President Trump Ends ACA Cost Sharing Reductions

Posted by Matt Schwartz on Mon, Oct 16, 2017 @ 08:10 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.

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Topics: Compliance Issues, Affordable Care Act, Employee Benefits

Compliance Recap September 2017

Posted by Matt Schwartz on Fri, Oct 13, 2017 @ 17:10 PM

September was quiet month in the employee benefits world.

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Topics: Compliance Issues, Affordable Care Act, Employee Benefits

October 2017 Executive Order on Healthcare

Posted by Matt Schwartz on Fri, Oct 13, 2017 @ 11:10 AM

On October 12, 2017, the White House released an Executive Order, signed by President Trump, titled "Promoting Healthcare Choice and Competition Across the United States."

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Topics: Compliance Issues, Affordable Care Act, Employee Benefits

Patient-Centered Outcomes Research Institute (PCORI) Fee, Transitional Reinsurance Fee (TRF) and Health Insurance Providers (HIP) Fee

Posted by Matt Schwartz on Thu, Oct 12, 2017 @ 14:10 PM

The IRS and the Department of Health and Human Services have issued final regulations that provide details on several fees that will be due as part of the Patient Protection and Affordable Care Act (ACA). Self-funded plans will calculate and pay these fees directly. Insurers will calculate and pay the fees due on insured policies, although insured plans should expect these fees to be passed along.

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Topics: Compliance Issues, Affordable Care Act

Contraception Mandate Rolled Back for Employers

Posted by Matt Schwartz on Tue, Oct 10, 2017 @ 08:10 AM

Two tri-agency (Internal Revenue Service, Employee Benefits Security Administration, and Centers for Medicare and Medicaid Services) Interim Final Rules were released and became effective on October 6, 2017, and will be published on October 31, 2017, allowing a greater number of employers to opt out of providing contraception to employees at no cost through their employer-sponsored health plan.

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Topics: Compliance Issues, Affordable Care Act, Employee Benefits

IRS Releases Draft Forms and Instructions for 2017 ACA Reporting

Posted by Matt Schwartz on Thu, Sep 28, 2017 @ 13:09 PM

Background

Under 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.

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Topics: Compliance Issues, Affordable Care Act, Employee Benefits

Anthem Revises Rate Filing for 2018 Individual Plan Offerings in KY

Posted by Matt Schwartz on Mon, Sep 11, 2017 @ 09:09 AM

After significant dialogue with state leaders and regulators, Anthem announced that they have made the difficult decision to revise their rate filing for their 2018 Individual plan offerings in Kentucky.

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Topics: Affordable Care Act

Compliance Recap August 2017

Posted by Matt Schwartz on Fri, Sep 8, 2017 @ 16:09 PM

Compliance Recap

August 2017

August was a quiet month in the employee benefits world. The Internal Revenue Service (IRS) released its 2018 affordability rate.

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Topics: Compliance Issues, Affordable Care Act, Employee Benefits

MLR Rebates for Kentucky and Indiana Health Plans

Posted by Matt Schwartz on Fri, Aug 25, 2017 @ 09:08 AM

One of the benefits of PPACA for insured groups and individuals is that insurance companies must spend 80-85% (depending on the insured group size) of the premiums they collect on claims and initiatives to reduce claims ("Medical Loss Ratio") ... or they must return money in the form of an MLR rebate to their customers. 

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Topics: Compliance Issues, Affordable Care Act, Employee Benefits

What You Need to Know about Health Flexible Spending Accounts

Posted by Matt Schwartz on Tue, Aug 15, 2017 @ 12:08 PM

A health flexible spending account (FSA) is a pre-tax account used to pay for out-of-pocket healthcare costs for a participant as well as a participant's spouse and eligible dependents. Health FSAs are employer-established benefit plans and may be offered with other employer-provided benefits as part of a cafeteria plan. Self-employed individuals are not eligible for FSAs.

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Topics: Compliance Issues, Affordable Care Act, Employee Benefits