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Tax-Advantaged Account Solutions HSA, FSA, DCAP, HRA and How they Impact the Bottom-line 2010 Amegy Bank N.A. Member FDIC. Introduction 2010 Amegy Bank N.A. Member FDIC. Introduction Employers face unprecedented challenges in 2011 In March 2010, comprehensive federal health care reform, called the Patient Protection and Affordable Care Act (PPACA), became law. It is intended to expand coverage while building upon and strengthening the private, employer- based health insurance system. Passage of PPACA will have both short and long term effects! The PPACA has many components-from new reporting mandates, taxes and fees to major structural changes such as insurance reforms, employer and Individual Mandates, and state insurance exchanges-phasing in over many years. Every employer-sponsored health plan will be impacted. 2010 Amegy Bank N.A. Member FDIC. Healthcare Reform Overview This law will have significant impact on employers and the health care market over the coming decade and beyond • • Goals of reform are embedded in the law's voluminous provisions – Expand coverage relying on many existing mechanisms, including public programs, employers, and the private insurance market – Remove perceived barriers to coverage – Address affordability issues Lack of detail and unknown consequences will require ongoing interpretation, monitoring and a flexible approach – Various government agencies must develop regulations - likely to be a long and staggered process taking many years 2010 Amegy Bank N.A. Member FDIC. There is a Partial Solution . . . Utilize Tax-Advantaged HealthCare Accounts • Health Savings Accounts – HSAs • Flexible Spending Accounts – FSAs • Dependant Care Assistance Plans – DCAPs • Health Reimbursement Arrangements – HRAs They provide Employer & Employee Meaningful Savings, Robust Benefits, Are Ease to Use and Comply with HCR 2010 Amegy Bank N.A. Member FDIC. Tax-Advantaged Accounts 2010 Amegy Bank N.A. Member FDIC. Health Savings Account A HSA is like a 401(k) for healthcare. The funds can be used to pay for qualified medical expenses today or can be saved for future expenses. Account Advantages • Interest and investments • Portable – it stays with you when you leave your company or retire You can spend your money on today’s expenses, or save and invest your HSA funds for future expenses or for retirement! 2010 Amegy Bank N.A. Member FDIC. Flexible Spending Account Contributions • Employees contribute – up to a limit of $2,500 • Contributions are tax free and processed through payroll Using The Account • Use the funds for qualified medical expenses of spouse & dependents – NOT Over The Counter • Total funds for the year are available when the plan becomes effective (even with no current year contributions) Funds Forfeiture Unused amounts at year-end are NOT rolled over to the next plan year 2010 Amegy Bank N.A. Member FDIC. Dependent Care Account Contributions • Contributions are tax free, processed through payroll up to $5,000 annual limit Using The Account • Use the funds for child or dependent care -- typical expenses include day care, before and after school care • Funds become available as contributed Funds Forfeiture Unused amounts at year-end are NOT rolled over to the next plan year 2010 Amegy Bank N.A. Member FDIC. Health Reimbursement Arrangement Contributions • Employers contributes funds into this account Using The Account • Use the funds for qualified medical expenses - (may be limited by employer) • Use the funds for spouse or dependents qualified medical expense Funds Forfeiture • Funds may roll over to the next plan year, depending on your employer’s plan 2010 Amegy Bank N.A. Member FDIC. Market Data 2010 Amegy Bank N.A. Member FDIC. Enrollment in CDHP Continues to Grow 2010 Amegy Bank N.A. Member FDIC. HDHPs Growth Rates 2010 Amegy Bank N.A. Member FDIC. 2012 Projected Growth by Market 2010 Amegy Bank N.A. Member FDIC. Why? . . . Meaningful Savings 2010 Amegy Bank N.A. Member FDIC. Case Study 2010 Amegy Bank N.A. Member FDIC. ZIONS BANCORPORATION 2010 Amegy Bank N.A. Member FDIC. Where We Were – 2004 Benefit Plans 2011 2004 •8 Health Care Carriers A Variety of Self-Funded & Fully-Insured Options Offered •12 Plan Options Varied by Affiliate & included diverse HMO, PPO, EPO & Rx plans •Benefits plans Cost increased annually by 19%+ 2010 Amegy Bank N.A. Member FDIC. Tipping Point – ’07 Benefits Increase CARRIER PLAN TYPE ANNUAL INCREASE* All HDHP 1.5% All HMOs 22.5% The average increase for all HMOs was over 20% greater than the average for all CDHP options. 2010 Amegy Bank N.A. Member FDIC. CDHP vs. HMO Costs CDHP continues to trend long-term reductions and medical cost savings. 6th Annual Aetna HealthFund Study March 2010 2010 Amegy Bank N.A. Member FDIC. Transitions To 100% CDHPs Phase One: Intro to HDHP Option High Deductible Health Plan Introduction • 33% of eligible employees enrolled in HDHP option, exceeding the industry average for HDHP enrollment by 6 times! • Zions funded a $500 dollar contribution to all HDHP participant Health Savings Accounts. 2010 Amegy Bank N.A. Member FDIC. CDHPs BRING RealDOWN Results PLAN . . . COSTS Zions & Our Employees Have Saved More Than $10 Million Since the CDHP was Introduced in 2005 Financial Impact Financial Impact 30% 30% 25% 25% 20% 20% 15% 15% 10% 10% 5% 5% 0% 0%2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Percent Increase Percent from Prior Increase Year from Prior Year From 2006-2011, the Annual Percentage Increase in Health Care Costs Fell From Double Digit Levels to Below 5%. 2010 Amegy Bank N.A. Member FDIC. What Could You Save?? Employer HSA Savings Employer Information Small Number of HSA Plan Participants Average Cost for PPO/HMO/Month Mid-Size Large 50 $800 250 $800 1,500 $800 $1,600 $80,000 $1,600 $400,000 $1,600 $2,400,000 $6,120.00 $30,600.00 $183,600.00 $14,000.00 $20,120.00 $70,000.00 $100,600.00 $420,000.00 $603,600.00 $5 $2,700 $1,500 $13,500 $2,500 $81,000 Participant Contributions Annual Per Participant Contribution Total Annual Participant Contribution Employer Savings Employer Tax Savings (7.65% FICA) Savings on Reduced Premiums Total Savings HSA Implementation Fee (One -time) Annual HSA Administration Fees Annual EMPLOYER Savings after HSA Fees* $ 17,420.00 $ 87,100.00 $ 522,600.00 ADDITIONAL ACCOUNTS $ 11,420.00 $ 57,100.00 $ 571,000.00 TOTAL $ 28,840.00 $ 144,200.00 $ 1,093,600.00 Assumptions Premium Reduction % Monthly HSA Administration Fee (per acct) $ 35% 4.50 *For Illustrative Purposes Only For a SINGLE employee that moves from a traditional plan to a HDHP/HSA, the employer could realize a savings of over $300/year. 2010 Amegy Bank N.A. Member FDIC. Conclusion 2010 Amegy Bank N.A. Member FDIC. What’s It All Mean? This is Complicated Stuff Be Pro-active so You Can Control Costs Find a Partner That Understands and Can Help Even with HCR – Employers Can Still Provide Vital Benefits and Save Significant Amounts on Overall Healthcare Costs A HDHP/HSA is One Good Mechanism 2010 Amegy Bank N.A. Member FDIC. Thank You and Questions 2010 Amegy Bank N.A. Member FDIC.