Employers
The U.S. Department of Treasury announced on Tuesday that the Employer Mandate will be delayed until 2015. This rule is also commonly referred to as the Employer Shared Responsibility requirement or the Pay or Play provision.
The Employer Mandate was set to impose financial penalties starting in 2014 on employers with 50 or more full-time equivalent employees that failed to offer health insurance to employees, as well as those employers that offered health insurance that was considered unaffordable.
Most health insurance professionals have some familiarity about the government subsidies that will be available next year to eligible individuals. These subsidies will reduce insurance premiums and out-of-pocket medical expenses for those that qualify, and will only be available to individuals that enroll in coverage through health insurance marketplaces, also known as the public exchanges.
Last week, Senator Ben Cardin (D-MD) and Senator Mike Enzi (R-WY) introduced S 9.66, the Medical FSA Improvement Act, to eliminate the Use-It or Lose-It rule by allowing individuals to cash-out unused Flexible Spending Account (FSA) balances with the amounts treated as taxable income.
View the legislative language >>
What could this mean for Americans?
Most employers will be required to provide a written notification to employees in regards to the ability to access coverage through the new Health Insurance Marketplaces, also known as the exchanges. Even employers that don't provide coverage to their employees will be required to provide this written notification.
The Center for Medicare and Medicaid Services (CMS) issued a statement on April 30, 2013 that the public exchange applications, officially referred to as the Marketplace Consumer Applications, have been revised.
The Invidual Short Form is now just three pages in length. The Family Form is also said to have been reduced by about two-thirds its original length.
Recent guidance helped clarify some of the confusion about Patient-Centered Outcomes Research Institute (PCORI) fees applicable to Health Reimbursement
Arrangements (HRAs) and Flexible Spending Accounts (FSAs). It was originally thought that the fee would be applicable to all covered lives including spouses and dependents. That is no longer the case in some instances.
What will the exchanges look like? What are the exchange deadlines? How will subsidies and payments be processed? There constantly seems to be questions about the health insurance marketplaces, also known as the exchanges.
The Center for Medicare & Medicaid Services (CMS) released a progress fact sheet about the exchanges on April 22, 2013. This new information provides additional details about eligibility and enrollment, plan management, financial management, consumer support and more.
Like the popular television commercials with children explaining their theories on what’s better (when asked if more is better than less), they want more. The concept is that simple. People, in general, do not want to settle for less.
Small businesses want more from a program that is named the Small Business Health Options Program or SHOP exchange. The government, however, has stripped away the “options” (at least for a year). If you’re a worker for a small business employer who is offered the SHOP exchange, you really don’t have anything to “shop” around for.
The Obama administration announced last week that parts of the Small Business Health Options Program (SHOP) would be delayed until 2015. This announcement has created a lot of confusion in the market.
The SHOP will be a new health insurance marketplace to provide exchange-based coverage to small businesses with up to 50 employees in most states. The SHOP is still expected to be launched as planned in 2014, but one of its key components will be delayed until 2015.
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