Employers

Posted May 15th, 2015 in Producers, Employers
The third installment of the Patient-Centered Outcomes Research Institute (PCORI) fees will be due on July 31, 2015. 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. Here is information and some reminders about the upcoming fee that is due.
 
  • The fee is paid on the average number of covered lives for the plan year ending in 2014.
Posted May 8th, 2015 in Producers, Employers, Individuals
On May 4, 2015, the Internal Revenue Service (IRS) has released Revenue Procedure 2015-30 which details the inflation-adjusted amounts that impact qualified high deductible health plans and Health Savings Accounts (HSAs) for the 2016 calendar year, as outlined below:
 

These limits are updated annually and reflect cost-of-living adjustments.

Posted May 1st, 2015 in Producers, Employers, Individuals
There have been several attempts to dismantle the Affordable Care Act (ACA) and none have prevailed up to this point. The House of Representatives voted nearly 40 different times to repeal the law with no avail. The constitutionality of the Individual Mandate was challenged and ultimately upheld by the Supreme Court. Now we are awaiting a decision on whether the federal government can legally provide subsidies to Exchange applicants.  
 
Posted April 24th, 2015 in Producers, Employers

The Affordable Care Act (ACA) has eliminated the need for certificates of creditable coverage (a.k.a. HIPAA notices) as of this year. These notices detailed the amount of time a person was covered under a health plan, and their primary purpose was to reduce or eliminate pre-existing condition waiting periods when someone was changing from one health plan to another. Since the ACA has eliminated pre-existing condition waiting periods in almost all market segments, these notices are deemed to be no longer relevant.

Posted April 17th, 2015 in Producers, Employers, Individuals
Since 1997, the federal government has used a system referred to as the Sustainable Growth Rate (SGR) to pay doctors that participate in the Medicare program. The SGR has aimed to slow increasing costs related to Medicare by limiting and reducing payments to doctors. However, the SGR has seen a lot of backlash from doctors, with many indicating they would not participate in the Medicare program if payments were reduced.
Posted April 2nd, 2015 in Producers, Employers
The Illinois Department of Insurance (IDOI) issued a bulletin on March 20, 2015 as it relates to the renewal of certain health plans in 2016. In particular, the bulletin indicates that certain health plans may continue to be renewed for plan years on or before October 1, 2016 without being considered out of compliance with Affordable Care Act (ACA) regulations.  
 
The bulletin impacts the following plan types: 
 
    Posted March 27th, 2015 in Producers, Employers, Individuals

    On March 4, 2015 the U.S. Supreme Court heard oral arguments in regards to the King vs. Burwell case, which is the most significant challenge to the Affordable Care Act (ACA) since the constitutionality of the Individual Mandate was challenged back in 2012. The plaintiffs in the King vs. Burwell case argue that subsidies can only be provided by states that establish an Exchange on their own. They further argue that the federal government, which is utilized in 37 states, cannot provide subsidies to Exchange applicants.  

    Posted March 20th, 2015 in Producers, Employers, Individuals
    The Department of Health and Human Services (HHS) issued nearly 500 pages of regulations that impact various components of the Affordable Care Act (ACA). These regulations were posted to the Federal Register on February 27th, and they take effect 60 days from the posting unless otherwise indicated in the regulations. Included in the final regulations are some key changes to Special Enrollment Periods (SEPs) for individual market coverage which are outlined below:  
    Posted March 16th, 2015 in Producers, Employers

    The IRS has released Notice 2015-17 with some new information about Employer Payment Plans, which are plans that are used to reimburse employees with pre-tax dollars for individual market coverage (e.g. HRA). Previous guidance had essentially eliminated Employer Payment Plans as an option for actively employed workers because they would not be able to comply with all of the Affordable Care Act (ACA) market reforms. Notice 2015-17 elaborates on the IRS’ position of Employer Payment Plans.

    Posted March 6th, 2015 in Producers, Employers
    The IRS released Notice 2015-16 which describes potential approaches that may be used in developing future regulatory guidance for the Excise Tax on High Cost Employer-Sponsored Health Coverage (a.k.a. Cadillac Tax). The Cadillac Tax would apply a tax of 40% to health coverage values that exceed certain thresholds starting in 2018.

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