United Benefit Advisors Insight and Analysis Blog

IRS Proposes New Section 6055 Reporting Requirements for Self-Insured Employers

Posted by: Vicki Randall    Sep 6, 2016 1:15:37 PM

Employers with self-insured health plans are facing new Section 6055 regulations regarding the reporting of minimum essential coverage. The proposed regulation requires self-insured employers to report this information to the IRS on either Form 1095-B or in Part III of Form 1095-C, if the coverage is provided by an applicable large employer.

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Topics: ACA, PPACA, self funded health plans, IRS Form 1095, Section 6055 Reporting

Transitional Reinsurance Fee for Self-funded Group Health Plans

Posted by: Jennifer Stanley    Oct 27, 2015 12:00:00 PM

The Patient Protection and Affordable Care Act (ACA) established the Transitional Reinsurance Program to help stabilize premiums in the individual private and public marketplaces. The Transitional Reinsurance Fee (TRF) applies to fully insured and self-funded major medical plans for 2014, 2015, and 2016, regardless of the policy or plan year. Insurers of fully insured major medical plans and sponsors of self-funded major medical plans are responsible for filing and submitting contributions for the Transitional Reinsurance Program.

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Topics: ACA, TRF, Patient Centered Outcomes Research Institute, Transitional Reinsurance Fee, Jennifer Kupper, self funded health plans, Group health plans, PCORI Fee, Transitional Reinsurance Program

The Key to Reducing Health Care Costs – Have We Found It?

Posted by: Elizabeth Kay    May 19, 2015 12:00:00 PM

Self-funding is a very hot topic these days for a number of reasons. For small group employers offering a self-funded plan this means they can charge a composite premium rate based on the employee population versus the community rates that are based on each individual enrollee’s age. For all employer sizes this also means that they are not subject to all of the taxes under the Patient Protection and Affordable Care Act (PPACA), which alone can translate into a savings of 3% to 4% of their premiums.

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Topics: wellness, health care costs, self-funding, self funded health plans, consumer-driven health plan, Elizabeth Kay, Cigna Collaborative Care Program, claims data

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

EEOC Files Suit Over Wellness Program

Posted by: Linda Rowings    Sep 9, 2014 1:32:00 PM

The Equal Employment Opportunity Commission (EEOC) has sued an employer because the penalty it applied for not participating in its wellness program was, in the eyes of the EEOC, so high that participation was not, as a practical matter, “voluntary.” Under EEOC rules, an employer may conduct medical examinations, which includes obtaining medical histories and blood draws, only in limited situations. One of those permitted situations is a voluntary wellness program. Because the program did not qualify as “voluntary,” the questions employees were asked about their health on a health risk assessment, a blood draw, and a range of motion assessment violated the Americans with Disabilities Act (ADA), according to the EEOC’s Complaint.

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Topics: employee engagement, wellness, ancillary benefits, health care costs, ACA, disability management, voluntary benefits, employee satisfaction, UBA Partner Firm, employee benefits, hr consulting, health care reform, health care, wellness programs, absence management, absenteeism, disability insurance, health risk assessment, PPACA Affordable Care Act, employee health, insurance solutions, medical plan, self funded health plans, HRA

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