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Posted August 8th, 2017 in Producers, Employers, Individuals
We all know that efforts by the Republican party to repeal and replace the Affordable Care Act (ACA) have failed up to this point. It’s unknown what healthcare legislation, if any, will ever get through both chambers of Congress and into the hands of President Donald Trump to sign into law. That will remain a mystery for the foreseeable future, but passing a law isn’t the only way the ACA can be altered. There is also regulatory action that can occur. 
 
Posted January 24th, 2017 in Producers, Employers, Individuals
Just hours after being sworn in as President of the United States, Donald Trump signed an executive order which instructs the Departments of Health and Human Services, Treasury and other agencies who are involved in administering the Affordable Care Act (ACA) to “waive, defer, grant exemptions from, or delay the implementation of any provision or requirement of the Act that would impose a fiscal burden on any State or a cost, fee, tax, penalty, or regulatory burden on individuals, families, healthcare providers, health insurers, patients, recipients of healthcare services, purchasers of h
Posted July 1st, 2016 in Producers, Employers
The Department of Health and Human Services (HHS) recently issued a final rule which effectively implements Section 1557 of the Affordable Care Act (ACA). The new rule prohibits certain discriminatory acts from occurring for health programs or activities that are administered by HHS, including plans that are sold on federal and state Marketplaces. 
 
Posted April 18th, 2016 in Producers, Employers
The Health Insurance Portability and Accountability Act (HIPAA) establishes national standards for the privacy and security of protected health information (PHI). HIPAA initially only applied to covered entities, which consist of health plans, health care providers and health care clearinghouses. In 2009, HIPAA was expanded by the Health Information Technology for Economic and Clinical Health Act (HITECH).
Posted April 11th, 2016 in Producers, Employers
Originally posted on January 2, 2015 and updated on April 10, 2015, June 19, 2015 and April 11, 2016.
 
Posted March 11th, 2016 in Producers, Employers, Individuals

Each year the Department of Health and Human Services (HHS) issues a set of rules referred to as the “Notice of Benefit and Payment Parameters.”  This set of rules generally addresses changes and new requirements that apply to certain provisions of the Affordable Care Act (ACA). 

Posted December 18th, 2015 in Producers, Employers, Individuals

On December 11, 2015, the Department of Health and Human Services (HHS) posted guidance for states interested in seeking a State Innovation Waiver under Section 1332 of the Affordable Care Act (ACA).

Posted December 10th, 2015 in Producers, Employers, Individuals
Below is a list of some key Affordable Care Act (ACA) changes and facts that will be effective in 2016:
 
  1. The Individual Mandate penalties increase to $695 per adult ($347.50 per child) or 2.5% of household income, whichever is greater. 
  2. The Employer Mandate expands to include all employers who have 50 or more employees. 
  3. The Employer Mandate offer rate increases from 70% to 95%. 
  4. Employer reporting related to the offer of coverage is due for the first time during Q1 2016. 
Posted October 30th, 2015 in Producers, Employers

PCORI Fees

The Internal Revenue Service (IRS) released Notice 2015-60 on October 9, 2015.  The notice includes information on the payable amounts that are due for the Patient-Centered Outcomes Research Institute fees (PCORI fees). The fee will increase from $2.08 to $2.17 per covered life for plan years ending on or after October 1, 2015 and before October 1, 2016. The next round of PCORI fees will be due by July 31, 2016 for plan years ending in 2015. The payment schedule will be as follows:
Posted May 22nd, 2015 in Producers, Employers, Individuals

The Affordable Care Act (ACA) established a maximum out-of-pocket limitation for single and family coverage. The limit established for 2016 is $6,850 for single coverage and $13,700 for family coverage. The Department of Health and Human Services (HHS) issued an FAQ document on May 8, 2015 which indicates a health plan that covers a family cannot impose an out-of-pocket maximum of more than $6,850 for any single family member covered under the plan.