not certify compliance with the individual mandate may be suspended pending receipt of additional information, and refunds may be delayed.

The self-employed may face the biggest change as the period for open enrollment decreases from three months to just six weeks. In previous years, open enrollment has run from Nov. 1 to Jan. 31. This year, open enrollment will close on Dec. 15. This will only affect those who do not utilize group insurance plans. Group insurance plans will renew at varying times as recognized by the carrier. Files said carrier renewal requirements are 60 days prior to the renewal date.

For small businesses that utilized the ONE MISSISSIPPI Shop Plan through the marketplace, other arrangements will need to be made because the one carrier that participated, United Healthcare, will not be available for 2018.

In Mississippi, the ACA marketplace has only one carrier participating this year — Ambetter of Magnolia. Various other carriers offer individual plans that can be accessed directly through the carrier or appointed insurance brokers. If you don’t have health insurance through an employer, Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), or another source that provides qualifying coverage, the Marketplace can help you get covered.

“Some Mississippians will qualify for financial assistance toward their premium cost. Financial assistance is based on gross yearly income and household size,” Mississippi Commissioner of Insurance Mike Chaney said.

Chaney’s office said during open enrollment, anyone can browse and compare available health insurance plans and prices before purchasing a plan. You can also change your plan choice at any time during the period.

The penalty for not having adequate health insurance coverage has increased. Unless you qualify for an exemption, you may have to pay 2.5 percent of your household income or $695 per adult when doing your 2017 income taxes.


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