individual mandate

Posted March 16th, 2015 in Producers, Employers

The IRS has released Notice 2015-17 with some new information about Employer Payment Plans, which are plans that are used to reimburse employees with pre-tax dollars for individual market coverage (e.g. HRA). Previous guidance had essentially eliminated Employer Payment Plans as an option for actively employed workers because they would not be able to comply with all of the Affordable Care Act (ACA) market reforms. Notice 2015-17 elaborates on the IRS’ position of Employer Payment Plans.

Posted February 6th, 2015 in Producers, Individuals
The Affordable Care Act (ACA) requires most people in the country to have health insurance coverage or pay a penalty. In addition, advanced premium tax credits were provided to millions of people who enrolled in coverage through a state-run or federally-facilitated Exchange. The government will be assessing penalties and reconciling subsidy payments on federal income tax returns effective for 2014.
 
Posted January 23rd, 2015 in Producers, Employers, Individuals

The IRS has released the maximum penalties that are payable by individuals who are without minimum essential coverage in 2015 and who do not qualify for an exemption from the Individual Mandate.

The maximum penalties for this year are the greater of:

  • $325 per uninsured adult or $162.50 per uninsured child under age 18. The maximum penalty using this method is capped at $975.

Posted January 9th, 2015 in Producers, Employers
The IRS has issued proposed regulations that will introduce a new excepted benefit available to some employees who purchase individual market coverage. Excepted benefits are exempt from most of the requirements and obligations under the Affordable Care Act (ACA).  
 
Posted June 27th, 2014 in Producers, Employers, Individuals

On June 26, 2014, the Department of Health and Human Services (HHS) issued proposed regulations on the renewal process for individuals that have purchased health coverage through the Exchange. The regulations aim to streamline the renewal process by auto-enrolling the vast majority of existing members into a health plan for the 2015 plan year.

Posted June 20th, 2014 in Producers, Employers, Individuals

Minimum Essential Coverage and Minimum Value are two terms that are mistakenly considered the same by many people, but in fact, these terms have different definitions. 

Minimum Essential Coverage is the type of coverage needed to satisfy the Individual Mandate requirements. The most common forms include the following health plans:

Posted May 22nd, 2014 in Producers, Employers, Individuals
On May 16, 2014, a new fine was spelled out by the Department of Health and Human Services (HHS) regarding individuals that knowingly and wilfully provide false information to receive subsidies in an Exchange.
 
Posted May 9th, 2014 in Producers, Employers, Individuals

The Department of Health and Human Services (HHS) issued some new guidance on May 2, 2014 as it relates to Special Enrollment Periods and Hardship Exemptions in the individual marketplace. The new guidance has been summarized below:

Posted March 11th, 2014 in Producers, Employers, Individuals

Can people apply for individual health coverage after Mar. 31, 2014? 

Only those individuals that experience a qualifying event can sign up for a qualified health plan mid-year after March 31stMost qualifying events will create a special enrollment period that lasts for 60 days. 

Posted February 28th, 2014 in Producers, Employers

Today is the last day of February which means we are only one month away from the end of the first open enrollment period for individual health plans. March 31st is the last day that individuals can sign up for coverage without a qualifying event, but there is one big question that is still looming – Will the open enrollment period get extended to a later date? 

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