small group health plans

Posted April 11th, 2014 in Producers, Employers

On April 1, 2014, President Obama signed into law the “Protecting Access to Medicare Act of 2014.” Although much of the law is designed to fix problems with the Medicare program, the law also included a repeal of the deductible limits that apply to small group health plans. In 2014, the Affordable Care Act (ACA) established deductible limits for health plans offered to small employers (defined as up to 50 employees in most states).

Posted March 14th, 2014 in Producers, Employers, Individuals

Last week, the Obama administration released several new Affordable Care Act (ACA) guidelines. Of particular note, any individual or small group with a non-ACA compliant plan will be able to keep that plan in place for additional time.

Posted December 27th, 2013 in Producers, Employers

The Small Business Health Options Program (SHOP) is a part of the healthcare reform law that is supposed to help small businesses provide affordable health insurance coverage to employees. Last month it was announced that the SHOP Exchange would be delayed until November 2014; however, this statement requires clarification as some of the core features of the SHOP are still available. 

Posted March 11th, 2013 in Employers, Producers

ACA Participation RequirementsThe U.S. Department of Health and Human Services (HHS) released final regulations on February 22, 2013 in regards to various health insurance market rules. The new guidance includes information about minimum participation requirements in the small employer marketplace. In most states, small employers are defined as those with 50 or fewer employees.

Insurance companies today require a minimum percentage of employees to enroll in coverage. This is referred to as the participation requirements and helps insurance companies avoid adverse selection. Minimum participation requirements can be up to 75% today.

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

The U.S. Department of Health and Human Services (HHS) posted final regulations about the deductible and out-of-pocket limitations to the Federal Registrar on February 25, 2013. Section 1302(c) of the Affordable Care Act (ACA) specifies that the maximum deductible for a qualified insurance plan cannot exceed $2,000 for single coverage and $4,000 for family coverage.

Posted February 28th, 2013 in Individuals, Employers, Producers

The U.S. Department of Health and Human Services (HHS) released the final regulations about Essential Health Benefits (EHB) on February 20, 2013. The guidance defines the benefits that must be included with all fully insured plans sold inside and outside of the public exchanges in 2014. This will impact all individual health plans and most small group health plans. Grandfathered plans and self-insured plans are exempt from the EHB requirements; however, self-insured plans that cover any EHB must provide coverage without any annual or lifetime dollar limits.

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