Presented By: Joel Flinchbaugh, CPA
Smith Elliott Kearns & Company LLC
   March 2010, Congress passed the Patient
    Protection and Affordable Care Act and the
    Health Care and Education Reconciliation Act
    of 2010
   Estimated cost - $940 billion over 10 years
   Expand coverage to 32 million Americans
   Changes for Business
    ◦   Summary of benefits
    ◦   W-2 reporting
    ◦   FSA limits
    ◦   Medical Loss Ratio rebate
    ◦   Minimum Essential Coverage

   Tax Impacts to Individuals
    ◦   Increased Medicare Taxes
    ◦   Surtax on Unearned Income
    ◦   Medical Expense Deduction
    ◦   Health Insurance Requirement
    ◦   Premium Assistance Credit
Healthcare reform seminar 1042012
◦ Uniform summary of benefits and coverage
  explanations in plain language
◦ Must be provided at plan renewal on or after
  9/23/12
◦ Revised summary of changes must be given 60 days
  prior to effective date
◦ Penalty of up to $1,000 per failure to provide
   Cost of employer sponsored coverage must
    be reported on employee’s W-2 beginning
    with the 2012 tax year.
      Employer’s issuing less than 250 W-2’s exempt until
       2013
      Reporting is for information purposes only
      Do not have to provide for individuals who would not
       otherwise get a W-2 (retiree, Cobra)
      Penalty for failure to comply (up to $250,000 per year)
   Effective 1/1/2013 max election for
    employee is $2,500
    ◦ No previous federal mandated limit


   Plan documents must be amended by
    12/31/2014
   Insurers required to spend so much of
    premiums on claims-excess refunded to
    employer
   Employer must distribute rebates to
    participants in some way…
      Distribute to enrollees/improve benefits/reduce future
       employee contributions
      Allocation amongst participants must be fair and
       reasonable
      Must be used within 3 months of receiving
   In 2014-Employers with 50 or more
    employees who DO NOT offer health
    coverage…
      Must offer insurance to full-time employees or pay a
       penalty
      Fine is $2,000 per employee, but first 30 employees
       are not counted….so with 65 employees penalty is only
       paid on 35 of them
   Employer with 50 or more employees who
    DOES offer health coverage…but has at least
    one Full time employee receiving a tax credit
    in the exchange will pay the lesser of…
      $3,000 for each employee receiving a credit or $2,000
       for each full time employee
      An individual with family income up to 400% of federal
       poverty level is eligible for credit if:
           The value of employer coverage is less than minimum
            standard (does not cover 60% of costs) or...
           The employer requires employee to contribute more than
            9.5% of employee’s family income toward coverage
Healthcare reform seminar 1042012
   Current Social Security Taxes:
    ◦ 6.2% (4.2% in 2012) to a maximum $110,100 for
      OASDI (old age survivor disability insurance)
                           and
    ◦ 1.45% on all wages for Medicare (HI)

   Withheld from wages; employer matches

   Self-employed pay both shares; receive
    deduction for ½ of tax on 1040
   2013—Medicare increases 0.9% for employee
    only on wages over - $200,000
   For joint returns additional tax on joint
    earned income in excess of $250,000.
   Self-Employment Tax increases to same
    amount
   No increase in Self-Employment deduction
   May have to remit additional Medicare on
    1040
   Also effective in 2013
   New 3.8% Surtax on investment income
   Calculated on the lesser of:

    1. Net investment income OR the
    2. Excess of taxpayers’ modified AGI over $200,000
       ($250,000 for MFJ)
   Interest
   Dividends
   Annuities
   Royalties
   Rent
   Capital Gains
   Passive income from business (limited
    participation)
   Active business income
   Qualified retirement plan and IRA
    distributions
   Self-employment income
   Tax-exempt interest
   Sale of principal residence
   Barack & Michelle, MFJ
   Salaries $280,000 + net interest income
    $20,000 = AGI $300,000
   Taxed on lesser of:
     1. Net investment =$20,000 OR
     2. Excess of AGI over $250,000 =$50,000

    Result
   $760= 3.8% surtax on $20,000
   Currently, medical expenses allowable if
    GREATER than 7.5% of AGI

   2013, threshold increases to 10% of AGI

   Exception-Taxpayer or Spouse is or turns 65
    during 2013-2016, 10% threshold is not
    effective until 2017
   Taxpayer AGI of $100,000 receives no
    deduction of unreimbursed medical costs
    until those expenses exceed $7,500 for
    2011-2012
   2013- medical expenses > $10,000 to be
    deductible
   2014 & 2015 phase in period—penalty on
    individuals who fail to maintain “minimum
    essential coverage”

   Penalty: 2014 = greater of 1% of household
             income OR $95 per uninsured

            2015 = greater of 2% of household
            income OR $325 per uninsured
In 2016, penalty is greater of:

2.5% of taxpayer’s household income
(In excess of filing threshold)

                 OR

$695 per uninsured adult plus half the amount per
   child under 18.

Penalty has a cap of $2,085 per household
Individual must maintain minimum essential
    health care coverage under:

   Medicare, Medicaid, TRICARE, veteran’s care
    or other governmental programs
   Employer sponsored group plan
   Grandfathered health plan
   Any coverage recognized by Department of
    Health & Human Services
   Health insurance premium exceeds 8% of
    household income
   Income below 1040 filing threshold
   Penalty included on 1040
   IRS may not impose interest on late payment
   Not subject to criminal prosecution or
    assessment
   IRS may not file a lien or levy property
    ◦ May reduce refund owed to taxpayer
   Penalty criticized as unconstitutional
    ◦ Supreme Court has ruled it is a tax and
      constitutional
   Voluntary?????????????
   2014 - Refundable credit to cover cost of
    premiums for health insurance purchased
    through a state health exchange
   Credit based on income
   Individual pays plan difference of premium
    and credit (credit goes directly to exchange)
   Low income individuals
   There are a lot of changes coming to the tax
    system as a result of healthcare legislation
   Clarifications are coming almost continually
   Keep in contact with your professionals
    (insurance agent, attorney, CPA)
   Good luck!!!
Joel Flinchbaugh, CPA
Smith Elliott Kearns & Company

Email: jflinchbaugh@sek.com
Phone: (717) 243-9104

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Healthcare reform seminar 1042012

  • 1. Presented By: Joel Flinchbaugh, CPA Smith Elliott Kearns & Company LLC
  • 2. March 2010, Congress passed the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010  Estimated cost - $940 billion over 10 years  Expand coverage to 32 million Americans
  • 3. Changes for Business ◦ Summary of benefits ◦ W-2 reporting ◦ FSA limits ◦ Medical Loss Ratio rebate ◦ Minimum Essential Coverage  Tax Impacts to Individuals ◦ Increased Medicare Taxes ◦ Surtax on Unearned Income ◦ Medical Expense Deduction ◦ Health Insurance Requirement ◦ Premium Assistance Credit
  • 5. ◦ Uniform summary of benefits and coverage explanations in plain language ◦ Must be provided at plan renewal on or after 9/23/12 ◦ Revised summary of changes must be given 60 days prior to effective date ◦ Penalty of up to $1,000 per failure to provide
  • 6. Cost of employer sponsored coverage must be reported on employee’s W-2 beginning with the 2012 tax year.  Employer’s issuing less than 250 W-2’s exempt until 2013  Reporting is for information purposes only  Do not have to provide for individuals who would not otherwise get a W-2 (retiree, Cobra)  Penalty for failure to comply (up to $250,000 per year)
  • 7. Effective 1/1/2013 max election for employee is $2,500 ◦ No previous federal mandated limit  Plan documents must be amended by 12/31/2014
  • 8. Insurers required to spend so much of premiums on claims-excess refunded to employer  Employer must distribute rebates to participants in some way…  Distribute to enrollees/improve benefits/reduce future employee contributions  Allocation amongst participants must be fair and reasonable  Must be used within 3 months of receiving
  • 9. In 2014-Employers with 50 or more employees who DO NOT offer health coverage…  Must offer insurance to full-time employees or pay a penalty  Fine is $2,000 per employee, but first 30 employees are not counted….so with 65 employees penalty is only paid on 35 of them
  • 10. Employer with 50 or more employees who DOES offer health coverage…but has at least one Full time employee receiving a tax credit in the exchange will pay the lesser of…  $3,000 for each employee receiving a credit or $2,000 for each full time employee  An individual with family income up to 400% of federal poverty level is eligible for credit if:  The value of employer coverage is less than minimum standard (does not cover 60% of costs) or...  The employer requires employee to contribute more than 9.5% of employee’s family income toward coverage
  • 12. Current Social Security Taxes: ◦ 6.2% (4.2% in 2012) to a maximum $110,100 for OASDI (old age survivor disability insurance) and ◦ 1.45% on all wages for Medicare (HI)  Withheld from wages; employer matches  Self-employed pay both shares; receive deduction for ½ of tax on 1040
  • 13. 2013—Medicare increases 0.9% for employee only on wages over - $200,000  For joint returns additional tax on joint earned income in excess of $250,000.  Self-Employment Tax increases to same amount  No increase in Self-Employment deduction  May have to remit additional Medicare on 1040
  • 14. Also effective in 2013  New 3.8% Surtax on investment income  Calculated on the lesser of: 1. Net investment income OR the 2. Excess of taxpayers’ modified AGI over $200,000 ($250,000 for MFJ)
  • 15. Interest  Dividends  Annuities  Royalties  Rent  Capital Gains  Passive income from business (limited participation)
  • 16. Active business income  Qualified retirement plan and IRA distributions  Self-employment income  Tax-exempt interest  Sale of principal residence
  • 17. Barack & Michelle, MFJ  Salaries $280,000 + net interest income $20,000 = AGI $300,000  Taxed on lesser of: 1. Net investment =$20,000 OR 2. Excess of AGI over $250,000 =$50,000 Result  $760= 3.8% surtax on $20,000
  • 18. Currently, medical expenses allowable if GREATER than 7.5% of AGI  2013, threshold increases to 10% of AGI  Exception-Taxpayer or Spouse is or turns 65 during 2013-2016, 10% threshold is not effective until 2017
  • 19. Taxpayer AGI of $100,000 receives no deduction of unreimbursed medical costs until those expenses exceed $7,500 for 2011-2012  2013- medical expenses > $10,000 to be deductible
  • 20. 2014 & 2015 phase in period—penalty on individuals who fail to maintain “minimum essential coverage”  Penalty: 2014 = greater of 1% of household income OR $95 per uninsured 2015 = greater of 2% of household income OR $325 per uninsured
  • 21. In 2016, penalty is greater of: 2.5% of taxpayer’s household income (In excess of filing threshold) OR $695 per uninsured adult plus half the amount per child under 18. Penalty has a cap of $2,085 per household
  • 22. Individual must maintain minimum essential health care coverage under:  Medicare, Medicaid, TRICARE, veteran’s care or other governmental programs  Employer sponsored group plan  Grandfathered health plan  Any coverage recognized by Department of Health & Human Services
  • 23. Health insurance premium exceeds 8% of household income  Income below 1040 filing threshold
  • 24. Penalty included on 1040  IRS may not impose interest on late payment  Not subject to criminal prosecution or assessment  IRS may not file a lien or levy property ◦ May reduce refund owed to taxpayer  Penalty criticized as unconstitutional ◦ Supreme Court has ruled it is a tax and constitutional  Voluntary?????????????
  • 25. 2014 - Refundable credit to cover cost of premiums for health insurance purchased through a state health exchange  Credit based on income  Individual pays plan difference of premium and credit (credit goes directly to exchange)  Low income individuals
  • 26. There are a lot of changes coming to the tax system as a result of healthcare legislation  Clarifications are coming almost continually  Keep in contact with your professionals (insurance agent, attorney, CPA)  Good luck!!!
  • 27. Joel Flinchbaugh, CPA Smith Elliott Kearns & Company Email: jflinchbaugh@sek.com Phone: (717) 243-9104

Editor's Notes

  • #27: Challenged in lawsuit brought by several state attorney generals