Producers

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 December 5th, 2014 in Producers, Employers
The High Cost Employer-Sponsored Health Coverage Excise Tax, more commonly known as the Cadillac Tax, is scheduled to take effect in 2018. The Cadillac Tax is described as an attempt to reduce health care usage and costs by encouraging employers to offer health plans that are more cost effective and that engage employees in the cost of care.  Experts estimate that the tax will raise $80 billion over a 10 year time period and will finance various components of the Affordable Care Act (ACA).
 
Posted October 31st, 2014 in Producers, Employers
Effective October 31, 2014, the Centers for Medicare & Medicaid Services (CMS) Office of e-Health Standards and Services (OESS), the division of the Department of Health & Human Services (HHS) that is responsible for enforcement of compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) standard transactions, code sets, unique identifiers and operating rules, announces a delay, until further notice, in enforcement of 45 CFR 162, Subpart E, the regulations pertaining to health plan enumeration and use of the Health Plan Identifier (HPID) in HIPAA transactions adopted in the HPID final rule (CMS-0040-F). 
 
This enforcement delay applies to all HIPAA covered entities, including healthcare providers, health plans, and healthcare clearinghouses.
Posted October 24th, 2014 in Producers
We, at the Flex General Agency, are excited about this Medicare sales season and wanted to provide some general insight for insurance professionals regarding this booming marketplace. 
 
Reminder: The 2015 Medicare Annual Open Enrollment Period started on October 15 and runs though December 7, 2014
 
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 July 25th, 2014 in Producers, Employers

The Affordable Care Act (ACA) created the Patient-Centered Outcomes Research Institute (PCORI) as a way to help improve clinical effectiveness. The research institute is partially funded by fees charged to health plans, including some Health Reimbursement Arrangements (HRAs) and some Flexible Spending Accounts (FSAs). The fees are payable over a seven year time period and started for the first time last year.

The next round of PCORI fees are due to the IRS by July 31, 2014 and are payable via Form 720 by applicable employers for plan years ending in 2013

Posted July 18th, 2014 in Producers, Employers
The IRS and other agencies have issued three different sets of guidance making it clear that employers cannot give actively employed workers pre-tax dollars through a Health Reimbursement Arrangement (HRA) ,or any other type of arrangement, to purchase individual coverage on their own.
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:

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