health insurance coverage Archives - Cosby Insurance Group

Reporting of Offers of Health Insurance Coverage by Employers

Information reporting under section 6056 is voluntary for calendar year 2014. Reporting is first required in early 2016 with respect to calendar year 2015. For more information, see question 2.

Basics of Employer Reporting: Questions 1-4
Who is Required to Report: Questions 5-8
Methods of Reporting: Questions 9-13
What Information Must ALE Members Report: Questions 14-16
How and When to Report the Required Information: Questions 17-21. What are the information reporting requirements for employers relating to offers of health insurance coverage under employer-sponsored plans?The Affordable Care Act added section 6056 to the Internal Revenue Code, which requires applicable large employers to file information returns with the IRS and provide statements to their full-time employees about the health insurance coverage the employer offered. (For a definition of applicable large employer, see question 5, below.)Under the regulations implementing section 6056, an applicable large employer may be a single entity or may consist of a group of related entities (such as parent and subsidiary or other affiliated entities). In either case, these reporting requirements apply to each separate entity and each separate entity is referred to as an applicable large employer member (ALE member). See question 7 for more information about the treatment of related entities.The IRS will use the information provided on the information return to administer the employer shared responsibility provisions of section 4980H. The IRS and the employees of an ALE member will use the information provided as part of the determination of whether an employee is eligible for the premium tax credit under section 36B.ALE members that sponsor self-insured group health plans also are required to report information under section 6055 about the health coverage they provide (See our section 6055 FAQs). Those ALE members that sponsor self-insured group health plans file with the IRS and furnish to employees the information required under sections 6055 and 6056 on a single form. The IRS and individuals will use the information provided under section 6055 to administer or to show compliance with the individual shared responsibility provisions of section 5000A.

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Contact Steven G. Cosby, MHSA with questions or to request more information and to schedule a healthcare plan evaluation, savings analysis or group plan solution for your company.

Why Health-Care Reform Might Mean More Jobs, Less Automation

Using technology to automate business processes is a good thing that enhances operational efficiency and drive cost savings, right? Not always. Today’s health-care industry offers a counter-intuitive case in point.

As the Affordable Care Act continues to transform the health-care market, a growing number of health-care insurers are finding that maintaining and upgrading automated claims processing applications is becoming prohibitively expensive. In fact, decreasing automation and increasing investment in personnel can in many cases produce a more cost-efficient outcome.

In recent years, health-care payers have poured significant resources into developing software applications that automate the process of reviewing and processing claims for reimbursement of health-care costs – in some cases achieving auto-adjudication rates approaching 90%. At the time, this approach made sense, and these highly customized legacy systems were proven to be effective in relatively static environments.

Today, of course, it’s a different ballgame: health-care reform is driving fundamental and ongoing changes in regulatory and data reporting requirements. This means the myriad applications involved in auto-adjudication require constant upgrades, which not only drives costs but piles layer upon layer of additional complexity on to already highly customized and heavily engineered systems.

Read the full report here.

Contact Steven Cosby with questions or to request more information and to schedule a healthcare plan evaluation, savings analysis or group plan solution for your company.

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How To Get The Most Out Of Your Health Savings Account

Here are eight tips for getting the most out of your Health Savings Account:

1. Extracting the money from your HSA is as simple as using a checking account. You can receive blank checks, a debit card or both. The debit card may be used for online purchases.

2. You can use an HSA to pay for medications only if you have a prescription for them, including those sold over the counter. The exception is insulin; it doesn’t require a prescription. This rule was part of the Affordable Care Act, also known as Obamacare.

3. Nontraditional medical services, like acupuncture and massages, can qualify as legitimate HSA expenses. They’ll need to be permitted by your high-deductible health plan and you must have a prescription from your doctor, Grossmiller says.

4. Avoid the steep penalty for using your HSA for non-medical expenses before 65. “If you pull the money out before then for anything other than reimbursable expenses, there’s a 20% tax on the amount of the withdrawal,” Huber says.

5. If the IRS audits you about your HSA before age 65, you’ll need to prove the account was used for qualified expenses. To protect yourself, keep receipts for all out-of-pocket health costs and be sure the bills you pay with an HSA meet the IRS test for qualified medical expenses, Grossmiller says.

The complete rules about qualified medical expenses are in IRS Publication 969, but keep in mind that you can’t pay for health insurance premiums or cosmetic surgery out of an HSA.

6. Once you turn 65, you can no longer contribute to an HSA. But you can make penalty-free withdrawals.

7. An HSA is especially worth considering if you’re already maxing out your 401(k)-type plan and IRA.“It’s another avenue to fund a retirement account,” Grossmiller says.

8. Be careful about how you’ll invest your HSA. Employees are typically given an assortment of investment options, much like 401(k)s.

You probably should avoid putting all the money into stocks or equity mutual funds, due to the volatility of the market. “Since the purpose of an HSA is to pay for medical expenses, it is important to balance risk, especially in newer accounts that will have lower balances,” Grossmiller says. The last thing you’ll want is a medical emergency and no money to pay for it.

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Forever 21 Bumps Fraction Of Workforce Below PPACA

The teen-focused clothing maker has cut back all its line workers to 29.5 hours a week in an apparent move to get around the health care benefits trigger of the Patient Protection and Affordable Care Act.

The company didn’t cite the PPACA as the impetus for its decision — quite the opposite. It insisted that the decision was made “independent of the Affordable Care Act.” Rather, it was strictly the result of an internal audit of stores that indicated a new workforce design was needed, it said. As part of its response, Forever 21 also noted that it has promoted and converted 421 part-time store employees to full-time status since March of this year.

Click here to read full article.

How Employees Can Save Money on Health Care Costs

Use these strategies to save money on medical expenses and make smart decisions during open enrollment.

The Kaiser Family Foundation just announced the results of its 2013 annual health benefits survey, which provides a great snapshot of the trends in costs and coverage for employer-based insurance. You can use the foundation’s findings to save money on medical expenses now and to help you make smart decisions during open enrollment this fall, when you choose coverage for next year.

Click here to read full article from Kiplinger’s Kimberly Lankford.

Tag: health insurance coverage

Reporting of Offers of Health Insurance Coverage by Employers

Why Health-Care Reform Might Mean More Jobs, Less Automation

How To Get The Most Out Of Your Health Savings Account

Forever 21 Bumps Fraction Of Workforce Below PPACA

How Employees Can Save Money on Health Care Costs

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