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Posts Tagged ‘public exchange’

Employers reducing spousal, family coverage

Wednesday, December 17th, 2014

Benefits Pro reports:

“The evidence continues to mount that mid-to-large corporations will fine-tune, but won’t abandon, employee health plans.

A Towers Watson survey of 379 companies in that size range found, among other trends, that companies believe in providing health coverage, but want to be able to predict the cost of coverage.

To accomplish both, they are gradually shifting some costs to employees, eliminating some benefits, such as spousal coverage, and encouraging their workers to take more ownership of their health coverage to share in the economic risk of providing coverage.


Employers not interested in PPACA exchanges

Friday, October 3rd, 2014

Benefits Pro reports:

“Nearly one in four employers say they may move their employees toprivate exchanges within the next few years, but virtually none of them are considering public exchanges under the Patient Protection and Affordable Care Act, new analysis from consulting firm Towers Watson finds.

The firm’s Health Care Changes Ahead survey of 349 HR professionals at mid- and-large-sized companies found that 24 percent of those surveyed believe a private exchange will be a viable alternative for providing employee health benefits by 2016.


Exchange enrollees sicker than average

Friday, May 16th, 2014

Benefits Pro reports:

“Those who enrolled in health coverage through the exchanges aren’t as healthy as some would like, according to new data.

Analysis from Express Scripts shows that, based on their medication usage, PPACA enrollees are sicker than patients off the exchanges, often requiring specialty drug prescriptions.


Why employers may consider public health care exchanges

Tuesday, February 18th, 2014

The Journal of Accountancy reports:

New public health care insurance exchanges may provide more affordable coverage than plans employers currently use, according to a new report.

An analysis by PwC’s Health Research Institute showed that the median 2014 premium on 51 public exchanges nationally is $5,844 for a plan with coverage similar to that of the average employer-sponsored plan.


Meet the woman tasked with selling PPACA

Friday, July 12th, 2013

Benefits Pro reports:

“The Patient Protection and Affordable Care Act isn’t as old as you think, but its history has already been long and arduous. Three years after President Obama signed it into law, it’s still overwhelmingly confusing — not to mention unpopular — among Americans across all demographics.


Health reform turns 3, with the hardest part yet to come

Tuesday, April 9th, 2013

NBC News reports:

“Three years ago this weekend, President Obama signed the Affordable Care Act into law.

Its provisions sound sweeping – get health insurance to 32 million Americans who don’t have it now, stop insurers from cherry-picking their customers, require basic coverage that’s proven to improve health and lower costs, not to mention initiatives to get doctors to work together in teams. But the law’s written to go into effect in stages, and it’ll be years before all the provisions are up and running.


ACA Affordability, Penalty & Subsidy Quick Guide

Thursday, April 4th, 2013

Benefits Buzz Blog reports:

“The U.S. Department of Health and Human Services (HHS) and the Internal Revenue Service (IRS) have jointly issued rules that define affordable coverage. Employers and employeesstill have several questions about how this affects penalty calculations and subsidy eligibility. The following offers some insight on these key issues:


Quick Guide to ACA Affordability, Penalty & Subsidy Calculations

Tuesday, April 2nd, 2013

Flex reports:

The U.S. Department of Health and Human Services (HHS) and the Internal Revenue Service (IRS) have jointly issued rules that define affordable coverage. Employers and employees still have several questions about how this affects penalty calculations and subsidy eligibility. The following offers some insight on these key issues:



“Failure to Offer” Penalty

Employers that have 50 or more full-time equivalent employees must offer group health insurance to their employees next year or pay a penalty. The penalty is $2,000 per full-time employee with an exemption for 30 employees.


For example, if an employer had 100 full-time employees the penalty would be applied to 70 employees, which would result in a $140,000 penalty. The penalty is pro-rated on a monthly basis for employers that offer coverage for only a portion of the year.

“Unaffordability” Penalty

Employers (with 50+ employees) that choose to offer health insurance coverage must then make sure it is considered affordable, or be faced with a different penalty. Coverage is considered affordable if the employee cost for self-only coverage is less than 9.5% of their compensation, as reported in Box 1 of their W-2 statement.


For example, an employee making $35,000 would have to be charged $277.08 or less per month ($35,000 x 9.5% = $3,325/12) for self-only coverage for it to be considered affordable.


The employer can charge additional premium for employees that elect to cover dependents. There is actually no contribution requirement that the employer must make towards dependent coverage, and this is not taken into account to determine if the employer is offering affordable coverage.


If the coverage is considered unaffordable the employer may be subject to a penalty. The penalty is $3,000 per employee, and it is only applicable to employees in which coverage is considered unaffordable, and that apply for coverage through a public exchange and qualify for a premium tax subsidy. The penalty would also be pro-rated on a monthly basis if the employer provided affordable coverage for only a portion of the year.


ACA: Come Out And Play

Tuesday, March 5th, 2013

Insurance News Net reports:

“One percent.”

“I would be surprised if we see many, if any.”

According to most experts, the number is small. Not only is it small, it keeps getting smaller. We speak, of course, of the number of companies with 50 or more employees that will drop employer-sponsored insurance in 2014 – opting to send employees to state-run insurance exchanges and pay per-employee fines levied by the Patient Protection and Affordable Care Act. After a McKinsey & Company study in 2011 famously concluded that 30% of employers would “pay” rather than “play,” survey after survey has revealed that fewer than 5% of employers plan to eliminate employee health benefits. Even the Government Accountability Office, which originally reported as much as 20% of employers would drop coverage, now has backed off to around 2%.


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