individual mandate

Posted July 7th, 2016 in Producers, Employers, Individuals
It should be pretty clear by now that two of the biggest provisions of the Affordable Care Act (ACA) are the Individual and Employer Mandates. The Individual Mandate requires all Americans to have a health insurance plan or pay a penalty, unless an exemption applies. Factors that may influence the amount of the Individual Mandate penalty include household size and income. The Employer Mandate requires employers with 50 or more employees to offer health insurance coverage to at least 95% of its full-time employees or risk penalties.
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 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 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 July 2nd, 2015 in Producers, Employers, Individuals
On June 25, 2015, the Supreme Court of the United States (SCOTUS) ruled 6-3 in favor of the federal government and their ability to provide subsidies in Exchanges. The plaintiffs had contested the federal government’s interpretation of the healthcare law citing language in the Affordable Care Act (ACA) which specifically says subsidies can only be provided by an Exchange “established by the state.”  
 
Posted May 1st, 2015 in Producers, Employers, Individuals
There have been several attempts to dismantle the Affordable Care Act (ACA) and none have prevailed up to this point. The House of Representatives voted nearly 40 different times to repeal the law with no avail. The constitutionality of the Individual Mandate was challenged and ultimately upheld by the Supreme Court. Now we are awaiting a decision on whether the federal government can legally provide subsidies to Exchange applicants.  
 
Posted March 27th, 2015 in Producers, Employers, Individuals

On March 4, 2015 the U.S. Supreme Court heard oral arguments in regards to the King vs. Burwell case, which is the most significant challenge to the Affordable Care Act (ACA) since the constitutionality of the Individual Mandate was challenged back in 2012. The plaintiffs in the King vs. Burwell case argue that subsidies can only be provided by states that establish an Exchange on their own. They further argue that the federal government, which is utilized in 37 states, cannot provide subsidies to Exchange applicants.  

Posted March 20th, 2015 in Producers, Employers, Individuals
The Department of Health and Human Services (HHS) issued nearly 500 pages of regulations that impact various components of the Affordable Care Act (ACA). These regulations were posted to the Federal Register on February 27th, and they take effect 60 days from the posting unless otherwise indicated in the regulations. Included in the final regulations are some key changes to Special Enrollment Periods (SEPs) for individual market coverage which are outlined below:  

Benefits Buzz

Enter Your Email

Tag Cloud

Archives