Producers
Each year, the Centers for Medicare and Medicaid Services (CMS) adjusts the premiums and out-of-pocket expenses for Medicare beneficiaries. Below is a summary of the 2019 costs.
Premiums
Part A: Most individuals don't have to pay a premium for Part A, however, those that do will generally have to pay $437 per month in 2019. This is an increase from $422 in 2018.
As a small group health insurance producer, you are always looking to provide your employer clients with the best possible coverage at the lowest possible price. With the Affordable Care Act (ACA) mandating coverage for specific benefits and driving up premiums, this can sometimes be an uphill battle. There are a few different types of group health plans available, and it’s up to you to determine which option is best for your clients.
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.
Consumer-Driven Health Plans (CHDPs) have been steadily gaining in popularity for several years now. According to the Society for Human Resource Management (SHRM) 2018 Annual Benefits Report, 40% of the employers surveyed now offer a CDHP to their employees. SHRM defines a CDHP as a Health Reimbursement Arrangement (HRA) or a Health Savings Account (HSA) paired with any underlying medical plan.
While we continue to hear about the rapid growth of Health Savings Accounts (HSAs), there is one feature about Health Flexible Spending Accounts (Health FSAs) that keeps some employees enrolled in this type of consumer-driven account (CDA). That’ s the uniform coverage requirement of Health FSAs.
ERISA Section 607 defines the term group health plan as an employee welfare benefit plan providing “medical care” to participants or beneficiaries:
You did it! You followed our tips for generating leads, and you overcame your prospect’s objections, and now you’ve got a face-to-face meeting with a potential new client. Your hard work is beginning to pay off, but you’re not home-free yet. You still need to nail your sales pitch and turn that potential client into an actual one.
2018 ACA Reporting Requirements
The Internal Revenue Service (IRS) has released draft versions of the forms and instructions for the 2018 reporting year. The reporting, which is required under the Affordable Care Act (ACA), helps the IRS enforce the Individual Mandate, Employer Mandate and verify subsidy eligibility for individuals who obtain coverage through the Health Insurance Marketplace.
The Employer Mandate regulations refer to seasonal employees and seasonal workers, and yes, there is a difference. Let’s break this down as simply as possible by starting with a few refresher points.
The midterm elections will be held on November 6, 2018, and the Affordable Care Act (ACA) will surely be a hot topic on campaign trails. Republicans are expected to continue down a path of conveying their belief that the ACA is ineffective and has driven up healthcare costs. Democrats are expected to point out consumer protections that are included in the ACA, such as coverage for pre-existing conditions and essential health benefits.
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