As an employee benefits compliance professional, Salazar possesses extensive experience addressing employers’ responsibilities under federal, state and local laws. She interacts with regulatory agencies, such as the Department of Labor, Internal Revenue Service, Centers for Medicare & Medicaid Services, Department of Health and Human Services and state insurance departments, to address the applicability of laws and regulations to group health plans.As Congress crafted and passed PPACA, I sensed health reform would accelerate the decline of employer sponsored health insurance. Frankly, I saw this as an unstated aim of the bill.
Salazar and her staff are actively involved in identifying and implementing cost-effective employer solutions that comply with new health care reform mandates, including defined contribution plans and consumer-driven health care plans.
Citizens may have heard Mayor Alvin New talk about the City's health insurance as a "defined contribution" health plan. Changes made the last three years sent some 200 people from the City sponsored health insurance coverage.
The Standard Times reported on Salazar's lecture:
Salazar talked about how the goal of the health care reform is to get everybody legally residing in the United States coverage with health care insurance. She mentioned the three means for a person obtaining that insurance in 2014: through a private insurance company, employer benefits and federal exchanges.Salazar helped business leaders understand where they fit in PPACA's complex scheme. Smaller employers could get federal tax credits (a direct subsidy) for offering insurance to their employees. Larger employers will need to provide coverage or pay a penalty, however the penalty is a fraction of the cost of providing coverage.
There is widespread agreement that employers will continue to do less in the healthcare benefit arena. This is from LIMRA
A new LIMRA survey of U.S. employers found more than half of employers have increased or plan to increase deductibles, co-pays or the contributions from employees to cover the cost of coverage for their medical plans. This follows a 15-year trend of health care cost-shifting by employers to their employees. According to a Kaiser/HRET survey, premiums for families have nearly tripled since 1999 – from $5,791 to $15,745 in 2012. Simultaneously, Department of Labor statistics show that employees’ wages have been stagnant over the past 10 years.
GAO took a shotgun approach to estimating PPACA's impact, as seen in the image below:
The tale of the tape is:
Employers covered fewer Americans as a percentage in 2011. The percent dropped from 55.3% in 2010 to 55.1% in 2011. This is down from 64.2% in 1997. If employers covered Americans at the 1997 rate, there'd be 28 million more people with health coverage.
Liliana Salazar's role/visit is another step in the great employer health insurance shedding. I don't consider myself a coach, but brace for change. Individuals will shoulder a much larger responsibility for health care and retirement.
Update 11-23-13: Confirming my last sentence, Obama advisor and health economist David Cutler said "The trend in health care nationally is to put more and more on the patient."