Affordable Care Act

Posted March 18th, 2016 in Producers, Employers, Individuals
We can categorize health insurance plans in a number of different ways. There are fully-insured and self-insured plans, HMOs and PPOs, high deductibles and low deductibles, and metallic tiers (bronze, silver, gold and platinum) which are used in some market segments. There’s also one other way to categorize health insurance plans, and that’s by their “grandparent” status. The grandparent status determines which Affordable Care Act (ACA) rules a health insurance plan must comply with.
 
Grandfathered Plans 
Posted March 11th, 2016 in Producers, Employers, Individuals

Each year the Department of Health and Human Services (HHS) issues a set of rules referred to as the “Notice of Benefit and Payment Parameters.”  This set of rules generally addresses changes and new requirements that apply to certain provisions of the Affordable Care Act (ACA). 

Posted February 26th, 2016 in Producers, Employers, Individuals
The Centers for Medicare and Medicaid Services (CMS) recently announced a new process that will impact anyone seeking to enroll with a special enrollment period (SEP) on the Healthcare.gov website.  Under the current process, individuals who experience a qualifying event simply need to check a box on the application to be eligible for an SEP.
Posted February 12th, 2016 in Producers, Employers, Individuals
In most instances an employer can no longer pay or reimburse employees with pre-tax dollars for health coverage that is obtained in the individual market. The Department of Labor (DOL) recently issued Technical Release 2016-1 in relation to how this rule impacts student health plans.
 
Posted February 5th, 2016 in Producers, Employers, Individuals
2016 will be the first year that most Americans will receive a Form 1095. As you would suspect, several people are wondering which forms will be provided and when. Here is some basic information to help answer those questions.  
 
Posted December 31st, 2015 in Producers, Employers
The New Year is expected to bring more regulatory changes which will impact employers and group health plans alike. Here are five predictions of things that are likely to happen in 2016.
 
Posted December 30th, 2015 in Producers, Employers
The Internal Revenue Service (IRS) recently issued Notice 2016-4 which extends the deadlines to complete the new Affordable Care Act (ACA) reporting requirements. The reporting is used to help the IRS enforce the Individual and Employer Mandates, and it’s also used to help the IRS administer subsidies in the Exchange. It applies to insurers and certain employers effective for the 2015 calendar year and moving forward. The new deadlines are as follows:
 
Posted December 18th, 2015 in Producers, Employers, Individuals

On December 11, 2015, the Department of Health and Human Services (HHS) posted guidance for states interested in seeking a State Innovation Waiver under Section 1332 of the Affordable Care Act (ACA).

Posted December 10th, 2015 in Producers, Employers, Individuals
Below is a list of some key Affordable Care Act (ACA) changes and facts that will be effective in 2016:
 
  1. The Individual Mandate penalties increase to $695 per adult ($347.50 per child) or 2.5% of household income, whichever is greater. 
  2. The Employer Mandate expands to include all employers who have 50 or more employees. 
  3. The Employer Mandate offer rate increases from 70% to 95%. 
  4. Employer reporting related to the offer of coverage is due for the first time during Q1 2016. 
Posted November 25th, 2015 in Producers, Employers

You may have thought the penalty for applicable large employers who fail to offer minimum essential coverage was $2,000 per employee. You may have also thought that if you offered coverage, but it was unaffordable and/or didn’t provide minimum value, then the penalty was $3,000 per employee who waived coverage and received a subsidy in the Exchange.

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