Employers

Posted September 19th, 2016 in Producers, Employers, Individuals
Employers must provide a written notice on an annual basis to any Medicare-eligible individuals who are covered under a group health plan that includes prescription drug coverage. The notice is required to include information as to whether the prescription drug coverage is considered to be creditable. In other words, is the prescription drug coverage at least as good as the standard Medicare Part D plan? 
 
Posted September 13th, 2016 in Producers, Employers
Today, September 13, 2016,  marks the three-year anniversary of the release date for IRS Notice 2013-54, which ironically occurred on Friday the 13th. A few years back, benefits industry leaders thought employers could be deterred from adopting Health Reimbursement Arrangements (HRAs) since much of the guidance made changes to the types of HRAs that could be offered. Below is a snapshot of the (now) permissible types of HRAs.
Posted September 6th, 2016 in Producers, Employers, Individuals

The Affordable Care Act (ACA) continues to evolve. Here are 10 changes expected to take effect in 2017. 

Posted August 29th, 2016 in Producers, Employers, Individuals
In 2013 and 2014 the word “exchange” was being used everywhere in the health insurance industry. Now, just a couple of years later, that term isn’t being used as frequently as it was just a couple years prior. Why? For one, the federal government decided the phrase “health insurance marketplace” or “marketplace” was what they would start calling their exchange. The media and general public also seem to associate the word “Obamacare” as being synonymous with the government-run exchanges. Additionally, private exchanges are not experiencing the growth rates that many had projected.
Posted August 22nd, 2016 in Producers, Employers
By now, you’ve probably heard about the Employer Mandate on several different occasions. Without reiterating all of the specific details, applicable large employers (ALEs) must offer health insurance coverage to full-time employees that has minimum value and is considered affordable or risk paying penalties.
 
Posted August 15th, 2016 in Producers, Employers
If you are an employer who offers a group health plan to employees who reside in the following states, then the Department of Labor (DOL) requires you to provide a premium assistance notice to employees who are eligible for the group health plan and who are also eligible (or may become eligible) for Medicaid, including the employees children who are also eligible (or may become eligible) for the Children’s Health Insurance Program (CHIP): 
 
Posted August 3rd, 2016 in Producers, Employers
According to a DOL website, “The Form 5500 Series is an important compliance, research, and disclosure tool for the Department of Labor, a disclosure document for plan participants and beneficiaries, and a source of information and data for use by other Federal agencies, Congress, and the private sector in assessing employee benefit, tax, and economic trends and policies.
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.
 
Posted July 22nd, 2016 in Producers, Employers
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.

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