Individuals

Posted February 6th, 2015 in Producers, Individuals
The Affordable Care Act (ACA) requires most people in the country to have health insurance coverage or pay a penalty. In addition, advanced premium tax credits were provided to millions of people who enrolled in coverage through a state-run or federally-facilitated Exchange. The government will be assessing penalties and reconciling subsidy payments on federal income tax returns effective for 2014.
 
Posted January 23rd, 2015 in Producers, Employers, Individuals

The IRS has released the maximum penalties that are payable by individuals who are without minimum essential coverage in 2015 and who do not qualify for an exemption from the Individual Mandate.

The maximum penalties for this year are the greater of:

  • $325 per uninsured adult or $162.50 per uninsured child under age 18. The maximum penalty using this method is capped at $975.

Posted December 19th, 2014 in Producers, Employers, Individuals
The U.S. House of Representatives and Senate have both voted and approved an extension of more than 50 different tax provisions that expired at the end of 2013. The actions taken would retroactively extend these tax provisions for 2014, but it does not extend them into 2015.  
 
Posted December 12th, 2014 in Producers, Individuals
Earlier this year the IRS released three revenue procedures (2014-46, 2014-37, 2014-41) which provide guidance to individuals on their obligation to maintain minimum essential coverage and includes information on subsidies available through the Health Insurance Marketplace (Exchange).  
 
Posted November 26th, 2014 in Individuals
Here's an example eligible expenses that someone with a Health Care Flexible Spending Account (FSA) might encounter on Thanksgiving Day:
 
6:00 AM Wakes up
8:30 AM Picks up prescription medicine* from a local drugstore to be ready for anything
9:15 AM Starts preparing the side dishes
Posted August 8th, 2014 in Producers, Employers, Individuals
The Affordable Care Act (ACA) limits the maximum waiting period that employers can use for health coverage to 90 calendar days. However, there is something also referred to as an orientation period which seems to have taken a back seat to the 90 day waiting period. The final ACA rules allow employers to use an orientation period of up to one month (in addition to the 90 day waiting period) for bona fide employment reasons.
 
What Does That Really Mean?
Posted August 1st, 2014 in Producers, Employers, Individuals

July 22nd was quite an eventful day as it relates to the Affordable Care Act (ACA). On the same day, two different U.S. Courts of Appeals came to opposite conclusions as it relates to the ability for federally-facilitated Exchanges to provide subsidies to enrollees. 

Posted June 27th, 2014 in Producers, Employers, Individuals

On June 26, 2014, the Department of Health and Human Services (HHS) issued proposed regulations on the renewal process for individuals that have purchased health coverage through the Exchange. The regulations aim to streamline the renewal process by auto-enrolling the vast majority of existing members into a health plan for the 2015 plan year.

Posted June 20th, 2014 in Producers, Employers, Individuals

Minimum Essential Coverage and Minimum Value are two terms that are mistakenly considered the same by many people, but in fact, these terms have different definitions. 

Minimum Essential Coverage is the type of coverage needed to satisfy the Individual Mandate requirements. The most common forms include the following health plans:

Posted June 13th, 2014 in Producers, Employers, Individuals

On June 1, 2014, same-sex marriage became legal in the state of Illinois. As a result, we wanted to revisit marriage as a qualifying event for health insurance coverage and discuss how account-based health plans are impacted.

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