Cabrillo College
ACA Overview
May 2015
PURPOSE OF HEALTH CARE REFORM
Improve access to healthcare
Make coverage more affordable
 Require health insurance
 Larger employers must offer
comprehensive, affordable coverage
 Create healthcare Exchanges
 No pre-existing conditions
 Coverage becomes guarantee issue
 Dependent coverage up to age 26
 No cost preventive care






Federal subsidies for lower income families
Caps on employee contributions
Expanded access to Medicaid
Caps on non-claims costs
Minimize cost-shifting for uninsured care
Pilot programs to address healthcare cost,
quality and transparency
© 2015 Alliant Insurance Services, Inc. All rights reserved. Alliant Employee Benefits, a division of Alliant Insurance Services, Inc. CA License No. 0C36861
2
ACA OVERVIEW
WHAT HAS THE COLLEGE ALREADY DONE TO COMPLY?

Cover dependent children up to age 26

Eliminate annual and lifetime maximums

Offer no cost Preventive Care

Meet new employee communication requirements
 Summary of Benefit Coverage
 Marketplace Exchange Notice

Meet governmental reporting requirements – W2 Reporting

Pay certain applicable fees and taxes
 Reinsurance Fee – Support state exchange risk pools
 PCORI – Funds a private, not for profit organization to help providers, payers and policy makers
improve healthcare
 Industry Tax – Funds general operations of the ACA
 2% to 4% of premium
© 2015 Alliant Insurance Services, Inc. All rights reserved. Alliant Employee Benefits, a division of Alliant Insurance Services, Inc. CA License No. 0C36861
3
PURPOSE OF HEALTH CARE REFORM
2015
Coverage &
Benefit
Mandates
• Employer “Pay or Play” begins if 100+ FTEs
(at renewal in most cases)
Taxes & Fees
• Health industry tax of about 2% (included in
insured rates) – Paid by SISC
Tracking &
Reporting
• 70% FTE offer threshold (2015 only)
2016+
• Employer “Pay or Play” applies to 50+ FTEs
• 95% FTE offer threshold
• Health industry tax – Paid by SISC
• PCORI fees of $2 PEPY due 7/31 for selffunded – Paid by SISC
• Reinsurance fee payment of $63 PEPY – Paid
by SISC
• PCORI fees (through 2019) – Paid by SISC
• Reinsurance fee payment of $44 PEPY due
1/16– Paid by SISC
• Cadillac tax of 40% on high value plans
(2018+)
• Coverage value on W-2s (if issue 250+ W-2s)
• Coverage value on W-2s
• Coverage level reporting to participants
(1/31/16) and government (3/31/16)
• Coverage level reporting to participants
(1/31) and government (3/31) for prior year
© 2015 Alliant Insurance Services, Inc. All rights reserved. Alliant Employee Benefits, a division of Alliant Insurance Services, Inc. CA License No. 0C36861
4
ACA OVERVIEW
FUTURE COMPLIANCE

IRS Reporting - 2016
 The ACA requires employers to provide certain reporting to the IRS and
Employees in 2016 to prove coverage offered is sufficient
 Alliant will ensure that the College is aware of all of the IRS reporting
Guidelines

Cadillac Tax – 2018
 The Cadillac Tax will require employers to pay an 40% excise tax on any
portion of health insurance premium that is over a pre-determined threshold
 Assuming trend increases for the next three years, health insurance
premiums would elevate above the current identified thresholds
© 2015 Alliant Insurance Services, Inc. All rights reserved. Alliant Employee Benefits, a division of Alliant Insurance Services, Inc. CA License No. 0C36861
5
ACA OVERVIEW
PAY OR PLAY
The Affordable Care Act requires large employers (50+ employees) to offer
medical coverage that is…
Affordable
Comprehensive
Full-Time Employees
• Employee contribution for single coverage of lowest cost
plan does not exceed 9.5% of employee’s income (W-2
income, actual wages, or federal poverty level safe harbor)
• Coverage meets minimum value (60% actuarial value)
requirement and meets Minimum Essential Coverage
requirements
• Offer coverage to all employees working 30+ hours per
week and their eligible dependents (spouses not
required)
• Safe-harbors exist to define 30 hour determination
… or the employer may pay annual penalties of $2,080 or $3,120 per employee for 2015
© 2015 Alliant Insurance Services, Inc. All rights reserved. Alliant Employee Benefits, a division of Alliant Insurance Services, Inc. CA License No. 0C36861
6
ACA OVERVIEW
PAY OR PLAY PENALTIES
Effective October 1, 2015 for Cabrillo College (if the District offers affordable coverage
to all ACA FT employees as of October 1, otherwise the effective date is January 1, 2015
Penalty A
Penalty B
Employer does NOT offer
Minimum Essential Coverage
(MEC) to “substantially all fulltime ee”
Employer does offer MEC,
but it is not Affordable
$2,080 per each
full time
employee less 30
(less 80 in 2015)
1 FT EE goes to the
Exchange, enrolls and
gets subsidized
coverage
$3,120 per each
subsidized
employee
© 2015 Alliant Insurance Services, Inc. All rights reserved. Alliant Employee Benefits, a division of Alliant Insurance Services, Inc. CA License No. 0C36861
7
ACA OVERVIEW
TO AVOID PENALTY A

To avoid Penalty A, Employers are required:
 To offer access to coverage to essentially all (95% or more in) of FT employees
(as defined) and dependents up to age 26 but there is no mandate to offer
coverage for spouses
 “Currently defined” - Variable or part time employees, including substitutes,
could be considered full time and
 These employees could expose the College to Penalty A if they represent
more than 5% of the full time work force
 70% for 2015 – New – Moves to 95% or more starting in 2016
 No requirement to pay for dependent coverage
© 2015 Alliant Insurance Services, Inc. All rights reserved. Alliant Employee Benefits, a division of Alliant Insurance Services, Inc. CA License No. 0C36861
8
ACA OVERVIEW
TO AVOID PENALTY B

To avoid Penalty B
 At least one plan offered to full time employees and dependent children up to
age 26 must be:
 Of minimum value (60% of medical expenses paid by plan)
 Affordable for self-only coverage – 9.5% or less of Box1 Wages, FPL, or
Rate of Pay, depending on applicable Safe Harbor
 No requirement by ACA to offer coverage to spouses
 No requirement to contribute to cost of dependents
 Penalty B is $3,120 per year ($260 per month) on any employee that meets all
of these requirements
 Qualifies for a federal subsidy from the Exchange based on total
household income (excluding MediCal eligible participants)
 Elects and receives subsidized coverage from the Exchange
 Demonstrates that the lowest cost, minimum value coverage offered by
the employer was not affordable for self-only coverage
© 2015 Alliant Insurance Services, Inc. All rights reserved. Alliant Employee Benefits, a division of Alliant Insurance Services, Inc. CA License No. 0C36861
9
ACA OVERVIEW
SAFE HARBOR AFFORDABILITY TESTS

The IRS has developed safe harbor tests
 A safe harbor is a means of complying with the law using a prescribed test

W2 Earnings Safe Harbor Test
 The employee share of the premium required for the least costly, self only
coverage must be less than 9.5% of the W2, box 1 wages paid to the employee

Rate of Pay Safe Harbor Test
 Single coverage employee cost is less than 9.5% of employee’s lowest hourly
wage x 130

Federal Poverty Level Safe Harbor Test
 This method examines whether the cost of coverage exceeds 9.5% of the Federal
Poverty Line (FPL)
 An employer satisfies the FPL safe harbor if the employee’s contribution for the
lowest cost plan for self-only coverage does not exceed 9.5% of FPL (See chart)
© 2015 Alliant Insurance Services, Inc. All rights reserved. Alliant Employee Benefits, a division of Alliant Insurance Services, Inc. CA License No. 0C36861
10
ACA OVERVIEW
WHO IS ELIGIBLE FOR A SUBSIDY?
2014 Federal Poverty Level (not related to the FPL Affordability
Safe Harbor for Employers)
138% federal poverty level
400% federal poverty level
Household
size
Household
income
Maximum
contribution*
Household
income
Maximum
contribution*
1
2
4
6
$16,105
$21,707
$27,310
$32,913
$127.50
$171.84
$216.20
$260.56
$46,680
$62,920
$95,400
$127,880
$369.55
$498.11
$755.25
$1,012.38
*Maximum contribution is based on monthly maximum affordable employee contribution for single
coverage based on 9.56% of household income.
The FPL safe harbor is based only on the FPL for a single individual for the applicable calendar year
(divided by 12 – to get the monthly amount). Employers may use the FPL guidelines in effect six months
prior to the beginning of the plan year.
© 2015 Alliant Insurance Services, Inc. All rights reserved. Alliant Employee Benefits, a division of Alliant Insurance Services, Inc. CA License No. 0C36861
ACA OVERVIEW
TO AVOID PENALTIES - SISC PLAN SOLUTION
Requirements to avoid penalties:
Coverage available must be at least a minimum actuarial value (60% of the cost of
services) and must be affordable for the employee coverage on the lowest cost plan
offered by the College.
Solution:
SISC renewals include a minimum value “Bronze” plan. It will not count against the
maximum permitted number of plans SISC allows a group to offer. It will include only the
minimum coverage required by ACA
 It will only feature two-tiers: Employee Only and Employee + Child(ren).
 It will NOT include an option for spousal/domestic partner coverage.
 It will NOT be offered with any option for dental, vision or life coverage.
The primary purpose of the plan will be to allow Colleges to avoid exposure to Penalty A
and B by:
 offering access to a minimum value plan to employees who HAD NOT previously
qualified for SISC coverage and,
 providing a more affordable plan for single only coverage to employees who HAD
previously qualified for SISC coverage.
© 2015 Alliant Insurance Services, Inc. All rights reserved. Alliant Employee Benefits, a division of Alliant Insurance Services, Inc. CA License No. 0C36861
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“AT RISK” COLLEGE PENALTY B SCENARIOS
 Employee enrolls in College coverage
No Penalty
 Employee enrolls in spouse’s health plan
No Penalty
 Employee is eligible to enroll in spouse’s “affordable”
health plan
No Penalty
 Employee remains uninsured
No Penalty
 Employee’s household income qualifies for MediCal
No Penalty
 Employee enrolls in individual coverage outside the
Exchange
No Penalty
 Employee enrolls in Exchange and household income
is greater than 400% of the federal poverty level
No Penalty
 Employee enrolls in the Exchange and,
• Demonstrates they were full time employee and,
• Demonstrates College coverage was unaffordable and,
• Employee receives a federal subsidy
College pays $260
per month penalty
© 2015 Alliant Insurance Services, Inc. All rights reserved. Alliant Employee Benefits, a division of Alliant Insurance Services, Inc. CA License No. 0C36861
13
ACA OVERVIEW
EMPLOYEE CLASSES
Full-Time Employee
Based on facts and circumstances at their start date, the employee is expected to work an
average of 30+ hours of service a week (regardless of how long their assignment is expected to
be, unless Seasonal) – Offer Benefits
Part Time Employee
Reasonably expected at start date to work an average of less than 30 hours of service per week
– Initial Measurement Period
New Variable Hour Employee
Based on the facts and circumstances at their start date, the employer cannot determine
whether they will work 30+ or more hours of service a week because their hours are variable or
otherwise uncertain – Initial Measurement Period
New Seasonal Employee
Hired into a position for which customary annual employment is six months or less – Initial
Measurement Period
14
© 2015 Alliant Insurance Services, Inc. All rights reserved. Alliant Employee Benefits, a division of Alliant Insurance Services, Inc. CA License No. 0C36861
ACA OVERVIEW
SPECIAL CONCERNS: NEW GUIDANCE
Adjunct Professors
•
“IRS suggests: for each classroom hour, count 2.25 hours (to account for
preparation and grading) + an hour per week for each additional hour
outside of the classroom performing required duties”
•
Must be reasonable method
Volunteers
•
Allows exclusion of bona fide volunteers” (Note: many employees who
receive stipends still must be included as employees under the employer
mandate)
Students in Work Study Programs
•
Excludes hours of service for positions subsidized through the federal workstudy program or similar state program
15
© 2015 Alliant Insurance Services, Inc. All rights reserved. Alliant Employee Benefits, a division of Alliant Insurance Services, Inc. CA License No. 0C36861
ACA OVERVIEW
CALCULATING HOURS OF SERVICE
# Regular
hours
worked
# Hours of
paid time off
+ special
unpaid leave
# Months in
measurement
period
Average #
hours
worked per
month
All employees
Rehires
 # Hours of paid time off: include
vacation, PTO, sick time, teacher
breaks of at least 4 consecutive
weeks
Use all hours worked during
measurement period if:
 # Hours of special unpaid leave:
includes jury duty, USERRA
and FMLA. These leaves don’t count
against employees.
 Break in service is 13 weeks
or less
o 26 weeks or less for
education employees
 Rule of parity
Can treat as new employee if break in
service is more than 13 weeks (26
weeks for education employee)
© 2015 Alliant Insurance Services, Inc. All rights reserved. Alliant Employee Benefits, a division of Alliant Insurance Services, Inc. CA License No. 0C36861
16
ACA OVERVIEW
BREAK IN SERVICE RULES
Break in Service Rules
 Employees must have a break in service of 26 weeks before they can be
placed in a new initial measurement period or otherwise treated as a new
employee for the purposes of pay or play
 For employment breaks of 4 or more weeks, the employer must “credit”
hours of service as follows:
 Determining the average hours of service per week for the employee during the
measurement period, excluding the employment break period, and using that
average for the employee for the entire measurement period; or
 Crediting the employee with hours of service for the employment break period at
a rate equal to the average weekly rate at which the employee was credited
during the other weeks in the measurement period.
NOTE
 Educational organizations are not required to credit employees with more than 501 hours of service for any employment break
period in a calendar year (applies to continuing employees, not rehires; does not include special unpaid leave)
© 2015 Alliant Insurance Services, Inc. All rights reserved. Alliant Employee Benefits, a division of Alliant Insurance Services, Inc. CA License No. 0C36861
17
ACA OVERVIEW
ADJUNCT FACULTY
Counting Hours of Service for Adjunct Faculty
 The Employer Shared Responsibility IRS Section 4980H document,
provides the following guidance for counting hours of service for
adjunct faculty members who work variable hours:
 Employers should use a reasonable method of crediting hours of service that is
consistent with the purposes of section 4980H
 An instructor’s hours should include not only classroom or other instruction time, but
also include necessary hours that are needed to perform the employee’s duties such
as classroom preparation time, etc.
 A method of crediting hours of service would not be reasonable if it only accounts for
some of an employee’s hours of service with the goal to redefine as non-full time (for
employees in positions that traditionally involve more than 30 hours per week).
 The Final guidance expressly allow crediting an adjunct faculty member with 2 ¼
hours of service per week for each hour of teaching or classroom time as a
reasonable method for this test
 Other methods can be used as long as they are “reasonable”
© 2015 Alliant Insurance Services, Inc. All rights reserved. Alliant Employee Benefits, a division of Alliant Insurance Services, Inc. CA License No. 0C36861
18
ACA OVERVIEW
STUDENT WORKERS AND VOLUNTEERS
Student Workers
 The final regulations provide that hours of service do not include hours of service performed
by students in positions subsidized through the federal work-study program or a similar state
or local program
 There is no exception for student workers overall
Volunteers
 The final regulations do not directly refer to stipend employees, however there is language
included regarding “Bona Fide Volunteers”
 Hours of service for purposes of the pay or play rules do not include hours worked as a “bona fide
volunteer.” The term “bona fide volunteer” means any employee of a government or tax-exempt
entity whose only compensation from that entity or organization is in the form of:
 (i) reimbursement for (or reasonable allowance for) reasonable expenses incurred in the performance
of services by volunteers; or
 (ii) reasonable benefits (including length of service awards) and nominal fees customarily paid by
similar entities in connection with the performance of services by volunteers.
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FULL-TIME EMPLOYEES
STANDARD MEASUREMENT PERIOD
All employed when measurement period begins
Standard
Measurement Period
 Time over which
employee hours of
service are counted
 3-12 months
Administrative
Period
 Time to determine
full-time or part-time
status based on
average hours of
service
 Up to 90 days
Stability Period
 Time during which
employee’s full-time or parttime status is locked
 Must be at least six (6)
months long and cannot be
shorter than measurement
period
 Must = stability period for
initial measurement period
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PAY OR PLAY – FULL-TIME EE DETERMINATION
Standard Measurement Period – October 1 plan year
1st Standard
Measurement Period
Admin
Jun-16
May-16
Apr-16
Mar-16
Feb-16
Jan-16
Dec-15
Nov-15
Oct-15
Sep-15
Aug-15
Jul-15
Jun-15
May-15
Apr-15
Mar-15
Feb-15
Jan-15
Dec-14
Nov-14
Oct-14
Sep-14
Aug-14
Jul-14
Jun-14
May-14
2016
2015
2014
1st Stability
Period
2nd Standard
Measurement Period
1st Standard Measurement Period, start measuring August 1, 2014. Administrative Period 2 months
(August 1, 2015 – September 30, 2015). Stability Period 12 months (October 1, 2015 – September 30,
2016).
© 2015 Alliant Insurance Services, Inc. All rights reserved. Alliant Employee Benefits, a division of Alliant Insurance Services, Inc. CA License No. 0C36861
21
FULL TIME EMPLOYEES
INITIAL MEASUREMENT PERIOD
New variable hour and/or seasonal employees
Max duration 13 months + fraction
Initial
Measurement Period
 Time over which new
employee hours of
service are counted
 3-12 months
 Start on DOH or 1st of
month following
Administrative
Period
 Time to determine 
full-time or parttime status based
on average hours of
service
 Up to 90 days

 Can split admin
period if IMP starts
1st of the month

following DOH
Stability Period
Time during which
employee’s full-time or
part-time status is locked
Can’t be more than one
month longer than Initial
measurement period
Must = stability period for
ongoing measurement
period
Limited for employees
deemed part-time
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22
ACA OVERVIEW
MEASUREMENT PERIODS
Some basic rules for easier administration:

Use 12 month initial measurement periods (IMPs) and associated 12 month stability
periods – effectively have 12 IMPs in a year

Start tracking new variable hour/seasonal employees on first of the month following date
of hire
o
Note—new employees hired to work full-time must be offered coverage no later
than 60 days of date of hire (CA) – recently repealed back to 90 days

New variable hour, seasonal or part time employees whose hours of service measure as
full-time will be considered full-time during the associated stability period

An ongoing measured employee will always be in a measurement period and a stability
period
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23
PROPOSED REPORTING REQUIREMENTS
FORM 1094-C AND 1095-C

Starts in 2016 for 2015 calendar year

Employer must report to the IRS by March 31, 2016 and each March thereafter, an
electronic listing of every employee and retiree including all dependents enrolled in
medical coverage and the months of coverage (College must e-file)
 Name
 Social
 Residence
 Months Covered

Employer must issue to each employee by January 31, 2016 and each January
thereafter, a certificate of coverage including the above information for the employee
or retiree to file with their tax return to avoid the individual mandate penalty

SISC Solution: To the extent SISC can do this as a service to member Colleges, or, if
not as a service, then provide the information needed to do this to the member
Colleges, SISC will.
© 2015 Alliant Insurance Services, Inc. All rights reserved. Alliant Employee Benefits, a division of Alliant Insurance Services, Inc. CA License No. 0C36861
24
ACA OVERVIEW: CADILLAC TAX
WHAT IS A CADILLAC HEALTH PLAN ?
 The Affordable Care Act includes a tax on benefit rich plans, known as the “Cadillac Tax”
 The tax is for health plans that have lower out-of-pocket costs and most health care services are
covered
 The excise tax is 40% on any health plan premium over the following thresholds:
 $10,200 for Single Coverage
 $27,500 for Family Coverage
 Higher limit for workforces with older populations
 These amounts are benchmarked to the Federal Employee Health Benefit Plan (FEHBP)
 The Cadillac Tax includes the following:
 Medical premiums
 Non-Excepted Dental and Vision Premiums
 FSA, HRA and HSA Contributions
 The Cadillac Tax is meant to be charged to plan insurers and plan sponsors and would be collected and
used to help defray America's multi-trillion dollar health care plan
 The Cadillac Tax is scheduled to become effective January 1, 2018
© 2015 Alliant Insurance Services, Inc. All rights reserved. Alliant Employee Benefits, a division of Alliant Insurance Services, Inc. CA License No. 0C36861
25
Cadillac Tax - Illustration
Cabrillo College
Actives
Early Retirees
$10,200.00
Current Cadillac Threshold (2018) - Single
$11,850.00
Current Cadillac Threshold (2018) - Single
$27,500.00
Current Cadillac Threshold (2018) - Family
$30,950.00
Current Cadillac Threshold (2018) - Family
Blue Shield HMO $30-20% - Actives
Current
Enrollm ent
Current
Monthly Cost
Current
Annual Cost
2018 Cadillac Tax
Projected Tax - 40%
Projected Annual Cost 2018
Annual Increase
N/A
N/A
N/A
6%
9%
12%
6%
9%
12%
Employee
33
$742.00
$8,904
$10,605
$11,531
$12,509
$162
$532
$924
Employee + 1
7
$1,453.00
$17,436
$20,767
$22,580
$24,496
$0
$0
$0
Employee & Family
27
$2,043.00
$24,516
$29,199
$31,749
$34,443
$680
$1,700
$2,777
$23,692
$63,457
$105,472
Projected Tax
Blue Shield HMO $30-20% - Early Retirees
Current
Enrollm ent
Annual Increase
Employee
Current
Monthly Cost
Current
Annual Cost
2018 Cadillac Tax
Projected Tax - 40%
Projected Annual Cost 2018
N/A
N/A
N/A
6%
9%
12%
6%
9%
12%
0
$742.00
$8,904
$10,605
$11,531
$12,509
$0
$0
$264
Employee + 1
1
$1,453.00
$17,436
$20,767
$22,580
$24,496
$0
$0
$0
Employee & Family
0
$2,043.00
$24,516
$29,199
$31,749
$34,443
$0
$320
$1,397
$0
$0
$0
Projected Tax
Blue Shield HMO $25-500 w/Chiro - Actives
Current
Enrollm ent
Current
Monthly Cost
Current
Annual Cost
2018 Cadillac Tax
Projected Tax - 40%
Projected Annual Cost 2018
Annual Increase
N/A
N/A
N/A
6%
9%
12%
6%
9%
12%
Employee
98
$792.00
$9,504
$11,319
$12,308
$13,352
$448
$843
$1,261
Employee + 1
48
$1,554.00
$18,648
$22,210
$24,150
$26,199
$0
$0
$0
Employee & Family
90
$2,186.00
$26,232
$31,243
$33,971
$36,854
$1,497
$2,588
$3,742
$178,620
$315,595
$460,322
Projected Tax
Blue Shield HMO $25-500 w/Chiro - Early Retirees
Current
Enrollm ent
Annual Increase
Employee
Current
Monthly Cost
Current
Annual Cost
2018 Cadillac Tax
Projected Tax - 40%
Projected Annual Cost 2018
N/A
N/A
N/A
6%
9%
12%
6%
9%
12%
9
$792.00
$9,504
$11,319
$12,308
$13,352
$0
$183
$601
Employee + 1
7
$1,554.00
$18,648
$22,210
$24,150
$26,199
$0
$0
$0
Employee & Family
0
$2,186.00
$26,232
$31,243
$33,971
$36,854
$117
$1,208
$2,362
$0
$1,649
$5,409
Projected Tax
© 2015 Alliant Insurance Services, Inc. All rights reserved. Alliant Employee Benefits, a division of Alliant Insurance Services, Inc. CA License No. 0C36861
26
Cadillac Tax - Illustration
Cabrillo College
Actives
Early Retirees
$10,200.00
Current Cadillac Threshold (2018) - Single
$11,850.00
Current Cadillac Threshold (2018) - Single
$27,500.00
Current Cadillac Threshold (2018) - Family
$30,950.00
Current Cadillac Threshold (2018) - Family
Blue Shield HMO $10-0 w/Chiro - Actives
Current
Enrollm ent
Current
Monthly Cost
Current
Annual Cost
2018 Cadillac Tax
Projected Tax - 40%
Projected Annual Cost 2018
Annual Increase
N/A
N/A
N/A
6%
9%
12%
6%
9%
12%
Employee
14
$980.00
$11,760
$14,006
$15,230
$16,522
$1,523
$2,012
$2,529
Employee + 1
15
$1,900.00
$22,800
$27,155
$29,527
$32,032
$0
$811
$1,813
Employee & Family
15
$2,653.00
$31,836
$37,917
$41,229
$44,727
$4,167
$5,491
$6,891
$83,819
$122,697
$165,961
Projected Tax
Blue Shield HMO $10-0 w/Chiro - Early Retirees
Current
Enrollm ent
Current
Monthly Cost
Current
Annual Cost
2018 Cadillac Tax
Projected Tax - 40%
Projected Annual Cost 2018
Annual Increase
N/A
N/A
N/A
6%
9%
12%
6%
9%
12%
Employee
10
$980.00
$11,760
$14,006
$15,230
$16,522
$863
$1,352
$1,869
Employee + 1
6
$1,900.00
$22,800
$27,155
$29,527
$32,032
$0
$0
$433
Employee & Family
1
$2,653.00
$31,836
$37,917
$41,229
$44,727
$2,787
$4,111
$5,511
$11,412
$17,630
$26,796
Projected Tax
Blue Shield PPO 80-E - Actives
Current
Enrollm ent
Current
Monthly Cost
Current
Annual Cost
2018 Cadillac Tax
Projected Tax - 40%
Projected Annual Cost 2018
Annual Increase
N/A
N/A
N/A
6%
9%
12%
6%
9%
12%
Employee
29
$968.00
$11,616
$13,835
$15,043
$16,320
$1,454
$1,937
$2,448
Employee + 1
17
$1,807.00
$21,684
$25,826
$28,081
$30,464
$0
$233
$1,186
Employee & Family
9
$2,679.00
$32,148
$38,289
$41,633
$45,166
$4,316
$5,653
$7,066
$81,004
$111,010
$154,742
Projected Tax
Blue Shield PPO 80-E - Early Retirees
Current
Enrollm ent
Current
Monthly Cost
Current
Annual Cost
2018 Cadillac Tax
Projected Tax - 40%
Projected Annual Cost 2018
Annual Increase
N/A
N/A
N/A
6%
9%
12%
6%
9%
12%
Employee
19
$968.00
$11,616
$13,835
$15,043
$16,320
$794
$1,277
$1,788
Employee + 1
17
$1,807.00
$21,684
$25,826
$28,081
$30,464
$0
$0
$0
Employee & Family
0
$2,679.00
$32,148
$38,289
$41,633
$45,166
$2,936
$4,273
$5,686
$15,085
$24,267
$33,969
Projected Tax
© 2015 Alliant Insurance Services, Inc. All rights reserved. Alliant Employee Benefits, a division of Alliant Insurance Services, Inc. CA License No. 0C36861
27
Cadillac Tax - Illustration
Cabrillo College
Actives
Early Retirees
$10,200.00
Current Cadillac Threshold (2018) - Single
$11,850.00
Current Cadillac Threshold (2018) - Single
$27,500.00
Current Cadillac Threshold (2018) - Family
$30,950.00
Current Cadillac Threshold (2018) - Family
Blue Shield PPO 80-J - Actives
Current
Enrollm ent
Annual Increase
Current
Monthly Cost
Current
Annual Cost
2018 Cadillac Tax
Projected Tax - 40%
Projected Annual Cost 2018
N/A
N/A
N/A
6%
9%
12%
6%
9%
12%
Employee
15
$861.00
$10,332
$12,306
$13,380
$14,516
$842
$1,272
$1,726
Employee + 1
13
$1,607.00
$19,284
$22,968
$24,973
$27,093
$0
$0
$0
Employee & Family
11
$2,382.00
$28,584
$34,044
$37,017
$40,158
$2,618
$3,807
$5,063
$41,427
$60,957
$81,592
Projected Tax
Blue Shield PPO 80-J - Early Retirees
Current
Enrollm ent
Annual Increase
Employee
Current
Monthly Cost
Current
Annual Cost
2018 Cadillac Tax
Projected Tax - 40%
Projected Annual Cost 2018
N/A
N/A
N/A
6%
9%
12%
6%
9%
12%
1
$861.00
$10,332
$12,306
$13,380
$14,516
$182
$612
$1,066
Employee + 1
1
$1,607.00
$19,284
$22,968
$24,973
$27,093
$0
$0
$0
Employee & Family
0
$2,382.00
$28,584
$34,044
$37,017
$40,158
$1,238
$2,427
$3,683
$182
$612
$1,066
Projected Tax
Total Projected Tax
Blue Shield PPO HDHP - B w/HSA Compatibility - Actives
Current
Enrollm ent
Annual Increase
Employee
Current
Monthly Cost
Current
Annual Cost
2018 Cadillac Tax
Projected Tax - 40%
Projected Annual Cost 2018
N/A
N/A
N/A
6%
9%
12%
6%
9%
12%
27
$701.00
$8,412
$10,019
$10,894
$11,818
$0
$278
$647
Employee + 1
3
$1,323.00
$15,876
$18,909
$20,560
$22,305
$0
$0
$0
Employee & Family
3
$1,998.00
$23,976
$28,556
$31,050
$33,685
$422
$1,420
$2,474
$1,267
$11,752
$24,899
Projected Tax
Total Projected Tax
Blue Shield PPO HDHP - B w/HSA Compatibility - Early Retirees
Current
Enrollm ent
Current
Monthly Cost
Current
Annual Cost
N/A
N/A
N/A
6%
9%
12%
6%
9%
Employee
1
$701.00
$8,412
$10,019
$10,894
$11,818
$0
$0
$0
Employee + 1
0
$1,323.00
$15,876
$18,909
$20,560
$22,305
$0
$0
$0
Employee & Family
0
$1,998.00
$23,976
$28,556
$31,050
$33,685
$0
$40
$1,094
$0
$0
$0
$436,507
$729,626
$1,060,228
Annual Increase
Projected Tax
Total Projected Tax
2018 Cadillac Tax
Projected Tax - 40%
Projected Annual Cost 2018
12%
© 2015 Alliant Insurance Services, Inc. All rights reserved. Alliant Employee Benefits, a division of Alliant Insurance Services, Inc. CA License No. 0C36861
28
DISCLAIMER
The Affordable Care Act (“ACA”) is an extraordinarily complex law that will impact all areas of
medical insurance in the U.S. Both federal and state agencies have been and will continue to
issue temporary and final regulations that materially impact compliance requirements and
necessitate new or modified compliance actions.
This document and the related resources are intended to support a best practice approach to
ACA compliance based on known regulations and practical responses to an evolving landscape.
ACA compliance will be an ongoing process that will require regular updates to an employer’s
strategy based on new regulations and marketplace developments.
This document provides general information regarding the mandates under the Affordable Care
Act (ACA). It does not provide a review of, or ensure compliance with, ACA mandates.
Alliant Insurance Services, Inc. does not provide legal advice or legal opinions. Please consult
counsel if a formal legal opinion is desired.
© 2015 Alliant Insurance Services, Inc. All rights reserved. Alliant Employee Benefits, a division of Alliant Insurance Services, Inc. CA License No. 0C36861
29
Public Entity Benefits Group
100 Pine Street, 11th Floor
San Francisco, CA 94111