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ACA Exchange Notice

Federal and state governments are manufacturing insurance exchanges/market places as another resource for existing insurance carriers to offer their products and plans. These same products and plans will be available outside the exchanges/market places. For most employers, this new market place will be a redundancy to the way you currently understand insurance to work. The benefactors will primarily be the indigent and certain small businesses that qualify for financial assistance.  As always, Cosby Insurance group will provide you thorough analysis of all your choices.

However, the Affordable Care Act (ACA or health care reform law) added a section to the Fair Labor Standards Act (FLSA) that said employers must provide a written notice to each existing employee. The Department of Labor (DOL) provided an update with temporary guidance and templates of the required notices. Starting on October 1, 2013, the notices have to be given to new employees on the day they are hired. The notices have to be given to existing employees no later than October 1, 2013. The notices will:

  • Advise employees about exchanges including a description of the services provided and how they can contact exchanges to request assistance;
  • Let employees know they may be eligible for a premium tax credit if the employer-sponsored plan does not meet certain standards, and the employee buys a qualified health plan through an exchange;
  • Explains that if the employee buys a qualified health plan through an exchange, he or she may lose the employer contribution to any health benefit plan the employer offers, and that all or a portion of the contribution may be excluded from income for Federal tax purposes.

Please know that the quality and affordability of your employer-sponsored benefits is important to being  a competitive employer. Providing competitive and affordable  benefits is now more important than ever.

Important links:
Technical Release 2013-02
Model Exchange Notice
Cobra model

ACA Allies To Focus On Uninsured In 18 States

Supporters of the Affordable Care Act said they’ll debut a campaign this month in 18 U.S. states to promote a law still poorly understood by those designed to benefit most.

Enroll America, a Washington-based nonprofit group, said it will hold 50 community events to kick off the effort in states with high numbers of uninsured residents, from California to Texas to Florida. An advertising campaign will follow as the law approaches the Oct. 1 opening of enrollment for subsidized insurance plans.

Click here to read more.

Health Exchanges Behind Schedule, Though Premiums Less Than Expected

The price for health coverage bought through the Affordable Care Act’s online exchanges appears to be cheaper than some of the most dire predictions. That’s assuming the U.S. government can get the new marketplaces ready in time.

Proposed monthly premiums in nine states for the benchmark level of medical coverage are less than congressional estimates, according to a study last week from Avalere Health, a Washington- based consulting company. The analysis is muted by a Government Accountability Office report also released this month that shows computer systems for the insurance marketplaces may not be ready on time and training for the people who will assist consumers is behind schedule.

Click here to learn more.

Will the Affordable Care Act’s (“ObamaCare”) Federal Health Insurance Exchanges Be Ready On Time? Finally the Facts!

Will the Affordable Care Act’s (“ObamaCare”) Federal Health Insurance Exchanges Be Ready On Time? Finally the Facts!
After months of speculation on just where the Obama administration is toward the development of the new health insurance exchanges, the Government Accountability Office (GAO) has issued a 48-page report complete with timelines and a detailed report on just where the Obama administration is––or at least was last month.

The key summary:
“Much progress has been made, but much remains to be accomplished within a relatively short amount of time. CMS’s timelines provide a roadmap to completion; however, factors such as the still-­evolving scope of CMS’s required activities in each state and the many activities yet to be performed—some close to the start of enrollment—suggest a potential for challenges going forward. And while the missed interim deadlines may not affect implementation, additional missed deadlines closer to the start of enrollment could do so. CMS recently completed risk assessments and plans for mitigating risks associated with the data hub, and is also working on strategies to address state preparedness contingencies. Whether these efforts will assure the timely and smooth implementation of the exchanges by October 2013 cannot yet be determined. ”

Re the Data Hub:
“FFEs [the federal exchanges] along with the data services hub services are central to the goal under PPACA of having health insurance exchanges operating in each state by 2014, and of providing a single point of access to the health insurance market for individuals. Their development has been a complex undertaking, involving the coordinated actions of multiple federal, state, and private stakeholders, and the creation of an information system to support connectivity and near real-­time data sharing between health insurance exchanges and multiple federal and state agencies. Much progress has been made in establishing the regulatory framework and guidance required for this undertaking, and CMS is currently taking steps to implement key activities of the FFEs, and developing, testing, and implementing the data hub. Nevertheless, much remains to be accomplished within a relatively short amount of time. CMS’s timelines and targeted completion dates provide a roadmap to completion of the required activities by the start of enrollment on October 1, 2013. However, certain factors, such as the still-­unknown and evolving scope of the exchange activities CMS will be required to perform in each state, and the large numbers of activities remaining to be performed—some close to the start of enrollment—suggest a potential for implementation challenges going forward. And while the missed interim deadlines may not affect implementation, additional missed deadlines closer to the start of enrollment could do so. CMS recently completed risk assessments and plans for mitigating identified risks associated with the data hub, and is also working on strategies to address state preparedness contingencies. Whether CMS’s contingency planning will assure the timely and smooth implementation of the exchanges by October 2013 cannot yet be determined.”
That about sums up the whole report––CMS has been outwardly optimistic but is clearly struggling to make the deadlines.

While the GAO report gives us a clear sense of where CMS was as of about May, we are now essentially in the dark again. As the GAO report says, whether the exchanges will be ready or not now depends upon key dates between May and October.

Why can’t the administration build upon this report and keep us informed?

Some opponents of “ObamaCare” will take satisfaction in the problems the Obama administration is having getting this thing launched.

Let’s be clear, even if the launch has to be delayed or is just a mess at the start, this will eventually get launched and the Affordable Care Act will be central to the health insurance and health care system for years to come––under the best scenario for Republicans they won’t be able to repeal or fundamentally change the law until after Obama leaves office.

But, Democrats do need to be concerned about what a messy launch would mean to them in the November elections.

Health insurers, and proponents of the law, need to be worried about what a messy launch would do toward the goal of getting the healthy to sign up for coverage. If the healthy stay away from the exchanges out of concerns for administrative problems that could undermine the financial sustainability of the insurance reforms.

You can access the full report here.

You can also access the companion report on the small business (SHOP) exchanges here.

Source:  Health Policy & Market Blogspot

Obama Administration May Be Enlisting NBA To Help With ACA Marketing

Following Wednesday’s news that Enroll America was set to launch its multi-million campaign to educate the uninsured about the Affordable Care Act, several publication, mostly out of the beltway, carry reports on other ACA-related campaign efforts. Receiving the most coverage is news that the White House is reportedly seeking the assistance of a high profile sports league. As the Washington Times Share to FacebookShare to Twitter (6/20, Chasmar) reports, the Obama Administration is trying to enlist the NBA’s help in selling the Affordable Care Act to the public. It is not yet known if “a potential marketing partnership would put big-name players at the center of ad campaigns” or if it would involve marketing materials linking the NBA with provisions of the law. So far, CMS officials have declined to comment on the report.

Politico Share to FacebookShare to Twitter (6/20, Cheney) notes that the news, “revealed recently by Massachusetts officials who have been in contact with the administration, offers a glimpse at how President Barack Obama’s team plans to push the new coverage options to a public that largely has been clueless about the new health insurance options.”

The Hill Share to FacebookShare to Twitter (6/20, Viebeck) “Healthwatch” blog reports that while declining to comment, an HHS official said, “We are speaking with a wide range of potential partners and organizations about our efforts to inform Americans of the opportunity to enroll in quality, affordable coverage in the health insurance marketplaces.”