Producers

Posted October 15th, 2019 in Producers, Individuals
The Centers for Medicare & Medicaid Services (CMS) recently announced plans to pilot healthcontingent wellness programs in the individual market, a practice that has been previously prohibited. However, the Affordable Care Act (ACA) included a provision calling for health-contingent wellness programs to be tested in the individual market, and that time has now come.   
 
Posted September 17th, 2019 in Employers, Producers

The Affordable Care Act (ACA) created a research institute known as the Patient-Centered Outcomes Research Institute (PCORI). The goal of PCORI is to help patients and those who care for them make better-informed decisions about healthcare choices. PCORI is funded by temporary fees which are charged to health plans. The following information is designed to help employers understand their upcoming payment obligations in 2020.

Posted September 11th, 2019 in Producers

Think you know how your small business clients feel about healthcare benefits? As their trusted advisor, you probably have the best perspective.

Posted September 3rd, 2019 in Employers, Producers

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 August 27th, 2019 in Individuals, Producers

The Centers for Medicare & Medicaid Services (CMS) announced earlier this month that plans sold on the Health Insurance Marketplace (Marketplace) will receive quality ratings using a five-star system (with  5 stars representing the highest quality plan).

Posted August 22nd, 2019 in Employers, Producers

It’s no surprise that more and more employers are offering qualified high deductible health plans (HDHPs) to their employees, and some employers are combining Health Reimbursement Arrangements (HRAs) and Health Savings Accounts (HSAs) to alleviate a portion of the deductible and/or out-of-pocket expenses that employees are exposed to. However, you have to be very careful with the HRA plan design in order to preserve HSA eligibility for employees.

Posted August 13th, 2019 in Employers, Producers

Senator Susan Collins (R-ME) submitted an inquiry to the Internal Revenue Service (IRS) earlier this year asking two very specific questions. She wanted to know if penalties related to the Employer Mandate could be reduced or waived if it would cause a hardship on an employer. She also wanted to know if the IRS would extend the transition relief that was previously available to employers with 50-99 employees. Previous transition relief exempted most employers of this size from the Employer Mandate during its first year of implementation in 2015.

Posted August 6th, 2019 in Employers, Producers

The Internal Revenue Service recently released Revenue Procedure 2019-29 which included details on the affordability percentage related to the Employer Shared Responsibility provisions of the Affordable Care Act (ACA), also known as the Employer Mandate. In 2020, an applicable large employer (ALE) will be considered to offer affordable coverage to its full-time employees if the cost of coverage is 9.78% or less of the employee’s household income.

Posted August 1st, 2019 in Employers, Producers

Is it or isn’t it a qualifying event?

Medicare entitlement of the employee is listed as a COBRA qualifying event; however, it is rarely a qualifying event. In situations where it is a qualifying event, it is only a qualifying event for the spouse or children that are covered under the group health plan.

Posted July 25th, 2019 in Employers, Producers, Individuals

President Donald Trump issued an executive order last month aiming to improve price and quality transparency in the healthcare industry.

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