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Posts Tagged ‘West Dundee’

High deductible plans have more people delaying treatment

Monday, January 12th, 2015

Yahoo Finance reports:

“As the cost of health care rises, more and more Americans in nearly every economic class are choosing to delay medical treatment because they can’t afford it.
A new Gallup poll released Friday found that about one in three Americans say they have put off treatment for themselves or a family member because of cost—the highest rate recorded in Gallup’s history.


Employer Shared Responsibility Payments and Reporting Requirements Under the Affordable Care Act: Code Sections 6055 and 6056

Friday, October 3rd, 2014

The National Law Review reports:

“There are two types of employer shared responsibility payments, also known as pay or play penalties, under the Affordable Care Act (ACA).  The first penalty under Internal Revenue Code (Code) Section 4980H(a) is the penalty for failure to offer health coverage.  Effective for plan years beginning on or after January 1, 2015, a $2,000 annual penalty applies to a large employer that fails to offer at least 70 percent of its full-time employees (FTEs) health coverage.  For plan years beginning on or after January 1, 2016, the $2,000 penalty applies to an employer that fails to offer health coverage to at least 95 percent of its FTEs.  The $2,000 penalty is assessed on a monthly basis, but applies to all of an employer’s FTEs, minus 30 FTEs (or minus 80 FTEs for 2015).


10 years on, tort reform sees suits, payouts drop

Tuesday, September 3rd, 2013

Merced Sun-Star reports:

“Ten years after the Texas Legislature capped damages in the state’s medical malpractice lawsuits, the number of suits and the amounts paid out have fallen sharply.

The Austin American Statesman reported ( ) Sunday that state Department of Insurance data shows medical malpractice claims, including lawsuits, resolved in a year fell by nearly two-thirds between 2003 and 2011 to 450. The average payout declined 22 percent to about $199,000.


Our View: Examining health care

Tuesday, July 23rd, 2013

Northwest Herald reports:

“The new marketplace opening in October will sell only one type of item – but it’s something that never has been presented in this manner before.

Oct. 1 is when open enrollment in the Health Insurance Marketplace, or the Exchange, starts in Illinois. It’s part of the federal Affordable Care Act, which, among other things, mandates that all Americans have health insurance.

The Exchange is an online portal that will serve as a central location for residents and small businesses to compare and choose from dozens of insurance plans. Six providers have proposed 165 plans, and coverage kicks in Jan. 1.


Looking For Summer Reading? Try Healthcare Reform Regulations

Friday, July 19th, 2013

Forbs reports:

“The federal government apparently was concerned that Americans would not find anything to read this summer, and kindly dropped hundreds of pages of regulations related to healthcare, just in time for the beach.

The Centers for Medicare and Medicaid Services (CMS), one of the Big Three Departments that spend our federal tax dollars (numero uno, at 22 percent, being the Social Security Administration; number two is CMS at 21 percent; and number three, the Defense Department, at 19 percent)  released a phone-book sized volume of  regulations the day after Independence Day. The new regulations define how Medicaid and Children’s Health Insurance Program (CHIP) will change as a result of the Patient Protection and Affordable Care Act.


Millions eligible for Obamacare subsidies, but most don’t know it

Wednesday, May 8th, 2013

CNN Money reports:

“Nearly 26 million Americans could be eligible for health insurance subsidies next year, but most don’t know it.

That’s because relatively few people are familiar with provisions in the Affordable Care Act, aka “Obamacare,” that will provide tax credits to low- and middle-income consumers to help them purchase health coverage through state-run insurance exchanges.

Most of those who will be able to claim the subsidies are in working families with annual earnings between $47,100 and $94,200, according to a recent analysis by Families USA, a consumer advocacy group. More than a third of those eligible will be young adults between ages 18 and 34. (more…)

Health Care Reform – 2013 & 2014 Planning

Wednesday, May 1st, 2013

Employers should review the fast-approaching 2013 and 2014 health care reform requirements. State Exchanges will be opening enrollment as soon as October 1, 2013 with benefits effective January 1, 2014. Along with many questions from employees, employers face a multitude of reform provisions. For answers and guidance, they will look to attorneys, brokers, consultants and third party administrators to help sort out the rules and reporting requirements. Below is a recap of the issues that employers face for 2013 and 2014 and what action they should take in response. In the following table, “PPACA” is an abbreviation for Patient Protection and Affordable Care Act of 2010, better known as the health care reform law. Please note that the following information may change due to future published guidance.

<Click Here for full PDF>

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.


Applying For Obama Plan Not Easy

Monday, March 25th, 2013

Insurance News Net reports:

“Applying for benefits under President Barack Obama’s health care overhaul could be as daunting as doing your taxes.

The government’s draft application runs 15 pages for a three-person family. An outline of the online version has 21 steps, some with additional questions.

Seven months before the Oct. 1 start of enrollment season for millions of uninsured Americans, the idea that getting health insurance could be as easy as shopping online at Amazon or Travelocity is starting to look like wishful thinking.


How to Save Money by Hiring an Insurance Broker

Thursday, February 28th, 2013

The Krazy Coupon Lady reports:

“Recently faced with purchasing new insurance as I moved out of state, a friend suggested an insurance broker in my new city. Insurance broker?

I thought…”Why wouldn’t I just call a company directly?” But after learning how much money this broker saved my friend, I thought this alternative approach was worth researching. I learned that an insurance agent tries to fit me into the one product their company sells, while an insurance broker finds the best product that fits around my specific needs and budget. With this knowledge, I said goodbye to the archaic mindset of buying insurance solely from one company and being bound to their pricing and policies.


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