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Tag: Health Insurance Marketplace

Five Myths About the ACA and Midsize Businesses

ACA and Midsize Businesses: Many businesses are struggling to understand and comply with the rules of the Affordable Care Act (ACA). Here are five common myths* midsize group clients (51-100 employees) may need your help with to understand:

· Myth #1: Our business is exempt from the Affordable Care Act’s employer mandate
Companies with more than 100 full-time employees must provide health insurance to full-time workers starting this year. In 2016, your employer clients with 51-100 full-time workers also will have to provide coverage.

· Myth #2: Most businesses of our size don’t provide health insurance today
The ACA requires your midsize employer groups to change their existing coverage. But, only a small percentage will be offering coverage for the first time.

· Myth #3: Even if we are penalized for not providing coverage, we can deduct the penalty on our income taxes
Companies that fail to comply with the employer mandate are subject to a penalty. But the mandate is set up as a shared responsibility fee. This makes the penalty a tax that cannot be deducted for federal income tax purposes.

· Myth #4: We can continue to offer a limited benefit or mini-med plan
Limited benefit plans do not meet ACA rules, so any midsize group clients currently offering these types of plans will need to upgrade their coverage to meet the employer mandate.

· Myth #5: We will have to buy our insurance from a government website
The Small Business Health Options Program (SHOP) is the online Health Insurance Marketplace, or exchange, for businesses. But, let your clients know that using the exchange is optional. Employers can come to you at no extra cost and buy directly from an insurance company.

Read the full article here.

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.

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Administration Announces Proposal to Clarify Availability of Health Insurance Marketplace Coverage to Workers Eligible for COBRA

The Obama administration today announced updates to model notices informing workers of their eligibility to continue health-care coverage through the Consolidated Omnibus Budget Reconciliation Act. The updates make it clear to workers that if they are eligible for COBRA continuation coverage when leaving a job, they may choose to instead purchase coverage through the Health Insurance Marketplace.

“In many cases, workers eligible for COBRA continuation coverage can save significant sums of money by instead purchasing health insurance through the Marketplace,” said Assistant Secretary of Labor for Employee Benefits Security Phyllis C. Borzi. “COBRA continues to play an important role in helping workers and families maintain coverage after a job loss, and it is important that workers know that in some cases there is a Marketplace option as well.”

Workers and their families who are eligible for employer-sponsored coverage generally must be informed of their right to COBRA continuation coverage at the start of employment. They must also be informed of their right to purchase COBRA coverage when separating from a job. The proposed changes to the model notices would offer information on more affordable options available through the Marketplace, where workers and families may be eligible for financial assistance that would not otherwise be available for COBRA continuation coverage. In most cases, workers and their families eligible for, but not enrolled in, COBRA continuation coverage would be able to enroll in Marketplace coverage outside of the normal open enrollment period.

“We are pleased that the Marketplace is providing affordable health insurance options to consumers,” said Centers for Medicare & Medicaid Services Administrator Marilyn Tavenner. “With over eight million enrollees, we know that the Marketplace is working and is providing consumers with additional choices and control over their health care.”

The Departments of Labor, Health and Human Services, and Treasury are also publishing frequently asked questions related to the proposed changes to model notices.

The FAQs are posted on the Department of Labor website at http://www.dol.gov/ebsa/faqs/faq-aca19.html and the HHS website at http://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/aca_implementation_faqs19.html.

In addition, HHS is publishing a clarifying bulletin regarding a special enrollment period in the Marketplace for individuals already enrolled in COBRA continuation coverage.

The bulletin is posted on the HHS website at http://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/SEP-and-hardship-FAQ-5-1-2014.pdf.

The updated model notices are posted on the Department of Labor website at:  http://www.dol.gov/ebsa/modelgeneralnotice.doc and http://www.dol.gov/ebsa/modelelectionnotice.doc.

A related notice of proposed rulemaking on the COBRA notice requirements will be published in the May 7 edition of the Federal Register.

The notice of proposed rulemaking can also be viewed here at http://www.dol.gov/ebsa/pdf/cobranprm.pdf.

Read full news release article here.

Read proposed rules document 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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