Individuals

Posted June 19th, 2015 in Producers, Employers, Individuals

What happens to Health and Dependent Care FSAs when a merger or acquisition occurs?  

 
Of course the Cafeteria Plan regulations do not specify how this should be treated, but the IRS has provided some guidance in the form of Revenue Ruling 2002-32. Fortunately, for employees, the IRS has taken a position that employees should not be punished as a result of a merger or acquisition, and the guidance suggests two possible options that would be acceptable in their eyes. Both options maintain the salary reduction of the employee and preserve the annual election.
Posted June 12th, 2015 in Producers, Employers, Individuals
There’s an interesting story developing in Texas which may have a carryover effect to other states. The Texas House of Representatives and Senate have approved House Bill 1514, which would require the letters “QHP” to be included on ID cards of any health plan purchased through the Exchange. QHP, which stands for Qualified Health Plan, would help doctors and medical providers understand the type of coverage a patient has prior to providing any services.
Posted June 5th, 2015 in Producers, Employers, Individuals
The Supreme Court is expected to rule on the King vs. Burwell case at the end of this month. This is the court case that is challenging whether or not the federal government can provide subsidies to Exchange enrollees in the 37 states in which it operates. Media coverage of the case implies that the judges are evenly split and a ruling could go either way.
Posted June 1st, 2015 in Producers, Employers, Individuals
The Affordable Care Act (ACA) has created a great deal of change in the healthcare market. Individuals, employers, insurers, doctors, hospitals, pharmaceutical companies and many others have all experienced change in one way, shape or form. Next on the list is the restaurant industry, and that’s because the food you eat can have an impact on your overall health.  
 
Posted May 22nd, 2015 in Producers, Employers, Individuals

The Affordable Care Act (ACA) established a maximum out-of-pocket limitation for single and family coverage. The limit established for 2016 is $6,850 for single coverage and $13,700 for family coverage. The Department of Health and Human Services (HHS) issued an FAQ document on May 8, 2015 which indicates a health plan that covers a family cannot impose an out-of-pocket maximum of more than $6,850 for any single family member covered under the plan.

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 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 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:  

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