Affordable Care Act

Posted July 10th, 2013 in Employers, Producers

The initial Patient-Centered Outcomes Research Institute (PCORI) fee for plan years ending after September 30, 2012 will be payable by July 31, 2013. Employers are required to pay this fee on plans that are considered to be self-insured.

Insurance companies will pay the PCORI fee on fully insured plans. However, the updated Form 720 in which the fees are paid gives the impression that employers are also responsible for this fee on fully insured plans.

Posted July 8th, 2013 in Individuals, Employers, Producers

Section 3210 of the Affordable Care Act (ACA) required nominal cost sharing to be added to Medicare Supplement Plans C & F. Under the current structure these Medicare Supplement plans eliminate nearly all of the cost sharing that is associated with Original Medicare.

It has been a common belief by many people that Plans C & F cause excessive and unnecessary utilization as a result of the limited cost sharing. The expectation was that Section 3210 would modify Plans C & F to include some form of a front-end deductible to encourage more appropriate uses of physician services.

Posted July 5th, 2013 in Individuals, Employers, Producers

Millions of Americans Countdown to October 1st

Less than 3 months from today marks the start of the 6 month open enrollment period under the Affordable Care Act (ACA). As officials scramble to promote the new healthcare reform enrollment season, we at Flexible Benefit Service Corporation (Flex) have been keeping up-to-date with the fluid changes of rules and regulations contained within the growing law.

Posted May 3rd, 2013 in Employers, Producers

Recent guidance helped clarify some of the confusion about Patient-Centered Outcomes Research Institute (PCORI) fees applicable to Health Reimbursement
Arrangements (HRAs) and Flexible Spending Accounts (FSAs). It was originally thought that the fee would be applicable to all covered lives including spouses and dependents. That is no longer the case in some instances.

Posted April 22nd, 2013 in Individuals, Employers

Like the popular television commercials with children explaining their theories on what’s better (when asked if more is better than less), they want more. The concept is that simple. People, in general, do not want to settle for less.

Small businesses want more from a program that is named the Small Business Health Options Program or SHOP exchange. The government, however, has stripped away the “options” (at least for a year). If you’re a worker for a small business employer who is offered the SHOP exchange, you really don’t have anything to “shop” around for.

Posted April 15th, 2013 in Individuals, Employers, Producers

The Obama administration announced last week that parts of the Small Business Health Options Program (SHOP) would be delayed until 2015. This announcement has created a lot of confusion in the market.

The SHOP will be a new health insurance marketplace to provide exchange-based coverage to small businesses with up to 50 employees in most states. The SHOP is still expected to be launched as planned in 2014, but one of its key components will be delayed until 2015.

Posted April 8th, 2013 in Producers

Last week the U.S. Department of Health and Human Services (HHS) released proposed regulations about the role of Navigators. The new guidance provides some clarification about the role of Navigators, but it has several producers questioning how they will be compensated for their services next year.

Navigators are organizations that will provide unbiased information to consumers about health insurance.

Posted March 22nd, 2013 in Individuals, Employers, Producers

The U.S. Department of Health and Human Services (HHS) and the Internal Revenue Service (IRS) have jointly issued rules that define affordable coverage. Employers and employees still have several questions about how this affects penalty calculations and subsidy eligibility.

The following offers some insight on these key issues:

Posted March 14th, 2013 in Employers, Producers

The U.S. Department of Health and Human Services (HHS) released final regulations on March 1, 2013 about the Transitional Reinsurance Program. This new program will require insurance companies and some employers to fund a program that will provide partial reimbursements to commercial insurers that provide coverage to high risk individuals.

Posted March 7th, 2013 in Employers, Producers

Small employers able to provide simple, effective program with defined contribution strategy and online insurance marketplace.

InsureXSolutions® recently announced more small businesses in the Chicagoland area are looking to adopt a private health insurance exchange as an alternative to increasing healthcare costs. Through a defined contribution benefits strategy and the use of a private insurance exchange, businesses can now take control of their healthcare spending and offer a personalized insurance buying experience for employees.

Approximately 75 percent of Illinois employers have fewer than 50 employees, according to Kaiser Family Foundation. Of those employers, only a third currently offer group health coverage due to expensive premiums, participation requirements or other challenges that exist in today’s marketplace.

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