Individuals

Posted December 23rd, 2015 in Producers, Employers, Individuals
You may have heard that President Obama recently signed into law the Consolidated Appropriations Act of 2016, a $1.1 trillion spending bill, avoiding a shutdown and funding the federal government through September 30, 2016. The President also signed the Protecting Americans from Tax Hikes (PATH) Act of 2015 which provides nearly $700 billion in tax breaks. Here’s what it means to the Affordable Care Act (ACA) and transit reimbursement plans.   
 
Cadillac Tax
  • The Cadillac Tax has been delayed by two years until 2020.
Posted December 18th, 2015 in Producers, Employers, Individuals

On December 11, 2015, the Department of Health and Human Services (HHS) posted guidance for states interested in seeking a State Innovation Waiver under Section 1332 of the Affordable Care Act (ACA).

Posted December 10th, 2015 in Producers, Employers, Individuals
Below is a list of some key Affordable Care Act (ACA) changes and facts that will be effective in 2016:
 
  1. The Individual Mandate penalties increase to $695 per adult ($347.50 per child) or 2.5% of household income, whichever is greater. 
  2. The Employer Mandate expands to include all employers who have 50 or more employees. 
  3. The Employer Mandate offer rate increases from 70% to 95%. 
  4. Employer reporting related to the offer of coverage is due for the first time during Q1 2016. 
Posted December 4th, 2015 in Producers, Employers, Individuals
The Senate needed 51 votes to pass the Restoring Americans' Healthcare Freedom Reconciliation Act of 2015 (HR 3762), a budget reconciliation bill which would repeal several key parts of the Affordable Care Act (ACA).  They got 52 when they voted on December 3rd.  The bill, which was previously passed by the House of Representatives (House), was approved by the Senate with some amendments.  That means the bill will have to go back to the House for another vote, where most expect it will be passed.
Posted November 20th, 2015 in Producers, Employers, Individuals
The Centers for Medicare and Medicaid Services (CMS) has released premium and cost sharing information for Medicare beneficiaries in 2016.  Approximately 70% of individuals will pay $104.90 per month for Part B, however, the premium cost will be higher for the remaining 30% of individuals who:
 
  1. Enroll in Part B for the first time in 2016; or
  2. Those who don’t currently receive Social Security benefits; or
  3. People who have Medicare and Medicaid, and Medicaid pays the Part B premium; or
Posted October 8th, 2015 in Employers, Producers, Individuals

The open enrollment period (OEP) in the individual market will begin on November 1, 2015 and end on January 31, 2016.

During this time period, just about anyone can enroll or make plan changes to coverage in the individual market.

Here are some helpful reminders as the OEP approaches:

Who is eligible for a subsidy?

There are a number of factors that affect eligibility or can disqualify an individual for a subsidy, such as:

Posted October 7th, 2015 in Producers, Employers, Individuals

On October 1, 2015, the medical industry launched ICD-10 in the U.S.  ICD-10, which stands for the International Classification of Diseases, 10th revision, is a medical classification system adopted by the World Health Organization (WHO). Simply put, it’s an international coding system that requires physicians, hospitals and other medical providers to assign a unique number for every patient disease, diagnosis, abnormal finding, cause of injury, etc.

Posted August 7th, 2015 in Producers, Employers, Individuals
In a perfect world we would all save as much money as we could for retirement, but the reality is the average person has a limited amount they can save for the future. That being said, some Health Savings Account (HSA) advocates are saying employees should consider funding an HSA before a 401(k) or other retirement savings vehicle. Advocates stress that HSAs have one leg up on 401(k) plans because of a triple tax advantage feature.
 
  1. HSA contributions are tax deductible……just like 401(k) contributions.
Posted July 2nd, 2015 in Producers, Employers, Individuals
On June 25, 2015, the Supreme Court of the United States (SCOTUS) ruled 6-3 in favor of the federal government and their ability to provide subsidies in Exchanges. The plaintiffs had contested the federal government’s interpretation of the healthcare law citing language in the Affordable Care Act (ACA) which specifically says subsidies can only be provided by an Exchange “established by the state.”  
 

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