ComplianceMnthlyRecap MH 5.16.22

What Employers Need to Know about the Senate Proposed Healthcare Bill

Posted by: Danielle Capilla    Jun 26, 2017 8:30:00 AM

US capitolOn June 22, 2017, the United States Senate released a "Discussion Draft" of the "Better Care Reconciliation Act of 2017" (BCRA), which would substitute the House's House Resolution 1628, a reconciliation bill aimed at "repealing and replacing" the Patient Protection and Affordable Care Act (ACA). The House bill was titled the "American Health Care Act of 2017" (AHCA). Employers with group health plans should continue to monitor the progress in Washington, D.C., and should not stop adhering to any provisions of the ACA in the interim, or begin planning to comply with provisions in either the BCRA or the AHCA.

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Topics: ACA, health care reform, Better Care Reconciliation Act of 2017, American Health Care Act of 2017

Small Businesses No Longer Going for the Gold in Medical Insurance

Posted by: Carol Taylor    Dec 17, 2015 11:00:00 AM

MedalsSmall employers are feeling the squeeze from increasing costs of medical care and increasing premiums for the medical insurance they offer their employees. Recently released findings from the 2015 UBA Health Plan Survey show that 54 percent of small employers are currently offering gold or platinum plans to their employees. However, with the pressure from rising medical care costs, the introduction of community rating in setting insurance rates, and the end of grandmothering, it is highly unlikely that this trend will continue.

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Topics: health care costs, ACA, health care reform, Carol Taylor, community rating, UBA Health Plan Survey, Affordable Care Act, metal level benefits

IRS Releases Draft 2015 Instructions for 6055/6056 Reporting

Posted by: Danielle Capilla    Sep 10, 2015 11:00:00 AM

IRS FilingUnder 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. In order for the Internal Revenue Service (IRS) to verify that (1) individuals have the required minimum essential coverage, (2) individuals who request premium tax credits are entitled to them, and (3) ALEs are meeting their shared responsibility (play or pay) obligations, employers with 50 or more full-time or full-time equivalent employees and insurers will be required to report on the health coverage they offer. Reporting will first be due early in 2016, based on coverage in 2015. All reporting will be for the calendar year, even for non-calendar year plans. Mid-size employers (those with 50 to 99 employees) will report in 2016, despite being in a period of transition relief in regard to having to offer coverage. The reporting requirements are in Sections 6055 and 6056 of the ACA. Draft instructions for both the 1094-B and 1095-B and the 1094-C and 1095-C were released in August 2015.

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Topics: ACA, health care reform, IRS Reporting Rules, PPACA Affordable Care Act, IRS Form 1095, IRS Form 1094, Danielle Capilla, Affordable Care Act

UBA Survey Finds Self-Funded Pharmacy Plans Have Increased Nearly 30 Percent in Five Years

Posted by: Bill Olson    Sep 8, 2015 2:51:33 PM

Pharmacy PlansAs a result of the Patient Protection and Affordable Care Act (ACA) triggering cost increases for fully insured employer-sponsored health insurance plans, more employers are moving to a self-funded model for pharmacy plans, particularly among large employers (1,000+ employees), according to the 2014 United Benefit Advisors (UBA) Health Plan Survey.

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Topics: ACA, health plan benchmarking, health care reform, PPACA Affordable Care Act, pharmacy benefits, UBA Health Plan Survey

Medicare Costs Explained

Posted by: Kathy Binkley, RHU, ChHC    Aug 25, 2015 11:00:00 AM

HealthCareCostI’m sure you’ve heard the phrase “Nothing in life is free,” and nothing is – not even Medicare. In most cases, you won’t have to pay a premium to get Medicare, at least for Part A (here’s a refresher on the different parts of Medicare), but that doesn’t mean it’s free. You’ve just pre-paid in the form of taxes. So you don’t have to worry about a premium for Part A, which covers in-patient hospital expenses, assuming you or your spouse paid Social Security for at least 10 years. However, there are other costs associated with Medicare, which vary depending on the specific insurance.

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Topics: health care costs, health care reform, The Wilson Agency, retirement savings, Medigap, Medicare, Medicare secondary payer, Kathy Binkley

New Drugs for Some ... Will They Ultimately Cost Everyone an Arm and a Leg?

Posted by: Elizabeth Kay    Aug 20, 2015 11:00:00 AM

Prescription medicationAdvancements in science and technology can be absolutely amazing. The types of treatments that are available now are light years ahead of where we were even 10 years ago. For example, there are some new anti-viral drugs that have become available. One in particular that is for treating Hepatitis C has been very successful. It can actually cure patients of Hepatitis C, in just weeks for some cases.

So why might these drugs not be available to those who could really use them?

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Topics: health care costs, health care reform, Elizabeth Kay, AEIS Advisors, Affordable Care Act, multi-tier pharmacy benefits, prescription drug plans, prescription drug cost

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

Posted by: Danielle Capilla    Jul 7, 2015 11:00:00 AM

Supreme Court Upholds ACA Subsidy EligibilityThe 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

SCOTUS and the Future of U.S. Health Care

Posted by: Peter Freska    Apr 14, 2015 11:00:00 AM

SCOTUS and the Future of U.S. Health CareThe Patient Protection and Affordable Care Act (PPACA), commonly referred to as “Obamacare,” was signed into law with the intention of decreasing the number of uninsured Americans and reducing the overall costs of health care in the United States. In order to increase the number of U.S. citizens covered, a number of mechanisms including mandates, subsidies, and tax credits became effective beginning January 1, 2014. The federal health care law also contains many reforms aimed at improving health care outcomes and streamlining the delivery of care. While this reform may be appealing, there are many concerns as to its viability, beginning with the increased number of people covered to effective reduction of health care costs. In the latest arguments for or against PPACA, the Supreme Court of the United States (SCOTUS) heard arguments on the legality of who is able to provide subsidies to those who qualify for subsidies. This lawsuit contends that subsidies are illegal unless a state has set up its own health insurance exchange. The charge is based on wording in the law, which states that subsidies are for health coverage obtained on an “Exchange established by the State under section 1311.”

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Topics: health care reform, premium subsidies, Medicaid, PPACA Affordable Care Act, U.S. Supreme Court, Medicare, single-payer system, Obamacare

Agencies Provide Guidance on Single Benefit Products and Excepted Benefits

Posted by: Linda Rowings    Mar 12, 2015 11:00:00 AM

Agencies Provide Guidance on Single Benefit Products and Excepted BenefitsOn February 13, 2015, the regulatory agencies issued an FAQ on whether supplemental health insurance coverage that provides additional categories of benefits may qualify as supplemental excepted benefits. Many provisions of PPACA do not apply to excepted health benefits. Supplemental excepted benefits are those that are provided under a separate policy, certificate, or contract of insurance and are Medicare supplement insurance (Medigap), Tricare supplemental programs, or “similar” supplemental coverage.

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Topics: ACA, health care reform, PPACA, excepted benefits, supplemental health coverage

The State of Healthcare Insurance – The Top Five Highest and Lowest Costs of Health Insurance

Posted by: Peter Freska    Feb 17, 2015 12:06:07 PM

CTA-2014-Benchmarking-SurveyWith health care expenditures in the United States fast approaching 17.7% of gross domestic product (GDP), the cost of health care is a valid concern. Additionally, as employers of all sizes reel in the wake of the Patient Protection and Affordable Care Act (PPACA), the question they still beg to question is: How much does health care cost?

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Topics: health care reform, PPACA, 2014 Health Plan Survey, cost of health care