ComplianceMnthlyRecap MH 5.16.22

CMS Releases Updated Premium Assistance under Medicaid and the Children’s Health Insurance Program (CHIP) Model Notice

Posted by: Matthew Meidell    Mar 10, 2020 5:45:00 AM

The Centers for Medicare and Medicaid Services (CMS) released an updated Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP) model notice.

Read More

Topics: Medicaid, CMS, Medicare coverage, CHIP, compliance recap, children

CMS Releases SBC Materials for Plan Years Beginning 2021

Posted by: Karen Hsu    Jan 16, 2020 6:46:00 AM

Compliance_CMS_SBC_Guidance_Plan

The Centers for Medicare and Medicaid Services (CMS) released SBC materials and supporting documents including a template SBC, sample completed SBC, uniform glossary, instructions, and guidance for plan or policy years beginning on or after January 1, 2021. 

Read More

Topics: Medicaid, SBC, CMS, Medicare coverage, compliance recap

CMS Publishes 2020 Benefit Payment and Parameters Final Rule

Posted by: Karen Hsu    Jun 13, 2019 12:05:12 PM

shutterstock_577768111-1The Centers for Medicare and Medicaid Services (CMS) published its final rule and fact sheet for benefit payment and parameters for 2020. Although the final rule primarily affects the individual market and the Exchanges, the final rule addresses the following topics that may impact employer-sponsored group health plans:

  • The 2020 maximum annual limitation on cost sharing is $8,150 for self-only coverage and $16,300 for other-than-self-only coverage.
  • For fully-insured plans, any indication of a reduction in the generosity of a benefit for individuals that is not based on clinically indicated, reasonable medical management practices is potentially discriminatory.
Read More

Topics: health insurance, Medicaid, Centers for Medicare and Medicaid Services, Medicare coverage

Do you have a choice of where you will be taken care of?

Posted by: Rob Morrow    Oct 18, 2018 12:07:37 PM

If something should happen to you or one of your employees today that required Long Term Care, do you, or they, have a choice in where the care is received? shutterstock_423588130

Read More

Topics: Long-Term Care, employee benefits, Medicaid, long-term care insurance, long-term care benefits, senior care

U.S. Department of Labor Updates CHIP Notice

Posted by: Bill Olson    May 3, 2018 2:00:07 PM

unnamedIn March, the U.S. Department of Labor (DOL) updated its model Premium Assistance Under Medicaid and the Children's Health Insurance Program notice, otherwise known as the CHIP notice. (This update is standard process, and usually happens biannually.)

Read More

Topics: Medicaid, Department of Labor, health care benefits, health care coverage, CHIP

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.”

Read More

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

2014 Federal Poverty Guidelines

Posted by: Bill Olson    Feb 19, 2014 10:57:00 AM

The Federal Poverty Level (FPL) is used to determine eligibility for many government programs, including Medicaid and the premium tax credit/subsidy available through the health marketplace/exchange. The Department of Health and Human Services (HHS) has released the following 2014 Federal Poverty Level figures. They reflect a 1.5% cost of living increase over 2013.

Read More

Topics: health insurance exchanges, ACA, health marketplace, PPACA, Premium Tax Credit, Medicaid, Federal Poverty Level, FPL, premium tax subsidy

Open Enrollment Issues for the Marketplace Over? Not Hardly!

Posted by: Carol Taylor    Feb 12, 2014 10:18:00 AM

By Carol Taylor
Employee Benefit Advisor
D&S Agency, a UBA Partner Firmhealth marketplace enrollment issues

Read More

Topics: health insurance exchanges, ACA, health marketplace, PPACA, Medicaid, APTC, Advanced Premium Tax Credit, benefit communication, benefit management, compliance with health care reform

What's My State Doing with Exchanges and Medicaid?

Posted by: Bill Olson    Oct 15, 2013 11:16:00 AM

states mapStates have two major decisions to make with respect to the Patient Protection and Affordable Care Act (PPACA) – whether they will run the health exchange themselves, and whether they will expand Medicaid to cover most individuals whose income is below 133 percent of the federal poverty level.

Do you know where your state stands, and what your options are? If not, read on…

Read More

Topics: employee communication, health insurance exchanges, ACA, UBA, hr consulting, health care reform, PPACA, Medicaid