United Benefit Advisors Insight and Analysis Blog

House Passes AHCA Bill in First Step to Repeal and Replace the ACA

Posted by: Danielle Capilla    May 5, 2017 10:27:15 PM

On May 4, 2017, the U.S. House of Representatives passed House Resolution 1628, a reconciliation bill aimed at "repealing and replacing" the Patient Protection and Affordable Care Act (ACA). The bill, titled the "American Health Care Act of 2017" or "AHCA," will now be sent to the Senate for debate, where amendments can be made, prior to the Senate voting on the bill.

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Topics: ACA, Affordable Care Act, American Health Care Act

ACA Market Stabilization Final Rule

Posted by: Danielle Capilla    Apr 27, 2017 9:30:00 AM

On April 18, 2017, the Department of Health and Human Services’ (HHS) Centers for Medicare & Medicaid Services (CMS) published its final rule regarding Patient Protection and Affordable Care Act (ACA) market stabilization.

The rule amends standards relating to special enrollment periods, guaranteed availability, and the timing of the annual open enrollment period in the individual market for the 2018 plan year, standards related to network adequacy and essential community providers for qualified health plans, and the rules around actuarial value requirements.

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Topics: Affordable Care Act, benefits enrollment, guaranteed availability policy, continuous coverage, open enrollment periods

SBC Template and Required Addendums for Covered Entities under ACA Section 1557

Posted by: Danielle Capilla    Apr 20, 2017 11:54:46 AM

A Summary of Benefits and Coverage (SBC) is four page (double-sided) communication required by the federal government. It must contain specific information, in a specific order, and with a minimum size type, about a group health benefit's coverage and limitations. If an employer providing an SBC is a covered entity under the Section 1557 of the Patient Protection and Affordable Care Act (ACA), additional requirements apply.

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Topics: summary of benefits and coverage, SBC, Affordable Care Act, ACA Section 1557

An Employer’s Guide to Navigating the ACA’s Strong Headwinds

Posted by: Michael Weiskirch    Apr 13, 2017 9:30:00 AM

One might describe the series of events leading to the death of the American Health Care Act (Congress’s bill to repeal and replace the Affordable Care Act) as something like a ballistic missile exploding at launch. The Patient Protection and Affordable Care Act (ACA) repeal debate began nearly a decade ago with former President Barack Obama’s first day in office and reemerged as a serious topic during the 2016 presidential election. Even following the retraction of the House bill, repeal of the ACA remains a possibility as the politicians consider alternatives to the recent bill. The possibility of pending legislation has caused some clients to question the need to complete their obligation for ACA reporting on a timely basis this year. The legislative process has produced a great deal of uncertainty which is one thing employers do not like, especially during the busy year end.

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Topics: ACA, employer shared responsibility, Affordable Care Act, ACA reporting, independent employee benefits advisors

CMS Allows States to Extend Life of "Grandmothered" or Transitional Health Insurance Policies

Posted by: Danielle Capilla    Mar 21, 2017 9:30:00 AM

On February 23, 2017, the Department of Health and Human Services' Centers for Medicare & Medicaid Services (CMS) released its Insurance Standards Bulletin Series, in which it re-extended its transitional policy for non-grandfathered coverage in the small group and individual health insurance markets.

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Topics: ACA, health plan benchmarking, UBA Health Plan Survey, Danielle Capilla, Affordable Care Act, grandmothering, transitional relief, transitional health insurance policy

Tax Treatment of Fixed Indemnity Health Plans

Posted by: Danielle Capilla    Mar 9, 2017 9:30:00 AM

A fixed indemnity health plan pays a specific amount of cash for certain health-related events (for example, $40 per office visit or $100 per hospital day). The amount paid is neither related to the medical expense incurred, nor coordinated with other health coverage. Further, a fixed indemnity health plan is considered an "excepted benefit."

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Topics: ACA, HIPAA, excepted benefits, Danielle Capilla, Affordable Care Act, fixed indemnity health plan, fixed dollar indemnity plans, taxation of health benefits

The “Line 22” Question: Which Box(es) Do I Check?

Posted by: Danielle Capilla    Mar 1, 2017 9:30:00 AM

Under the Patient Protection and Affordable Care Act (ACA), individuals are required to have health insurance while applicable large employers (ALEs) are required to offer health benefits to their full-time employees.

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Topics: ACA, employer shared responsibility, Danielle Capilla, Affordable Care Act, play or pay requirements, applicable large employers, IRS Form 1094-C

Top Five Compliance Assessment Surprises

Posted by: Bob Bentley    Feb 23, 2017 9:30:00 AM

Our Firm is making a big push to provide compliance assessments for our clients and using them as a marketing tool with prospects. Since the U.S. Department of Labor (DOL) began its Health Benefits Security Project in October 2012, there has been increased scrutiny. While none of our clients have been audited yet, we expect it is only a matter of time and we want to make sure they are prepared.

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Topics: compliance, ACA, COBRA, Affordable Care Act, Albers & Company, benefits compliance, Department of Labor audit, USERRA, life insurance, compliance assessment, Bob Bentley, benefits notices

IRS Q&A About Employer Information Reporting on Form 1094-C and Form 1095-C

Posted by: Danielle Capilla    Feb 22, 2017 9:30:00 AM

The Internal Revenue Service (IRS) recently updated its longstanding Questions and Answers about Information Reporting by Employers on Form 1094-C and Form 1095-C that provides information on:

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Topics: ACA, Danielle Capilla, Affordable Care Act, COBRA continuation coverage, Form 1094-C, IRS reporting, Form 1095-C, offer of coverage

Keeping Pace with the Protecting Affordable Coverage for Employees Act

Posted by: Vicki Randall    Feb 16, 2017 9:30:00 AM

Last fall, President Barack Obama signed the Protecting Affordable Coverage for Employees Act (PACE), which preserved the historical definition of small employer to mean an employer that employs 1 to 50 employees. Prior to this newly signed legislation, the Patient Protection and Affordable Care Act (ACA) was set to expand the definition of a small employer to include companies with 51 to 100 employees (mid-size segment) beginning January 1, 2016.

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Topics: health care costs, ACA, essential health benefits, minimum essential coverage, Affordable Care Act, PACE Act, Compliancedashboard, Vicki Randall, Protecting Affordable Coverage for Employees Act, small employer