United Benefit Advisors Insight and Analysis Blog

President Trump Ends ACA Cost Sharing Reductions

Posted by: Danielle Capilla    Oct 17, 2017 9:30:00 AM

On the evening of October 12, 2017, President Trump announced that cost sharing reductions for low income Americans in relation to the Patient Protection and Affordable Care Act (ACA) would be stopped. The Department of Health and Human Services (HHS) has confirmed that payments will be stopped immediately. While there is no direct impact to employers at this time, UBA will continue to educate employers about changes in the law and its Health Plan Survey will continue to track group health plan rates over time as insurance companies potentially seek to recoup lost revenue. It is anticipated at least some state attorneys general will file lawsuits to block the ending of the subsidy payments, with California Attorney General Xavier Becerra stating he is prepared to file a lawsuit to protect the subsidies.

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Topics: health insurance exchanges, Cost-Sharing, group health insurance, Affordable Care Act

Why Private Exchanges Haven't Taken Off As Predicted

Posted by: Paul Rooney, CEBS    Apr 26, 2017 9:30:00 AM

While the health care affordability crisis has become so significant, questions still linger—will private exchanges become a viable solution for employers and payers, and will they will continue to grow? Back in 2015, Accenture estimated that 40 million people would be enrolled in private exchange programs by 2018; the way we see this model’s growth today doesn’t speak to that. So, what is preventing them from taking off as they were initially predicted? We rounded up a few reasons why the private exchange model’s growth may be delayed, or coming to a halt.

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Topics: health insurance exchanges, private exchanges

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