Individuals
Posted December 19th, 2017 in Producers, Employers, Individuals
The state of Maryland passed a law known as the Contraceptive Equity Act which is scheduled to take effect on January 1, 2018. The law requires fully insured health plans issued in the state of Maryland to cover male sterilization procedures (i.e. vasectomies) as preventive care without any copay, deductible or other cost-sharing requirements for the member.
Posted December 12th, 2017 in Producers, Employers, Individuals
We haven’t even gotten through the 2018 open enrollment season yet, but the Centers for Medicare and Medicaid Services (CMS) has already proposed rules that would impact health insurance markets for 2019. Each year, CMS issues a Notice of Benefit and Payment Parameters which explains various rules, inflation adjustments and other changes that will occur with the implementation of the Affordable Care Act (ACA).
Posted November 14th, 2017 in Producers, Employers, Individuals
Congressional Republicans have shifted their focus from healthcare reform to tax reform. According to an overview which was released in late September, three key objectives of tax reform are to:
- Make the tax code simple, fair and easy to understand.
- Give American workers a pay raise by allowing them to keep more of their paychecks.
- Bring back trillions of dollars that are currently kept offshore to reinvest in the American economy.
Posted November 1st, 2017 in Producers, Employers, Individuals
As you may have heard, the Trump administration discontinued funding for the cost-sharing reduction subsidies (CSR subsidies). Critics of this move believe it will create instability in the Exchange and individual marketplaces. Political efforts to restore the CSR subsidies are underway, but it appears Republican leadership has some demands as part of those restoration efforts.
Posted October 23rd, 2017 in Producers, Employers, Individuals
IRS Revenue Procedure 2017-58 was released last week. It includes a number of inflation adjustments to various benefits and other items for 2018 including the following for Consumer-Driven Accounts:
Posted October 10th, 2017 in Producers, Employers, Individuals
The Affordable Care Act (ACA) requires most health insurance plans to cover in-network preventive care at 100%, including coverage for prescribed contraceptives available to women. This has sparked some controversy with organizations who have a religious objection to the use of contraceptives. The Obama administration addressed this controversy by doing the following:
- Exempted group health plans offered by churches and houses of worship from providing coverage for contraceptives if there was a religious objection.
Posted October 3rd, 2017 in Producers, Employers, Individuals
Each year employers must provide a written notice to Medicare-eligible employees who are covered under their group health plan. The notice must include information about the creditable coverage status of the prescription drug benefit. In other words, the notice tells employees if the prescription drug benefit on the group health plan is at least as good as the standard Medicare Part D plan.
Posted September 26th, 2017 in Producers, Employers, Individuals
Spoiler Alert: The answer is no.
Senators Lindsey Graham (R-SC) and Bill Cassidy (R-LA) have been spearheading efforts to repeal and replace substantial parts of the Affordable Care Act (ACA). While there are many changes that the so-called “Graham-Cassidy” bill would make to the ACA, there are really three main themes that stand out:
Posted September 21st, 2017 in Producers, Employers, Individuals
The so-called Individual Mandate has been considered a widely unpopular provision of the Affordable Care Act (ACA) which most Republicans want to repeal and even several Democrats want to change. As members of Congress talk about the various ways the ACA could be modified or improved, options to change the Individual Mandate are being explored.
Posted September 5th, 2017 in Producers, Employers, Individuals
No, this article is not about the potential of the age rating ratio changing from 3:1 to 5:1. It’s about a different change that is actually going to happen in the individual and small group markets in 2018.
First, what is the age rating ratio?
Join Our Mailing List
Benefits Buzz RSS Feed