Many news outlets are reporting on the break the administration plans to give to insurers. (See the Kaiser report here.) The break is expected to come in the form of an adjustment to the MLR calculations. The Affordable Care Act (ACA) requires insurance carriers to maintain a certain medical loss ratio (MLR). The MLR requires carriers […]
The Other Shoe has (Finally) Dropped: Treasury Issues Final Regulations, Announces Another Delay of PPACA’s Employer Mandate
February 10, 2014 By
After more than a year of anticipation, on Monday, February 10, 2014, the US Treasury Department issued final regulations and announced yet another delay of the Patient Protection and Affordable Care Act’s Employer Shared Responsibility provision, which requires employers with more than 50 employees to offer health insurance coverage to full-time workers or pay a […]
Employers Sponsoring MEWA Plans Should Beware of ACA Non-compliance Risks
January 21, 2014 By
Although the employer mandate penalties of the Affordable Care Act (ACA) have been delayed until 2015, many other pieces of the ACA take effect this year, in 2014. For example, the prohibition on pre-existing condition exclusions, the out-of-pocket limits, and the prohibition on annual or lifetime limits for essential health benefits are all effective for […]
EAP Programs Escape the ACA Market Reforms, For Now at Least
January 20, 2014 By
With all that is going on with the Affordable Care Act (ACA) and whether and to what extent employers have to offer insurance to their employees, many employers may not be paying much attention to how their Employee Assistance Programs (EAPs) fit within the ACA. Ignorance is bliss, for now. However, employers should begin to […]
That’s a Wrap! The ACA Creates a New Excepted Benefit
January 20, 2014 By
Limited Wraparound Coverage is an interesting new concept brought mainstream by the Departments in proposed rules that were published just before the New Year. In the few weeks since, lawyers and consultants have weighed in with summaries of the proposed rules. The question remains, however, just who is this excepted benefit designed to benefit? On […]
Want health insurance coverage effective January 1, 2014? Today is the deadline to enroll!
December 23, 2013 By
UPDATE: Due to high website traffic that triggered the www.healthcare.gov queuing system, the Administration has decided to extend the enrollment deadline for Marketplace coverage to be effective to midnight on December 24, 2013. Individuals who enroll in coverage by midnight tomorrow will have coverage effective January 1, 2014. For more information on this extension, see […]
The skinny on tax credits in the Marketplace for young adults
December 3, 2013 By
Most employers by now are familiar with the Affordable Care Act requirement that if health insurance is offered to employees and their dependents, the dependent eligibility must extend up to age 26. What happens if those same young adults who are eligible for their parents’ employer-sponsored plans want to purchase their own coverage through the […]
New Dates for Marketplace Open Enrollment
November 27, 2013 By
The federally-facilitated Marketplace (Exchange) went live on October 1, 2013 and has been plagued with difficulties ever since. In recognition of this fact, the Obama administration has given individuals looking to find insurance through the Marketplace a little more time to enroll in coverage that will be effective on January 1, 2014. Originally, someone looking […]
Avoid Individual Mandate Penalties – Sign up for Coverage by March 31, 2014
October 24, 2013 By
Officials from the Department of Health and Human Services (HHS) announced late Wednesday that they are working on official guidance that will allow individuals additional time to get health insurance coverage before incurring a penalty. The Affordable Care Act (ACA) requires nearly all individuals, beginning on January 1, 2014, to maintain health insurance coverage or pay a […]
Lessons from the Health Insurance Marketplace – Is your IT system glitch-free?
October 10, 2013 By
Week two of enrollment in the health insurance marketplace continues with more reports of glitches in the systems causing delays in both federally-facilitated marketplaces and state marketplace. The troubles encountered with marketplace enrollment should serve as a warning for employers that will be facing federal reporting requirements in 2015. Although the employer mandate under the […]
