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Posts Tagged ‘group health plan’

Employer-paid Individual Health Plans

Wednesday, September 3rd, 2014

Flexible Benefit reports:

“The IRS and other agencies have issued three different sets of guidance making it clear that employers cannot give actively employed workers pre-tax dollars through a Health Reimbursement Arrangement (HRA) ,or any other type of arrangement, to purchase individual coverage on their own. Employers using this model will be subject to fines of up to $100 per employee per day.

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Small Firms Hit by Big Changes in Health Coverage

Wednesday, September 3rd, 2014

The Wall Street Journal reports:

“Businesses with fewer than 50 workers are exempt from the most stringent requirements for larger employers under the federal health-care law. But that doesn’t mean they’re off the hook entirely.

Smaller employers aren’t required under the Affordable Care Act to offer coverage for their full-time workers—as larger firms must by 2016 or face penalties, for instance. But many owners of small ventures and startup entrepreneurs are nonetheless facing big changes to how they obtain their own health coverage, as well as to the benefits they’re able to offer employees.

“It’s a myth that smaller firms aren’t being hit” by the health law, albeit in less obvious ways, says James Schutzer, president of the New York State Association of Health Underwriters, referring to employers with fewer than 50 workers.

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Support For Employer-Provided Health Plans Starts To Erode

Wednesday, April 2nd, 2014

Insurance News Net reports:

“The rumblings of employees dissatisfied with the value of employer-sponsored health benefits are getting louder.

But are the grumblings loud enough for employees to put their money where their mouths are? Are employees willing to walk out the door and leave their employer-sponsored cocoons, tossing all the value talk out the window?

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IRS puts off PPACA discrimination testing

Monday, February 17th, 2014

Benefits Pro reports:

“Robert Pear, a New York Timesreporter, made waves this week by calling the Internal Revenue Service about what happened to the Patient Protection and Affordable Care Act nondiscrimination provisions. (more…)

Questions and Answers on the Individual Shared Responsibility Provision

Tuesday, September 3rd, 2013

The IRS reports:

“Basic Information

1. What is the individual shared responsibility provision?

Under the Affordable Care Act, the federal government, state governments, insurers, employers and individuals are given shared responsibility to reform and improve the availability, quality and affordability of health insurance coverage in the United States. Starting in 2014, the individual shared responsibility provision calls for each individual to have minimum essential health coverage (known as minimum essential coverage) for each month, qualify for an exemption, or make a payment when filing his or her federal income tax return.

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ACA Out-of-Pocket Max Clarity

Tuesday, September 3rd, 2013

Flex Benefits reports:

“The Affordable Care Act (ACA) requires non-grandfathered plans to impose limitations on out-of-pocket expenses for essential health benefits starting in 2014. The out-of-pocket limitations will be capped next year at $6,350 for single coverage and $12,700 for family coverage.

However, some self-funded plans will be exempt from this requirement until 2015. The guidance indicates that self-funded plans contracting with multiple service providers can delay this requirement for one year.

For example, some self-funded plans contract with one service provider to administer their major medical benefits and another service provider to administer their pharmacy benefits.

The reason for the delay has been linked to administrative complications in tracking the out-of-pocket expenses when multiple service providers are used.

The new out-of-pocket limitations will still apply in 2014 to all individual health plans, fully insured group health plans and self-funded group health plans that use a single service provider to administer their plan benefits.””

Obama administration delays another healthcare reform provision

Tuesday, September 3rd, 2013

HR . BLR . com reports:

“The Obama administration has revealed the delay of another Affordable Care Act (ACA) provision. The administration has postponed a consumer protection provision that limits out-of-pocket costs until 2015. Under the provision, the limit on such out-of-pocket costs was not supposed to exceed $6,350 for an individual and $12,700 for a family.

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Implementing Health Reform: Contraceptive Coverage Final Regulations

Friday, July 12th, 2013

Heath Affairs Blog reports:

“The most controversial single issue presented by the Affordable Care Act is arguably the regulatory requirement that group health plans and insurers cover contraceptive services.  The ACA requires non-grandfathered group health plans and health insurers to offer, without cost sharing, coverage of preventive services, including women’s preventive services, that are designated by the Health Resources and Services Administration (HRSA).  Based on an Institute of Medicine study, HRSA in 2011 identified as women’s preventive services “all Food and Drug Administration approved contraceptive methods, sterilization procedures, and patient education and counseling for all women with reproductive capacity.”  Pursuant to this designation, the Department of Health and Human Services (HHS) listed contraceptives services and counseling as required preventive services.

(more…)

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