Affordable Care Act

Posted October 29th, 2013 in Producers, Employers, Individuals

The InsureXSolutions® private insurance exchange, operated by Flexible Benefit Service LLC (Flex), has launched new resources which can be found at insurexsolutions.com.

There is no need to wait.

Posted October 8th, 2013 in Producers

The 2014 Medicare Annual Enrollment Period (AEP) is just one week away and there is a lot of confusion among seniors in regards to their benefits. With all of the news and other programs focusing on driving people to the Public Exchanges that are now open for business, it is easy to understand why.

The individual mandate requirement of the Affordable Care Act (ACA) has everyone clamoring to find out how it applies to them so communication to senior clients is very important.

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

Last week, the U.S. Department of Treasury published final guidance on the Individual Shared Responsibility requirements, also known as the Individual Mandate. The Affordable Care Act (ACA) mandates that most U.S. citizens and permanent residents have a qualified health plan starting in 2014 or face financial penalties.

Posted August 2nd, 2013 in Producers, Employers, Individuals

On Monday, July 22nd, 2013, Governor Pat Quinn signed legislation that will expand the Medicaid program for residents of Illinois starting in 2014. Illinois is now the 23rd state that has decided to move forward with the expansion of its Medicaid program.

The Affordable Care Act (ACA) provides federal funds for states opting to expand its Medicaid program. Federal funds will pay for all of the costs to cover newly eligible people from 2014 to 2016. The federal funds will then start to gradually drop from 2017 until 2020 where it will level off at a 90% payment rate from that year and moving forward. 

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 LLC (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.

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