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cindyperry2010

(846 posts)
1. wait until people
Tue Jul 3, 2012, 03:11 PM
Jul 2012

understand they are going to get money back for their insurance companies not using 85% of the money for care. this is what the rethuglicans are all in a dither about. when people get money they like it and the insurance companies losing money to them is bad

 

TBMASE

(769 posts)
2. The problem with this plan is SEC and GAAP requirements
Tue Jul 3, 2012, 03:52 PM
Jul 2012

HHS might think they can tell corporations how to do their books but there are reporting requirements for public companies. Unless the SEC decides the new rule makes sense there is going to be a problem.

Expenses are not cash paid out, they are period costs which can be met by making an accrual for the anticipated expense. Revenue is not cash received, they accrue revenue of a reasonably expected collection of the cash either at a later date or, if they policy is paid up front, as the time elapses for the time period covered by the policy.
A company can book 85% of their costs in anticipation of claims but it doesn't mean those will ever be paid out to anyone.

An example would be $100 in revenue recognized for the year but there are only $70 in actual claims, they will book a deferred expense of $15 to meet the 85% rule. They've only paid out $70 but they've met the 85% threshold by booking the anticipated claim in the future.

Basically, they will be creating 2 sets of books...3 if you count the cash basis for tax purposes, which allows specific sales related expenses (like commisions and salaries) to be deducted from income.
until the SEC and GAAP can reconcile the change the new rule is meaningless and people won't see a penny

 

TBMASE

(769 posts)
4. They'll cut employees, outsource jobs to get to the 85% number
Tue Jul 3, 2012, 04:40 PM
Jul 2012

many of them already pay around 80-82% so finding 3-5% will be relatively easy for them.
They can cut back on people, slow down claim processing while they earn interest on the money they aren't actually paying out. Cut advertising expenses a couple of points and they're where they need to be.

It's not really the windfall people think it is

ProgressiveEconomist

(5,818 posts)
5. 'They will be creating 2 sets of books'. What's wrong with that?
Tue Jul 3, 2012, 07:29 PM
Jul 2012

HHS is set to pay health insurers hundreds of billions of dollars via tax credits to subsidize individual purchases of insurance policies. In return, can't HHS mandate cash-basis accounting to measure compliance with HHS rules? What statute would prevent HHS from demanding accounting that differs from the accounting corporations must use for financial statements mandated by other agencies?

IMO, your statement that 'they will be creating two sets of books' is TRUE, contradicts the rest of your post, and shows that you yourself recognize that your post is off the mark.

 

TBMASE

(769 posts)
6. IRS sets the way taxes are done as well as deductions and exemptions
Tue Jul 3, 2012, 08:28 PM
Jul 2012

SEC decides how public companies report their information to the public for investment purposes.

if HHS is going to demand Cash basis accounting, their rules for reporting would neccesarily differ from the IRS and the SEC. Cash Basis is less accurate because it recognizes expenses only when cash is paid or received instead of in the specific period in which the expense happens or revenue is earned.

so you would have books for the sec, irs and then for HHS. HHS requires you pay out 85% of premiums which doesn't capture all the revenue or expenses in the proper period or year.

Say they receive $100 for a premium but there are no claims against the policy until january of the following year. They refund the $85p er the rule, then have to come up with the cash to pay for the claim in the following year. Now they they get the $100 premium for the current year...they've already paid out $85 in the current year, therefore they've paid out 85% of the premium for the current year and wouldn't be obligated, under the HHS rule to pay out more on the policy.

under SEC/GAAP they would accrue the expected cost of $85 in the first year recognize the $15 as Gross Income. Pay the expense when it actually hits in the following year, recognizing $85 in estimated expenses in the following year which is offset against revenue in the same year

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