本月，《国家的医疗改革法》（《患者保护和负担得起的护理法》）开始认真地展开，承包商需要确保他们已经为变更做好了准备。
Before we address the new realities, however, it might help to explain how the law actually affects small contractors, which has been a source of confusion. The facts are: Before the final vote, Sen. Jeff Merkley, D-Oregon, attached an amendment requiring contractors with five or more employees and payrolls of more than $250,000 to provide health coverage. However, the amendment did not survive the reconciliation process between Senate and House versions of the bill. Moreover, it is highly unlikely the amendment will be reinstated. The AFL-CIO’s Building and Construction Trades Department, which was the driving force behind the amendment, and Sen. Merkley appear to have lost interest in rekindling the amendment.
如今，只有拥有50名或更多员工的公司才能提供保险，这意味着法律主要适用于最大的建筑公司。对于那些雇用49名或更少员工的公司，不需要医疗保险。实际上，一些承包商和建筑公司可能会倾向于放弃覆盖范围，以更好地与大型竞争对手竞争。承包商在这样做之前应该努力思考。美国相关总承包商的发言人布莱恩·图尔玛尔（Brian Turmail）最近说：“如果您削减福利，则削减了作为公司的能力。每个人都有相同的建筑设备。没有秘密的前端装载机会击败比赛。您要竞争的地方取决于员工的力量。’’
Turmail makes a good point.
WRIGHT
对于那些确实提供福利的人，将在未来四个月内发生一些重要的更改，这将发生在本月。现在，员工少于25岁的雇主现在可以利用税收抵免来换取提供医疗保健福利的雇主。只有向工人支付平均25,000美元或更少的公司才有资格获得全部信贷。随着平均工资的上升，信用降低了，当平均工资达到50,000美元时，完全阶段就消失了。只有覆盖50％或更多保险费用的公司才有资格，该信贷最多可用六年。18luck.cub
There is another important change that goes into effect this month. From June 23 through Dec. 31, 2013, employers will be able to participate in an incentive program to provide coverage for retirees over the age of 55 who are not eligible for Medicare. A temporary high-risk insurance pool will be created to provide health coverage to individuals with pre-existing medical conditions who have been uninsured for at least six months.
Because of these requirements, and others that will follow, contractors who have not reviewed the law with their accountants need to do so. A litany of changes will arrive incrementally over the next four years and contractors need to keep up.
For those who have lost track of what health-care reform will create over the next few years, here are the key features:
Tax Years 2010-2013:Employers with fewer than 25 employees may take advantage of tax credits in exchange for providing health-care benefits.
June 23, 2010 through Dec. 31, 2013:除了我已经讨论过的退休人员计划外，还将创建一个临时的高风险保险池，以向具有至少六个月没有保险的患有医疗状况的个人提供医疗保健。
For Plan Years Beginning Sept. 23, 2010 or for calendar year plans beginning Jan 1, 2011:1）保险公司将无法否认对患有医疗状况的儿童的承保范围。2）保险公司必须为27岁以下的受抚养儿童提供承保范围，只要成年子女没有资格参加另一项合格的雇主赞助的健康计划。新利luck3）对于那些生病的人，无法取消政策。4）计划不再对基本收益设定终身限制。5）将需要计划涵盖预防服务，例如对儿童进行免疫接种。
Jan. 1, 2011:1）对从健康储蓄账户上花钱的个人的联邦税将不合格的医疗费用增加到20％。2）必须每年在雇员的W-2表格上报告适用的雇主赞助承保范围的总成本。
2013年1月1日：1) The limit on how much individuals can contribute to flexible spending accounts will be set at $2,500. 2) The Medicare tax rate will increase from 1.45% to 2.35% on earnings over $200,000 for individuals and $250,000 for families.
2014年1月2日：1) Companies with 50 or more employees will be required to pay a penalty of $2,000 annually for each employee if the company does not provide a health insurance plan. (The threshold for construction companies was increased from five to 50 as part of the reconciliation process.) 2) Companies with 50 or more employees will pay a fine if any of their full-time workers qualify for federal health-care subsidies. 3) A state-based health care exchange will be created as a marketplace for uninsured individuals and small businesses. 4) Adults with pre-existing conditions can no longer be denied coverage. 5) Employers must automatically enroll employees in the company’s health plan. Employees may opt out later.
2018年1月1日：1）将对个人承保范围的卫生保健计划征收40％的税款，家庭承保范围为30,850美元。对于建筑雇主而言，这一数量要高于大多数其他行业，因为建筑是许多高风险行业之一，并且不包括牙科和视力收益的价值。2）各州可以选择允许拥有200名或更多员工的大型公司通过交流购买承保范围。
医疗保健改革即将造成许多会计变化，毫无疑问，几次税收变更。这一切都为企业主创造了一条新的学习曲线，但不应该担心。一切都可以管理。不要拖延建筑行业会计师的指导。
