United Benefit Advisors Insight and Analysis Blog

Employer Exchange Subsidy Notices: Should You Appeal?

Posted by: Vicki Randall    Dec 15, 2016 10:30:00 AM

Under the Patient Protection and Affordable Care Act (ACA), all public Exchanges are required to notify employers when an employee is receiving a subsidy (tax credits and cost-sharing reductions) for individual health insurance purchased through an Exchange. According to the final rules published in August 2013, employers have the right, but are not required, to engage in an appeal process through the IRS if they feel an employee should not be receiving a subsidy because the employer offers minimum value, affordable coverage.

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Topics: health insurance exchanges, ACA, IRS Reporting Rules, employer shared responsibility, Affordable Care Act, Compliancedashboard, Dan Bond, health insurance subsidy, Vicki Randall

U.S. Supreme Court Upholds ACA Subsidy Eligibility on Federal Exchanges

Posted by: Danielle Capilla    Jul 7, 2015 12:00:00 PM

The Supreme Court issued its opinion in King v. Burwell, holding that the Internal Revenue Service (IRS) may issue regulations to extend tax-credit subsidies to coverage purchased through Exchanges established by the federal government under the Patient Protection and Affordable Care Act (ACA). The six-to-three opinion was authored by Chief Justice John Roberts, who was joined by Justices Kennedy, Ginsburg, Breyer, Sotomayor, and Kagan. Justice Scalia dissented, and was joined by Justices Thomas and Alito.

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Topics: health insurance exchanges, health care reform, PPACA Affordable Care Act, The Patient Protection and Affordable Care Act, insurance Marketplace, health care subsidies, U.S. Supreme Court, Danielle Capilla

Supreme Court Hears Oral Argument in Subsidy Eligibility Battle

Posted by: Danielle Capilla    Apr 2, 2015 12:00:00 PM

Supreme Court Hears Oral Argument in Subsidy Eligibility BattleOn March 4, 2015, the U.S. Supreme Court heard oral arguments in King v. Burwell, a case that centers on the meaning of statutory language in the Patient Protection and Affordable Care Act (PPACA). At question in the case is whether or not the Internal Revenue Service (IRS) may issue regulations to extend tax-credit subsidies to coverage purchased through health Exchanges established by the federal government via the Department of Health and Human Services (HHS) under Section 1321 of PPACA.

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Topics: health insurance exchanges, PPACA Affordable Care Act, Play or Pay, health care subsidies, employer shared responsibility, tax-credit subsidy

The Story Behind Minimal Changes in Plan Designs and Premium Rates

Posted by: Carol Taylor    Oct 29, 2014 9:00:00 AM

By Carol Taylor, Employee Benefit Advisor
D&S Agency, a UBA Partner Firm 

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Topics: health insurance exchanges, private insurance exchange, health marketplace, employee wellness, PPACA, retirement, small group employers, summary of benefits and coverage, SBC, benefit communication, benefit consultants, benefit management, compliance with health care reform, employee health, group health insurance, healthcare consumerism, health plan compliance, health reimbursement account, insurance solutions, medical plan, self funded health plans, Group health plans, small business, dependents, dependent insurance, family insurance benefits

Determining If Dental and Vision Plans Are “Excepted Benefits”

Posted by: Linda Rowings    Oct 16, 2014 9:00:00 AM

By Linda Rowings
Chief Compliance Officer, UBA 

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Topics: health insurance exchanges, private insurance exchange, health marketplace, employee wellness, PPACA, retirement, small group employers, benefit communication, benefit consultants, benefit management, compliance with health care reform, employee health, group health insurance, healthcare consumerism, health plan compliance, health reimbursement account, insurance solutions, medical plan, self funded health plans, Group health plans, small business, dependents, dependent insurance, family insurance benefits

Navigating Narrow or Focused Provider Networks (Part 2)

Posted by: Elizabeth Kay    Oct 14, 2014 3:04:00 PM

By Elizabeth Kay
Compliance and Retention Analyst
AEIS, a UBA Partner Firm

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Topics: health insurance exchanges, private insurance exchange, health marketplace, employee wellness, PPACA, retirement, small group employers, benefit communication, benefit consultants, benefit management, compliance with health care reform, employee health, group health insurance, healthcare consumerism, health plan compliance, health reimbursement account, insurance solutions, medical plan, self funded health plans, Group health plans, small business, dependents, dependent insurance, family insurance benefits

Skinny Plans and Minimum Value: Do these plans really pass the test?

Posted by: Carol Taylor    Oct 10, 2014 2:39:00 PM

By Carol Taylor, Employee Benefit Advisor
D&S Agency, A UBA Partner Firm

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Topics: health insurance exchanges, private insurance exchange, health marketplace, employee wellness, PPACA, retirement, small group employers, summary of benefits and coverage, SBC, benefit communication, benefit consultants, benefit management, compliance with health care reform, employee health, group health insurance, healthcare consumerism, health plan compliance, health reimbursement account, insurance solutions, medical plan, self funded health plans, Group health plans, small business, dependents, dependent insurance, family insurance benefits

What to Include in an SBC

Posted by: Linda Rowings    Sep 10, 2014 3:12:00 PM

A Summary of Benefits and Coverage (SBC) must contain:

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Topics: health insurance exchanges, private insurance exchange, health marketplace, employee wellness, PPACA, retirement, small group employers, summary of benefits and coverage, SBC, benefit communication, benefit consultants, benefit management, compliance with health care reform, employee health, group health insurance, healthcare consumerism, health plan compliance, health reimbursement account, insurance solutions, medical plan, self funded health plans, Group health plans, small business, dependents, dependent insurance, family insurance benefits

Religious Objections to Covering Contraceptives

Posted by: Linda Rowings    Sep 5, 2014 3:06:00 PM

On August 22, 2014, the Departments of Health and Human Services (HHS), Labor, and Treasury released an interim final rule and a proposed rule that provide some new accommodations to employers that have religious objections to covering contraception under their group health plans. The agencies also released a fact sheet on the rules and an alternate form that religious organizations (like religious hospitals, universities and charities) may use.

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Topics: health insurance exchanges, private insurance exchange, health marketplace, employee wellness, PPACA, retirement, small group employers, religious objections, contraception, religious opposition to contraception, benefit communication, benefit consultants, benefit management, compliance with health care reform, employee health, group health insurance, healthcare consumerism, health plan compliance, health reimbursement account, insurance solutions, medical plan, self funded health plans, Group health plans, small business, dependents, dependent insurance, family insurance benefits

Highlights of the SBC Requirement

Posted by: Linda Rowings    Aug 28, 2014 3:43:00 PM

With Fall open enrollment around the corner, most employers will need to provide a Summary of Benefits and Coverage (SBC) to eligible individuals. Here are some highlights of the requirement (as of August 2014):

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Topics: health insurance exchanges, private insurance exchange, health marketplace, employee wellness, PPACA, retirement, small group employers, benefit communication, benefit consultants, benefit management, compliance with health care reform, employee health, group health insurance, healthcare consumerism, health plan compliance, health reimbursement account, insurance solutions, medical plan, self funded health plans, Group health plans, small business, dependents, dependent insurance, family insurance benefits