healthcare reform

Posted April 4th, 2016 in Producers, Employers, Individuals
H&R Block®, the largest tax services provider in the country, has indicated that so far this year the average penalty paid by those individuals without health insurance in 2015 is $383. The average penalty paid in 2014 was $172, reflecting an increase of $211 from the previous year. The penalties will be steeper in 2016 being the greater of $695 or 2.5% of income.  
 
Posted March 24th, 2016 in Producers, Employers
Whether it be the ACA, COBRA, ERISA, HIPAA, Section 125, or another regulation, employers can find themselves out of compliance somehow, and they may not even be aware. Here is a list of some common areas of non-compliance, not ranked in any particular order.
 
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 January 29th, 2016 in Producers, Employers, Individuals

Insurance companies are concerned that some people are abusing the Special Enrollment Period (SEP) that is available in the individual marketplace. They have indicated at least some people are delaying enrollment in coverage until they get sick, applying for coverage only once they need it, and then canceling the coverage after treatment. They further argue that there aren’t enough rules in place to verify if a person actually experienced a qualifying event which would trigger a SEP.

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:
     

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