Benefits Buzz
Posted July 28th, 2016 in Producers, Employers, Individuals
There has been a lot of shake up in the recent weeks and months as it relates to health insurance options available in the individual marketplace. UnitedHealthcare (UHC) announced it would only offer individual plan options in three states next year. Humana also announced they would be limiting the number of states it offers individual plans in next year. More recently, three additional CO-OPs in Connecticut, Illinois and Oregon announced their closures by the end of the year.
The Internal Revenue Service (IRS), Social Security Administration (SSA), and the Centers for Medicare & Medicaid Services (CMS) are required to share information that each agency has about whether Medicare beneficiaries or their spouses are working. This sharing of information is referred to as the IRS-SSA-CMS Data Match, and the purpose of the Data Match is to identify situations where another group health plan may be primary to Medicare. In general, a group health will be primary to Medicare when:
Posted July 7th, 2016 in Producers, Employers, Individuals
It should be pretty clear by now that two of the biggest provisions of the Affordable Care Act (ACA) are the Individual and Employer Mandates. The Individual Mandate requires all Americans to have a health insurance plan or pay a penalty, unless an exemption applies. Factors that may influence the amount of the Individual Mandate penalty include household size and income. The Employer Mandate requires employers with 50 or more employees to offer health insurance coverage to at least 95% of its full-time employees or risk penalties.
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.
The fourth installment of the Patient-Centered Outcomes Research Institute (PCORI) fees will be due on July 31, 2016.
As its name suggests, PCORI is a research institute, and it was created by the Affordable Care Act (ACA) as a way to improve clinical effectiveness. It is partially funded by fees charged to health plans.
The following list contains information and some reminders about the upcoming PCORI fee that is due:
