INSURANCE COMPANY
HEALTH CARE REFORM
APRIL 2012 - NEWS ON HEALTH CARE REFORM
MARCH 2012 - NEWS ON HEALTH CARE REFORM
FEBRUARY 2012 - NEWS ON HEALTH CARE REFORM
DECEMBER 2011 - NEWS ON HEALTH CARE REFORM
NOVEMBER 2011 - NEWS ON HEALTH CARE REFORM
SEPTEMBER 2011 - NEWS ON HEALTH CARE REFORM
JULY 2011 - NEWS ON HEALTH CARE REFORM
JUNE 2011 - NEWS ON HEALTH CARE REFORM
MAY 2011 - NEWS ON HEALTH CARE REFORM
APRIL 2011 - NEWS ON HEALTH CARE REFORM
MARCH 2011 - NEWS ON HEALTH CARE REFORM
FEBRUARY 2011 - NEWS ON HEALTH CARE REFORM
JANUARY 2011 - NEWS ON HEALTH CARE REFORM
| 1/20/2011 |
Spousal Carve-Outs and Surcharges
In order to reduce rising health care costs, some employers have adopted group health plan provisions restricting coverage of spouses. |
| 1/20/2011 |
Imputed Income Concerns for Adult Dependent Children Currently Covered Under Benefit Plans
Imputed income is the addition of the fair market value of cash/non-cash compensation (insurance premiums) that is income and taxable wages to an employee. These should be imputed/added to an employee's income via the W-2. |
| 1/20/2011 |
Health Savings Accounts: Questions and Answers
For a comprehensive list of important definitions, most commonly asked questions and detailed examples regarding Health Savings Accounts, please download the printable PDF. |
| 1/20/2011 |
Health Savings Account Regulatory Limits
Health Savings Accounts (HSAs) are a relatively new health care program. HSAs represent a breakthrough strategy that can lower health care costs today and increase retirement savings for future health care needs. |
| 1/20/2011 |
Health Savings Account Payroll Reminder
This notice is a reminder of the IRS personal tax filing requirements for all HSA participants. |
| 1/20/2011 |
Health Coverage Tax Credit COBRA Extension Letter
Congress passed the Omnibus Trade Act of 2010 which extends the length of time by law an employer must offer COBRA coverage |
| 1/20/2011 |
Exploring the Health Coverage Tax Credit
The Health Coverage Tax Credit (HCTC) helps certain trade-affected workers, retirees and their families pay their health insurance premiums. The HCTC makes health coverage more affordable by paying 80 percent of health insurance premiums for individuals who are eligible for the tax credit. |
| 1/20/2011 |
Spousal Carve Out and Waiver
Many medical plans are implementing either spousal carve out or spousal surcharge plans in an attempt to control health plan costs. |
| 1/20/2011 |
Rescissions
Many employers have asked for clarification of "rescission and what is allowable due to "normal course of business". |
| 1/20/2011 |
How To Grandfather Or Not: A Health Care Reform Update
When health care reform (the Patient Protection and Affordable Act) was signed into law in March, the bill called for the first phases of group medical insurance to take effect for all group plans renewing on or after September 23 - that being six months from the date President Obama signed the legislation into law. |
NOVEMBER 2010 - NEWS ON HEALTH CARE REFORM
| 11/20/2010 |
Fully Insured Plans Can Change Carriers and Remain "Grandfathered"
In the interim final regulations, if a group health plan entered into a new policy, certificate, or contract of insurance (including but not limited to a change in issuers/carriers) after March 23, 2010, the plan would have ceased to have been a grandfathered health plan. |
OCTOBER 2010 - NEWS ON HEALTH CARE REFORM
SEPTEMBER 2010 - NEWS ON HEALTH CARE REFORM
| 09/20/2010 |
Federal External Review and Model Appeals Notices
The Patient Protection and Affordable Care Act (PPACA) requires non-grandfathered group health plans and health insurance coverage to adopt an improved internal claims and appeal process and to follow minimum requirements for external review... |
| 09/20/2010 |
Nondiscrimination Rules Apply to New Fully-Insured Group Health Plans
Under health care reform, some fully-insured group health plans will be required to comply for the first time with federal nondiscrimination rules related to compensation. These rules prohibit discrimination in favor of highly-compensated individuals (HCIs). They will apply to non-grandfathered fully-insured plans only and are effective for plan years beginning on or after September 23, 2010. |
| 09/20/2010 |
IRS Issues New Information for Employers on Over-The-Counter Drugs
The Patient Protection and Affordable Care Act (PPACA) changed the requirements related to reimbursements for over-the-counter (OTC) drugs. These changes affect health FSAs, HRAs, HSAs and Archer MSAs, which will need a prescription to reimburse the costs of OTC drugs purchased after December 31, 2010. |
AUGUST 2010 - NEWS ON HEALTH CARE REFORM
| 08/17/2010 |
Essential Health Benefits and Calendar Year Maximums
For some services listed below, state mandates may require coverage beyond PPACA requirements. Essential Health Benefits coverage is not required until 2014. However, if a group provides coverage for a service listed below, the maximums listed below apply. This list is not all-inclusive but is intended to represent the most common services with calendar year dollar maximums. All services are subject to medical policy and medical necessity. |
| 08/17/2010 |
Health Care Reform: The Open Enrollment Compliance Checklist
Health care reform, in the form of the Patient Protection and Affordable Care Act, brings many changes for employers and their health plans. As sponsors of group health plans prepare to comply with health care reform’s many requirements, they need to be aware of how health care reform will affect their plans for the coming plan year. Many changes are effective on the first day of the first plan year beginning on or after September 23, 2010, or January 1, 2011 for calendar year plans . |
JULY 2010 - NEWS ON HEALTH CARE REFORM
| 7/21/2010 |
Early Retiree Application
The early retiree reinsurance program provides $5 billion for temporary financial assistance for employers that have an early retiree insurance plan in place for retirees between 55 and 64. The program will reimburse 80% of of costs for health benefits/claims between $15,000 and $90,000. Funds received must be used to lower health costs for enrollees (can be all enrollees including active participants). The program is available through January 1, 2014. However, the program will officially end when the program funds are depleted. The Department of Health & Human Services published the official application, official instructions, application submission do's and don'ts. Please see http://www.hhs.gov/ociio/regulations/index.html#early_retiree for more information. |
| 7/21/2010 |
Model Notices
Three new model notices have been posted on the Department of labor website.
- Model Notice on Patient Protections, available at http://www.dol.gov/ebsa/patientprotectionmodelnotice.doc - This notice informs employees that they have the right to (1) choose a primary care provider or a pediatrician when a plan or issuer requires designation of a primary care physician; or (2) obtain obstetrical or gynecological care without prior authorization
- Model Notice on Lifetime Limits No Longer Applying and Enrollment Opportunity, available at http://www.dol.gov/ebsa/lifetimelimitsmodelnotice.doc - There is a graduated scale for the implementation of “Restricted Annual Limits” allowed for “Essential Health Benefits” for plan years beginning before 1.1.14. Additionally, higher than required or no annual limits permissible in each of the plan years on or after 9.23.10 but before 1.1.14. There is a waiver available if the requirement causes significant decrease in access to benefits or increase in premiums (i.e. limited or mini-med benefit plans). A plan can exclude benefits for a condition without violation as long as no benefits are provided for the condition. This provision applies to both grandfathered and non-grandfathered plans.
- Model Notice of Opportunity to Enroll in Connection with Extension of Dependent Coverage to Age 26, available at http://www.dol.gov/ebsa/dependentsmodelnotice.doc - See age 26 above.
|
| 07/21/2010 |
Preventive Care Coverage Guidelines Issued
The Patient Protection and Affordable Care Act requires new health plans to cover preventive health services without imposing cost-sharing requirements for the services. On July 14, 2010, the Departments of Health and Human Services (HHS), Labor and Treasury issued interim final rules relating to coverage of preventive services. This requirement is generally effective for plan years beginning on or after September 23, 2010. It does not apply to grandfathered health plans. |
| 07/14/2010 |
Potential Penalties for Employers Under the "Pay or Play" Rules
“Pay or Play” ... this term is coined to determine if large employers (50 full-time equivalents) will be subject to penalties based on either their health plan offering or a lack of offering. The concept can be complex and confusing. This brief offers clear and concise clarification with corresponding charts to help guide you through anticipated future penalties. |
| 07/14/2010 |
New Form W-2 Reporting Requirements
The Patient Protection and Affordable Care Act (PPACA), as amended by the Health Care and Education Reconciliation Act (the Reconciliation Act) on March 30, requires employers to report aggregate cost of applicable employersponsored coverage provided to employee’s on the employee’s Form W-2. This is a reporting requirement only. It does not require the employer to impute income tax on the cost of the benefits and it does not require the employee to pay taxes based on the cost of the benefits. The requirement is applicable for the 2011 tax year and will begin appearing on the employee's 2012 W-2. |
| 07/14/2010 |
The HIRE Act of 2010
The Hiring Incentives to Restore Employment Act (HIRE Act) was signed on Mary 18,2010. This Act provides tax incentives to employers that hire formerly unemployed orpart-time workers. In addition to claiming the tax credit on the revised 941, be certain tohave the employee complete the W-11 affidavit verifying their prior unemployed status. |
JUNE 2010 - NEWS ON HEALTH CARE REFORM
| 06/18/2010 |
"Grandfathered" Status
Health Care Reform Patient Protection and Affordable Act (PPACA), also known as The Affordable Care Act, has significant implications for employers who offer health care benefits. The Departments of Health and Human Services, Labor and Treasury released the long awaited interim final regulation on the changes that will affect a health plan’s “grandfathered” status under the PPACA. |
| 06/15/2010 |
2010/2011 Health Savings Accounts/High Deductible Health Plans Limits Released
The IRS has released the limits for HSAs and HDHPs for 2010/2011. |
| 06/15/2010 |
Health Care Reform FAQ's: General Questions and Answers for Employees
Answers to questions about current health coverage, flexible spending accounts, pre-existing conditions, COBRA and more. |
| 06/15/2010 |
Interim Final Rules on Dependent Coverage of Children Up to Age 26
The Patient Protection and Affordable Care Act (PPACA), as amended by the Health Care and Education Reconciliation Act (the Reconciliation Act), provides that health plans and issuers that offer dependent coverage to children on their parents’ plans must make the coverage available until the adult child reaches the age of 26. Under a new tax provision in the Reconciliation Act, the value of employer-provided health coverage for an employee’s child is excluded from income through the end of the taxable year in which the child turns 26, effective March 30, 2010. Please note that state taxes may differ based on each states Department of Revenue's guidelines. |
| 06/15/2010 |
Interim Final Rule on Retiree Reinsurance Program
On May 5, 2010, the Department of Health and Human Services (HHS) published an interim final rule (Final Rule) implementing the Early Retiree Reinsurance Program (the Reinsurance Program) established by the Patient Protection and Affordable Care Act. HHS expects the program to be finalized by June 1, 2010, and applications to be available by the end of June 2010. There is limited funding for this program, so employers who are interested should act quickly. |
| 06/15/2010 |
IRS Guidance on the Small Employer Health Care Tax Credit
The Patient Protection and Affordable Care Act (PPACA), as amended by the Health Care and Education Reconciliation Act (the Reconciliation Act), provides a tax credit to certain small employers that provide health care coverage to their employees, effective with tax years beginning in 2010. |
| 06/15/2010 |
Upcoming Plan Design Issues
The Patient Protection and Affordable Care Act, along with the Health Care and Education Reconciliation Act of 2010, make up the new health care reform law. This legislation creates a number of issues for employers that sponsor group health plans. |
MAY 2010 - NEWS ON HEALTH CARE REFORM
| 05/19/2010 |
Extending Medical FSA's to Age 26
The Affordable Care Act was recently passed on March 30, 2010. Pursuant to the Act, effective March 30, 2010, the definition of “dependent” for purposes of tax free health coverage was expanded. |
| 05/17/2010 |
Break Time for Nursing Mothers
On March 23, 2010, President Obama signed into law the health care reform bill, the Patient Protection and Affordable Care Act. This legislation, along with the Health Care and Education Reconciliation Act of 2010, makes sweeping changes to the U.S. health care system, including a little noticed requirement that employers provide rest breaks and accommodations for employees who are nursing mothers to express breast milk. |
| 05/19/2010 |
Grandfathered Plans
In March 2010, President Obama signed sweeping health care legislation into law. The health care reform law contains many provisions that will affect your business and your employees. |
| 05/06/2010 |
Reinsurance for Early Retirees
Historic health care reform is now law and many of its provisions are already beginning to go into effect. A reinsurance program for early retirees is one of the provisions that will be available to businesses this year. |
| 05/06/2010 |
Upcoming HR Implications
The landmark health care reform bills that were passed this year will undoubtedly affect how businesses provide and administer health care benefits to their employees. |
| 05/19/2010 |
Extension of Dependent Coverage
On March 23, 2010, President Obama signed into law the health care reform bill, the Patient Protection and Affordable Care Act. This legislation, along with the Health Care and Education Reconciliation Act of 2010, makes sweeping changes to the U.S. health care system, including an extension of health insurance coverage to young adult children up to age 26. |
| 05/06/2010 |
Implications on Wellness Programs
Under the recently passed health care reform legislation, employers can offer increased incentives to employees for participating in a workplace wellness program or meeting certain health status targets starting in 2014. |
| 05/19/2010 |
Key Provisions in Health Care Reform Taking Effect Immediately
A list of the provisions that will be taking immediate effect in the new Health Care Reform bill. |
APRIL 2010 - NEWS ON HEALTH CARE REFORM
| 04/15/2010 |
 Video: Illinois - April 15th, 2010 |
| 04/15/2010 |
 PDF: Presentation from April 15th, 2010 |
| 04/15/2010 |
Special Health Care Tax Credit Who is Eligible?
Under the recently enacted health care reform law, many small businesses and tax-exempt organizations that provide health insurance coverage to their employees now qualify for a special tax credit. |
| 04/15/2010 |
Health Care Reform Timeline
On March 23, 2010, President Obama signed into law the health care reform bill, the Patient Protection and Affordable Care Act. This legislation, along with the Health Care and Education Reconciliation Act of 2010, makes sweeping changes to the U.S. health care system. These changes will be implemented over the next several years. |
| 04/15/2010 |
New Requirements For Mental Health and Substance Use Disorder
On February 2, 2010, interim final rules regarding coverage for treatment of mental health and substance use disorders were issued. The new rules implement the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) and apply to employers with 50 or more workers who choose to offer mental health or substance use disorder benefits in a group health plan. |
| 04/15/2010 |
FMLA Fraud: An Employer Concern
Every year the Family and Medical Leave Act (FMLA) helps employees across the nation manage serious health issues and care for ill family members. With this comes a major frustration for employers – the suspected abuse or direct appearance of an employee using this leave inappropriately under FMLA. In fact, suspected employee abuse is the number one FMLA-related concern for employers – with more than 60 percent believing they have granted unfounded leave to employees in the past. |
| 04/01/2010 |
PDF: National Association of Health Underwriters
Timeline of Health Insurance Reforms that Will Impact Private Health Insurance Coverage under H.R. 3590, the Patient Protection and Affordable Care Act and the Health Care and Education Affordability Reconciliation Act of 2010 |
| 04/15/2010 |
PDF: Timeline of Tax Provisions Under The Patient Protection and Affordable Care Act |
|
|