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Posted July 17th, 2018 in Employers, Producers

Many of you are familiar with the reinsurance fees that were charged to health insurance plans from 2014 to 2016, but you may not be as familiar with the risk adjustment program. The risk adjustment program was authorized under the Affordable Care Act (ACA). This permanent program is intended to protect against adverse selection and risk selection in the individual and small group markets (inside and outside of the Exchanges).

Posted June 19th, 2018 in Employers, Producers, Individuals

A lawsuit contesting the legality of the Affordable Care Act (ACA), also known as Obamacare, is starting to gain a lot of attention. Last December, the Tax Cuts and Jobs Act was signed into law. Part of this law made the penalty under the Individual Mandate $0 starting in 2019. Technically the Individual Mandate is still in place, but there will no longer be any penalty under federal law for failing to health insurance.

Posted June 15th, 2018 in Employers, Producers, Individuals

The Tax Cuts and Jobs Act signed into law last year wiped out the federal penalty for not having health insurance (a.k.a. the Individual Mandate) starting in 2019. Some state officials are concerned that the elimination of the penalty could destabilize their local insurance markets, and they have responded with their own Individual Mandate requirements.

Posted May 29th, 2018 in Employers, Producers
The Internal Revenue Service (IRS) recently released Revenue Procedure 2018-34 which includes details about the affordability percentage related to the Employer Mandate for the upcoming year. In 2019, coverage will be considered affordable if the employee’s share of the premium for self-only coverage is no more than 9.86% of their household income. As most employers don’t know the household income of their employees, three alternative safe harbor methods may be used:
 
Posted May 8th, 2018 in Employers, Producers, Individuals

There seems to be a lot of confusion about the status of the Individual Mandate, so we thought it would be appropriate to provide some clarification on its status.

Posted April 24th, 2018 in Producers, Employers

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 fees which are charged to health plans.

The following information is designed to help employers understand their payment obligations.

Posted April 17th, 2018 in Producer
Health plans in the individual and small group markets that were issued after March 23, 2010 and prior to January 1, 2014 are commonly referred to as grandmothered plans.  March 23, 2010 is the date the Affordable Care Act (ACA) was signed into law, while January 1, 2014 is the so-called full implementation date of the ACA.
 
Posted March 29th, 2018 in Employers, Producers, Individuals
Last week, President Donald Trump signed into law a 2,232-page federal spending bill avoiding another government shutdown. In the days leading up to the bill’ s passage, it appeared that Congressional leaders were on the verge of including funds which aimed to stabilize the Affordable Care Act (ACA). 
 
Posted March 22nd, 2018 in Producers
If you make your living selling individual health insurance policies, then you know the Affordable Care Act (ACA) has wreaked havoc on the individual market. With skyrocketing premiums, narrowing carrier networks, commissions being cut and some carriers exiting the market altogether, the future seems uncertain. 
Posted March 6th, 2018 in Producers, Employers, Individuals
In 2012, a lawsuit challenging the constitutionality of the Affordable Care Act (ACA) found its way all the up to the U.S. Supreme Court. At the time, an argument was made that the Individual Mandate was not constitutional. The Individual Mandate requires most Americans to have health insurance or pay a penalty, and this provision has been considered the main crutch that has kept the ACA standing.