Quality health plans & benefits Healthier living Financial well-being Intelligent solutions

Size: px
Start display at page:

Download "Quality health plans & benefits Healthier living Financial well-being Intelligent solutions"

Transcription

1 Quality health plans & benefits Healthier living Financial well-being Intelligent solutions Understanding how the health insurance providers fee and transitional reinsurance contribution will affect you Health care reform update for insured and self-funded health plans (7/13)

2 Understanding the industry-wide fee and contribution that affect health plans The Affordable Care Act (ACA) includes a number of provisions that impact insured and self-funded health benefits and health insurance plans. As additional regulatory guidance has become available we have shared information with you. In that spirit, this communication is focused on two of the four ACA-mandated taxes and fees that are expected to directly impact health plans going forward. Health insurance providers fee (HIP fee) Transitional reinsurance contribution (RC) This flyer will help you understand: What each tax is about Which plans are affected How much each fee is and the expected cost to plans Who pays the fees When we expect each fee to affect Aetna plans 2

3 Health insurance providers fee What is it? One key component of the ACA is to make sure everyone has access to health insurance. As a result, an estimated 29 million to 33 million people will enter the insurance market in Many of these new entrants are lower-income families and individuals who may not have coverage today and who will receive federal subsidies toward the purchase of insurance. The ACA established a fee to help fund these subsidies. The fee will be assessed on health insurers beginning in 2014 and will not expire unless federal legislative changes are made. Because the new federal fee will impact the cost of plans going forward, we feel it s important for you to understand this fee. By doing so, you can better anticipate and plan for the expected impacts. Which plans? How much? The federal government will collect these amounts from health insurers to pay for the subsidies 2014: $8 billion 2015 and 2016: $11.3 billion 2017: $13.9 billion 2018: $14.3 billion Years after 2018: preceding year amount increased by the rate of annualized premium growth Under the current law, the fee has no expiration date. Given that this fee will be assessed only on insured health plans, the Secretary of the Treasury, through the IRS, will determine the amount of the fee due from each health insurer based on net premiums written for U.S. health risks, and bill each carrier annually. HIP fee applies to most forms of health insurance This includes: Insured new business and renewals Grandfathered and non-grandfathered plans The federal government will determine the amount to be collected, based on each insurer s portion of total premiums that are affected by the fee. The table below represents our assumptions of what is likely to be included in and excluded from the fee calculation, taking into account the statutory language and proposed regulations issued in March HIP fee applies to* Covering U.S.** health risks including medical, dental and vision Covering U.S. citizens and U.S. residents Covering individuals located in the United States (only during the location period) Federal Employee Health Benefit Plans (FEHBP) Medicare Advantage and Medicare Part D Medicaid risk Self-insured MEWAs (Multiple Employer Welfare Associations) HIP fee does not apply to* Self-funded business Medicare Supplemental Disability and/or accident-only coverages Long-term care Coverage for specific diseases if offered as independent non-coordinated benefits Hospital indemnity/other fixed indemnity insurance Stop Loss EAP/disease management/wellness Vital Savings by Aetna HRAs integrated with insured health coverage (no additional fee; fee applies to related medical coverage) *Based on our assumption. **U.S. defined as U.S. states, D.C., Puerto Rico and the U.S. possessions. 3

4 Here s how independent analysts estimate the HIP fee Research conducted by the National Federation of Independent Businesses (NFIB)* in November 2011 suggests that insurance premiums will increase by 2 percent to 3 percent as a result of this fee. The former director of the Congressional Budget Office, Douglas Holtz-Eakin, conducted a study in March 2011** suggesting premium increases of 2.4 percent to more than 3 percent. A letter from the Joint Committee of Taxation to Arizona Senator Jon Kyl in June 2011*** stated, estimated premiums would decrease by 2.0 percent to 2.5 percent if this fee is repealed. A study published by Oliver Wyman in October 2011 found that the HIP fee will, when fully implemented, increase the average cost of family coverage by $530 in the small group market, and $550 in the large group market. Who pays? Health insurance issuers are responsible for paying the fee The Secretary of the Treasury will determine the amount of the fee due from each health insurance issuer and bill each issuer annually. The total annual fee is allocated to each insurer based on its share of aggregated affected premiums. The fee is assessed only on insured health risks, not self-funded plans. When? Our 2014 assessment, which will be payable no later than September 30, 2014 will be spread across all customers whose policies include coverage for some portion of the 2014 calendar year. The extent to which premiums are affected by the HIP fee depends on the fraction of the 12-month policy period that represents 2014 coverage. Your renewal package or plan proposal will include details about how much the fee will impact your specific plans. * Effects of the PPACA Health Insurance Premium Tax on Small Businesses and Their Employers. Michael J. Chow, NFIB Research Foundation, November 9, Available at: Accessed June 17, ** Higher Costs and the Affordable Care Act: The Case of the Premium Tax. Douglas Holtz-Eakin, American Action Forum, March 9, Available at: Accessed June 17, *** A copy of the letter is available at: Kyl pdf. Accessed June 17,

5 Transitional reinsurance contribution (RC) What is it? Under the ACA, health insurance issuers and self-funded group health plans are required to make contributions to raise funds for transitional nonprofit reinsurance entities that will help offset the costs of high-risk individuals in the individual market. The contributions will be in effect from January 1, 2014, through December 31, The RC applies to both insured and self-funded plans. Insured: Beginning with new business and renewal effective dates of February 1, 2013, we will recover the contribution amount through health plan premiums. Self-funded: Each self-funded plan is responsible for collecting and remitting the contribution to the federal government. A self-funded plan can request a third-party administrator (TPA, such as Aetna) to collect and remit the contribution on its behalf. Contributions owed to the U.S. Department of Health and Human Services (HHS) will be collected on an annual basis. Further clarification on excluded plans Expatriate coverage will be excluded from the RC, but we need to wait for HHS to issue further guidance as to the definition of expatriate health coverage. While the RC applies in general to employer-provided health coverage, it does not apply to members for whom the employer-provided coverage pays secondary to Medicare. Additional excluded plans: coverage that consists solely of benefits for prescription drugs; integrated HRAs; HSAs; FSAs; as well as employee assistance plans (EAPs), disease management and wellness programs to the extent they do not provide major medical coverage. Which plans? The RC applies to insured and self-funded plans Insured new business and renewals Grandfathered and non-grandfathered plans Self-funded group health plans The table below represents our assumptions of what is likely to be included in and excluded from the fee calculation, taking into account the final regulations issued in March RC applies to* All major medical products: Insured plans (policies written by U.S.-licensed** insurance companies) Self-funded group health plans Grandfathered plans and non-grandfathered plans State and local government employee plans Federal Employee Health Benefit Plans (FEHBP) RC does not apply to* Medicare Advantage and Medicare Part D Medicaid State Children s Health Insurance Program (SCHIP) Medicare Supplement and similar group supplemental coverage Stop Loss Excepted benefits: --Disability and/or accident-only coverages --Benefits offered separately: limited-scope dental, limited-scope vision, long-term care --Specified disease/illness if offered as independent, non-coordinated benefits --Hospital indemnity/other fixed indemnity insurance *Based on our assumption. **U.S. defined as U.S. states, D.C., Puerto Rico and the U.S. possessions. 5

6 How much? The contributions will be in effect from January 1, 2014, through December 31, 2016 The ACA set an aggregate amount for the overall industry contribution under the transitional reinsurance program. The most recent guidance set the total RC to be collected over the three-year period 2014 through $12 billion in 2014 $8 billion in 2015 $5 billion in 2016 HHS determines the contribution amount on a per capita basis for health insurers and self-funded plan sponsors Under final regulations adopted in March 2013, the contribution amount will be expressed as a per capita rate. The national contribution payment for 2014 will be $63 annually per covered life, or $5.25 monthly per covered life for both insured and self-funded plans.* Insured plans Insurer contributions will be based on the national per capita contribution rate released by HHS, multiplied by insured plan lives subject to the contribution. The fee applies to member months in 2014, but premiums are level throughout the policy year, which (except for policies issued or renewed in January) spans two different calendar years. In order to collect the RC for all policies that cover 2014 risks, we are building this fee into any policy year that includes coverage for Self-funded plans Each self-funded plan s contribution will be based on the national per capita contribution rate released by HHS, multiplied by the self-funded plan s lives subject to the contribution. --Form 5500 Method (using an average of the number of covered lives filed with the U.S. Department of Labor for the last applicable plan year). As reported on the Form 5500, add the total number of participants at the beginning of the policy year with the total number of participants at the end of the year and divide by 2. The regulations state that aggregate enrollee data is needed; state-by-state enrollee breakdown is not required. For customers maintaining two or more group health plans that collectively provide major medical coverage for the same covered lives, the plans may be regarded as one group health plan for determining the RC amount. Customers can retrieve information about their Aetna covered lives from Aetna Health Information Advantage (AHIA). AHIA is available to all self-funded customers with at least 100 members covered by a medical or pharmacy plan administered by Aetna. We will provide the membership counts only for Aetna membership. This standard service is available at no charge and enables customers as well as authorized consultants and brokers to access plan membership information. AHIA can be accessed at Your renewal package or plan proposal will include details about how much the fee will impact your specific plans. Enrollment is calculated using either a daily, monthly or quarterly average of the first 9 months of the year, extrapolated to the full 12 months of The actual enrollment in the fourth quarter of each year will not be factored into the enrollment calculation. HHS has proposed the following counting methods: --Actual Count Method. Add the total number of covered lives for each day of the first nine months of the benefit year and divide by the total number of days in the first nine months. --Snapshot Count Method. Add the number of covered lives on any date or dates during the same corresponding month in each of the first three quarters of the benefit year. Then divide the total by the number of dates on which a count was determined. The date used for each quarter must be consistent. *In addition, if a state decides to operate their own reinsurance program there may be an additional state assessment. 6

7 Who pays and when? Health insurance issuers pay for insured plans. Insurers are required to remit payment to the federal government annually, within 30 days of receiving the annual invoice, which is expected to be issued around December 15. Self-funded plans are responsible for collecting and remitting the contribution to the federal government. The self-funded group health plan s role and the timing and frequency of payments On March 1, 2013, HHS released a final rule that provided, in part, additional guidance on the transitional reinsurance program for self-funded group plans. Third-party administrators (TPAs, such as Aetna) are not legally obligated to collect and remit the RC on behalf of self-funded group health plans. Each self-funded group health plan is responsible for collecting and remitting the RC to HHS. In addition, each self-funded group health plan is responsible for reporting annual enrollment counts. This report is due November 15. The RC is due in one annual payment, instead of quarterly as previous guidance had suggested. HHS will provide an invoice to each self-funded group health plan by December 15 or 30 days after the government receives the annual enrollment count, whichever is later. Self-funded plan sponsors can ask TPAs to report annual enrollment counts as well as collect and remit the RC on behalf of the plan. 7

8 Find more information on our website Visit where you can learn more about the ACA, its many requirements, and how Aetna is preparing for the changes ahead. The website includes: Detailed descriptions of many provisions of the law, including those that are already in effect and those that will take effect between now and 2018 Answers to the most common questions on the law and its requirements Our vision for creating a sustainable health care system We hope you ll find the information on the site helpful. Aetna is the brand name used for products and services provided by one or more of the Aetna Group of subsidiary companies, including Aetna Life Insurance Company (Aetna). This information is not intended to be legal or tax advice and should not be construed as such. The intent is to provide information only. Consult with your legal counsel and tax experts for legal and tax advice. If you have questions about Aetna health plans, contact your Aetna account representative. Health benefits and health insurance plans contain exclusions and limitations. Information in this document is believed to be accurate as of the publication date; however, it is subject to change. For more information about Aetna plans, visit Aetna Inc (7/13)

Quality health plans & benefits Healthier living Financial well-being Intelligent solutions

Quality health plans & benefits Healthier living Financial well-being Intelligent solutions uality health plans & benefits Healthier living Financial well-being Intelligent solutions Understanding how the Health Insurer Fee and Transitional Reinsurance Contribution will impact you Health care

More information

Self-funded Employer s Guide. Transitional Reinsurance Fee and Patient-Centered Outcomes Research Institute Fee

Self-funded Employer s Guide. Transitional Reinsurance Fee and Patient-Centered Outcomes Research Institute Fee Self-funded Employer s Guide Transitional Reinsurance Fee and Patient-Centered Outcomes Research Institute Fee To fund some of the changes mandated by the Affordable Care Act (ACA), several new taxes and

More information

Transitional reinsurance program results in significant new costs for group health plans

Transitional reinsurance program results in significant new costs for group health plans Transitional reinsurance program results in significant new costs for group health plans The Department of Health and Human Services (HHS) has issued additional guidance on the three-year transitional

More information

PCORI & Reinsurance Fees Keeping Them Straight

PCORI & Reinsurance Fees Keeping Them Straight June 18, 2013 Author: Christine L. Keller, Mark C. Nielsen, Vivian Hunter Turner, Brigen L. Winters If you have questions, please contact your regular Groom attorney or any of the Health and Welfare attorneys

More information

Transitional Reinsurance Program Fees

Transitional Reinsurance Program Fees Transitional Reinsurance Program Fees Submission of Annual Enrollment and Contributions The Patient Protection and Affordable Care Act (Affordable Care Act) fundamentally changed the way health insurance

More information

Frequently Asked Questions Affordable Care Act (ACA) Taxes: Reinsurance Tax and Insurer Tax May 16, 2013

Frequently Asked Questions Affordable Care Act (ACA) Taxes: Reinsurance Tax and Insurer Tax May 16, 2013 Frequently Asked Questions Affordable Care Act (ACA) Taxes: Reinsurance Tax and Insurer Tax May 16, 2013 Background: One of the goals of the Affordable Care Act (ACA) is to ensure that everyone involved

More information

Reinsurance and other fees could impact employer health care costs

Reinsurance and other fees could impact employer health care costs Reinsurance and other fees could impact employer health care costs To help offset the cost of coverage expansion and other provisions, the Patient Protection and Affordable Care Act (ACA) imposes a number

More information

INTERNATIONAL MEDICAL ADMINISTRATORS, INC. (IMA) Important Notice: ACA s Transitional Reinsurance Fee and Self Insured Plans

INTERNATIONAL MEDICAL ADMINISTRATORS, INC. (IMA) Important Notice: ACA s Transitional Reinsurance Fee and Self Insured Plans INTERNATIONAL MEDICAL ADMINISTRATORS, INC. (IMA) Important Notice: ACA s Transitional Reinsurance Fee and Self Insured Plans Under the Affordable Care Act (ACA), your group health plan is required to pay

More information

INTERNATIONAL MEDICAL ADMINISTRATORS, INC. (IMA)

INTERNATIONAL MEDICAL ADMINISTRATORS, INC. (IMA) INTERNATIONAL MEDICAL ADMINISTRATORS, INC. (IMA) Important Notice: ACA s PCORI Fee and Self Insured Plans Under the Affordable Care Act (ACA), your group health plan is required to pay a Patient Centered

More information

ACAP Guide to ACA Fees and Taxes for Health Insurers

ACAP Guide to ACA Fees and Taxes for Health Insurers Introduction ACAP Guide to ACA Fees and Taxes for Health Insurers Since being signed into law in March of 2010, the Patient Protection and Affordable Care Act (ACA) has introduced a wide range of health

More information

ESTIMATED PREMIUM IMPACTS OF ANNUAL FEES ASSESSED ON HEALTH INSURANCE PLANS OCTOBER 31, 2011 CHRIS CARLSON, FSA, MAAA

ESTIMATED PREMIUM IMPACTS OF ANNUAL FEES ASSESSED ON HEALTH INSURANCE PLANS OCTOBER 31, 2011 CHRIS CARLSON, FSA, MAAA ESTIMATED PREMIUM IMPACTS OF ANNUAL FEES ASSESSED ON HEALTH INSURANCE PLANS OCTOBER 31, 2011 CHRIS CARLSON, FSA, MAAA CONTENTS 1. Executive summary... 1 2. Background... 2 3. Data... 4 Base premiums...

More information

AHIP Comments to House Ways and Means Committee Work Groups Urging Repeal of the ACA Health Insurance Tax

AHIP Comments to House Ways and Means Committee Work Groups Urging Repeal of the ACA Health Insurance Tax AHIP Comments to House Ways and Means Committee Work Groups Urging Repeal of the ACA Health Insurance Tax April 12, 2013 I. Introduction America s Health Insurance Plans (AHIP) is the national trade association

More information

Health care reform for large businesses

Health care reform for large businesses FOR PRODUCERS AND EMPLOYERS Health care reform for large businesses A guide to what you need to know now DECEMBER 2013 CONTENTS 2 Introduction Since 2010 when the Affordable Care Act (ACA) was signed into

More information

IRS Issues Proposed Regulations on Research Fees

IRS Issues Proposed Regulations on Research Fees IRS Issues Proposed Regulations on Research Fees The Affordable Care Act (ACA) created the Patient-Centered Outcomes Research Institute (Institute) to help patients, clinicians, payers and the public make

More information

www.thinkhr.com AFFORDABLE CARE ACT SMALL EMPLOYER HEALTH REFORM CHECKLIST

www.thinkhr.com AFFORDABLE CARE ACT SMALL EMPLOYER HEALTH REFORM CHECKLIST www.thinkhr.com AFFORDABLE CARE ACT SMALL EMPLOYER HEALTH REFORM CHECKLIST Employers that provide health coverage to employees are responsible for complying with many of the provisions of the Affordable

More information

What s News in Tax Analysis That Matters from Washington National Tax

What s News in Tax Analysis That Matters from Washington National Tax What s News in Tax Analysis That Matters from Washington National Tax Health Insurance Companies and Employers: There s a New Fee to Consider A new fee may apply to issuers of health insurance policies

More information

Affordable Care Act (ACA) Violations Penalties and Excise Taxes

Affordable Care Act (ACA) Violations Penalties and Excise Taxes Brought to you by The Insurance Exchange Affordable Care Act (ACA) Violations Penalties and Excise Taxes The Affordable Care Act (ACA) includes numerous reforms for group health plans and creates new compliance

More information

The Transitional Reinsurance Program Operational Guidance: Counting Method Examples for Contributing Entities

The Transitional Reinsurance Program Operational Guidance: Counting Method Examples for Contributing Entities DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services Center for Consumer Information and Insurance Oversight 200 Independence Avenue SW Washington, DC 20201 Date: July 17, 2014

More information

The Impact on Business

The Impact on Business The Impact on Business Affordable Care Act Reform addresses access to coverage not healthcare cost or population health ACA passed in 2010. The Supreme Court upheld ACA in 2012 and President Obama was

More information

IRS ISSUES GUIDANCE ON CADILLAC TAX

IRS ISSUES GUIDANCE ON CADILLAC TAX Issue One Hundred One March 2015 IRS ISSUES GUIDANCE ON CADILLAC TAX March 30, 2015 The Cadillac tax is scheduled to take effect in 2018. It will apply to employers or insurance carriers that sponsor plans

More information

www.thinkhr.com 877-225-1101 Employer Health Reform Checklist

www.thinkhr.com 877-225-1101 Employer Health Reform Checklist www.thinkhr.com 877-225-1101 Employer Health ThinkHR grants the reader non-exclusive, non-transferable, and limited permission to use this document. The reader may not sell or otherwise use this document

More information

Health Care Reform Provision Plans/Insurers Impacted Effective Date What Employers Should be Doing Now

Health Care Reform Provision Plans/Insurers Impacted Effective Date What Employers Should be Doing Now Health Care Reform 2013 & 2014 Planning 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

More information

o The bipartisan Joint Committee on Taxation says that eliminating the tax would reduce family premiums. 2

o The bipartisan Joint Committee on Taxation says that eliminating the tax would reduce family premiums. 2 The Health Insurance Tax Will Hurt. The new health insurance tax will increase the cost of health care benefits, harming those who need help the most: small businesses, families who work for a small business

More information

HHS Final Rule on Transitional Reinsurance Fee Adds to Employer Costs

HHS Final Rule on Transitional Reinsurance Fee Adds to Employer Costs HHS Final Rule on Transitional Reinsurance Fee Adds to Employer Costs March 2013 A transitional reinsurance fee is being added to the penalties and taxes imposed on employers and their fully insured and

More information

P4P Preparing for PPACA. Session #15: Traps for the Unwary: Open PPACA Issues Heading into 2013-2014 September 20, 2012

P4P Preparing for PPACA. Session #15: Traps for the Unwary: Open PPACA Issues Heading into 2013-2014 September 20, 2012 P4P Preparing for PPACA Session #15: Traps for the Unwary: Open PPACA Issues Heading into 2013-2014 September 20, 2012 4980H Determining Full-Time Status Two just-released notices Notice 2012-58 and Notice

More information

AFFORDABLE CARE ACT LARGE EMPLOYER HEALTH REFORM CHECKLIST. Edition: November 2014

AFFORDABLE CARE ACT LARGE EMPLOYER HEALTH REFORM CHECKLIST. Edition: November 2014 AFFORDABLE CARE ACT Employers that offer health care coverage to employees are responsible for complying with many of the provisions of the Affordable Care Act (ACA). Most health reform changes apply regardless

More information

COMPLIANCE ADVISOR. 2014 Affordable Care Act Compliance Checklist

COMPLIANCE ADVISOR. 2014 Affordable Care Act Compliance Checklist COMPLIANCE ADVISOR August 2013 2014 Affordable Care Act Compliance Checklist IN THIS ISSUE: 1 2 3 4 5 6 7 8 9 10 11 12 Grandfathered Plan Status Confirmation No Annual Dollar Limits on Essential Health

More information

AFFORDABLE CARE ACT SMALL EMPLOYER HEALTH REFORM CHECKLIST HR COMPLIANCE CENTER

AFFORDABLE CARE ACT SMALL EMPLOYER HEALTH REFORM CHECKLIST HR COMPLIANCE CENTER AFFORDABLE CARE ACT Employers that provide health coverage to employees are responsible for complying with many of the provisions of the Affordable Care Act (ACA). Provisions take effect on staggered dates

More information

HEALTH REFORM AND MULTIEMPLOYER PLAN COVERAGE 2014 AND BEYOND

HEALTH REFORM AND MULTIEMPLOYER PLAN COVERAGE 2014 AND BEYOND WWW.BKLAWYERS.COM HEALTH REFORM AND MULTIEMPLOYER PLAN COVERAGE 2014 AND BEYOND ABA SECTION OF LABOR AND EMPLOYMENT LAW EMPLOYEE BENEFITS COMMITTEE MID- WINTER MEETING 201 BLITMAN & KING LLP Franklin Center,

More information

Health Care Reform: A Guide for Self-Funded Plans. Key steps to prepare for 2014 Preparing for the future Snapshot of reform (2010-2019)

Health Care Reform: A Guide for Self-Funded Plans. Key steps to prepare for 2014 Preparing for the future Snapshot of reform (2010-2019) Health Care Reform: A Guide for Self-Funded Plans Key steps to prepare for 2014 Preparing for the future Snapshot of reform (2010-2019) Table of Contents Health Care Reform is Here: Are you ready? 3 Key

More information

Health Policy Essentials: Private Health Insurance. Bernadette Fernandez, Annie Mach, & Namrata Uberoi February 13, 2015

Health Policy Essentials: Private Health Insurance. Bernadette Fernandez, Annie Mach, & Namrata Uberoi February 13, 2015 Health Policy Essentials: Private Health Insurance Bernadette Fernandez, Annie Mach, & Namrata Uberoi February 13, 2015 Briefing Agenda What is the purpose of private health insurance (PHI)? How is PHI

More information

Important Effective Dates for Employers and Health Plans

Important Effective Dates for Employers and Health Plans Brought to you by Sullivan Benefits Important Effective Dates for Employers and Health Plans On March 23, 2010, President Obama signed the health care reform bill, or Affordable Care Act (ACA), into law.

More information

2015-2016: What You Need To Know About The Affordable Care Act

2015-2016: What You Need To Know About The Affordable Care Act 2015-2016: What You Need To Know About The Affordable Care Act A nonprofit independent licensee of the Blue Cross Blue Shield Association National strength. Local focus. Individual care. SM We are committed

More information

Important Effective Dates for Employers and Health Plans

Important Effective Dates for Employers and Health Plans Brought to you by Krempa Associates, Inc. Important Effective Dates for Employers and Health Plans On March 23, 2010, President Obama signed the health care reform bill, or Affordable Care Act (ACA), into

More information

AFFORDABLE CARE ACT LARGE EMPLOYER HEALTH REFORM CHECKLIST. Edition: October 2015

AFFORDABLE CARE ACT LARGE EMPLOYER HEALTH REFORM CHECKLIST. Edition: October 2015 AFFORDABLE CARE ACT Employers that offer health care coverage to employees are responsible for complying with many of the provisions of the Affordable Care Act (ACA). Most health reform changes apply regardless

More information

Self-insured Plans under Health Care Reform

Self-insured Plans under Health Care Reform Brought to you by Good Neighbor Insurance Self-insured Plans under Health Care Reform The Affordable Care Act (ACA) includes numerous reforms affecting the health coverage that employers provide to their

More information

Important Effective Dates for Employers and Health Plans

Important Effective Dates for Employers and Health Plans Brought to you by Hipskind Seyfarth Risk Solutions Important Effective Dates for Employers and Health Plans On March 23, 2010, President Obama signed the health care reform bill, or Affordable Care Act

More information

Self-insured Plans under Health Care Reform

Self-insured Plans under Health Care Reform Brought to you by Cottingham & Butler Self-insured Plans under Health Care Reform The Affordable Care Act (ACA) includes numerous reforms affecting the health coverage that employers provide to their employees.

More information

to Health Care Reform

to Health Care Reform The Employer s Guide to Health Care Reform What you need to know now to: Consider your choices Decide what s best for you Follow the rules 2013-2014 Health care reform is the law of the land. Some don

More information

Health Care Reform Management Alert Series Roadmap of Plan Changes Needed For Upcoming Plan Years

Health Care Reform Management Alert Series Roadmap of Plan Changes Needed For Upcoming Plan Years Health Care Reform Management Alert Series Roadmap of Plan Changes Needed For Upcoming Plan Years Seyfarth Shaw has generously given permission to Lawyers Alliance for New York to circulate this chart

More information

THE AFFORDABLE CARE ACT AND YOU. An Overview for Large Groups

THE AFFORDABLE CARE ACT AND YOU. An Overview for Large Groups THE AFFORDABLE CARE ACT AND YOU An Overview for Large Groups TABLE OF CONTENTS Find Answers to Your Questions About Employer Mandate... 3 Access to Coverage... 5 Coverage Changes... 7 Health and Wellness

More information

AFFORDABLE CARE ACT SMALL EMPLOYER HEALTH REFORM CHECKLIST

AFFORDABLE CARE ACT SMALL EMPLOYER HEALTH REFORM CHECKLIST AFFORDABLE CARE ACT SMALL EMPLOYER Employers that offer health care coverage to employees are responsible for complying with many of the provisions of the Affordable Care Act (ACA). Most health reform

More information

Affordable Care Act Implementation

Affordable Care Act Implementation Affordable Care Act Implementation August 2012 Small Business Employers Disclaimer This document is designed to provide a general overview of portions of the health reform law - Affordable Care Act. It

More information

The Patient Protection and Affordable Health Care Act and the Health Care and Education Reconciliation Act of 2010

The Patient Protection and Affordable Health Care Act and the Health Care and Education Reconciliation Act of 2010 The Patient Protection and Affordable Health Care Act and the Health Care and Education Reconciliation Act of 2010 Important Provisions for IAAPA Members May 24, 2010 The health care reform bill which

More information

EXPLAINING HEALTH CARE REFORM: Risk Adjustment, Reinsurance, and Risk Corridors

EXPLAINING HEALTH CARE REFORM: Risk Adjustment, Reinsurance, and Risk Corridors EXPLAINING HEALTH CARE REFORM: Risk Adjustment, Reinsurance, and Risk Corridors As of January 1, 2014, insurers are no longer able to deny coverage or charge higher premiums based on preexisting conditions

More information

IRS Issues Second Notice to Assist in Developing Cadillac Tax Regulations

IRS Issues Second Notice to Assist in Developing Cadillac Tax Regulations IRS Issues Second Notice to Assist in Developing Cadillac Tax Regulations The IRS has issued its second notice regarding the upcoming implementation of the Patient Protection and Affordable Care Act s

More information

Selected Employer Provisions in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010

Selected Employer Provisions in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 Selected Employer Provisions in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 This chart outlines, in depth, selected provisions in the Patient

More information

Reporting Requirements for Employers and Health Plans

Reporting Requirements for Employers and Health Plans Brought to you by Cross Employee Benefits Reporting Requirements for Employers and Health Plans The Affordable Care Act (ACA) created a number of federal reporting requirements for employers and health

More information

Employer s guide to health care reform requirements

Employer s guide to health care reform requirements Employer s guide to health care reform requirements June 2015 edition As the Affordable Care Act (ACA) continues to be implemented, you ll need to remain aware of the policies and provisions that affect

More information

Keeping up with the new health care reform law. Helping you better understand what to expect and when to expect it. anthem.com/ca 14376CAEENABC 8/10

Keeping up with the new health care reform law. Helping you better understand what to expect and when to expect it. anthem.com/ca 14376CAEENABC 8/10 Keeping up with the new health care reform law Helping you better understand what to expect and when to expect it. 14376CAEENABC 8/10 anthem.com/ca 1 Staying up to date Here s a timeline of what you can

More information

Legislative Brief: 2015 COMPLIANCE CHECKLIST. Laurus Strategies

Legislative Brief: 2015 COMPLIANCE CHECKLIST. Laurus Strategies Laurus Strategies Legislative Brief: 2015 COMPLIANCE CHECKLIST The Affordable Care Act (ACA) has made a number of significant changes to group health plans since the law was enacted over four years ago.

More information

STATE OF OREGON DEPARTMENT OF CONSUMER & BUSINESS SERVICES INSURANCE DIVISION. Quarterly Health Enrollment Report Instructions Revised April 16, 2015

STATE OF OREGON DEPARTMENT OF CONSUMER & BUSINESS SERVICES INSURANCE DIVISION. Quarterly Health Enrollment Report Instructions Revised April 16, 2015 Page 1 of 10 STATE OF OREGON DEPARTMENT OF CONSUMER & BUSINESS SERVICES INSURANCE DIVISION Quarterly Health Enrollment Report Instructions Revised April 16, 2015 A. HISTORY AND PURPOSE Since 1996, the

More information

MEMORANDUM. Affordable Care Act (ACA) Action Items for Supplemental Benefit Funds to Consider

MEMORANDUM. Affordable Care Act (ACA) Action Items for Supplemental Benefit Funds to Consider 333 West 34th Street New York, NY 10001-2402 T 212.251.5000 F 212.251.5490 www.segalco.com MEMORANDUM To: From: Lynette Metz Lawrence Singer, Karen Johnson Date: July 19, 2013 Re: Affordable Care Act (ACA)

More information

Introduction. Affordable Care Act Overview of Changes

Introduction. Affordable Care Act Overview of Changes Introduction Affordable Care Act Overview of Changes Presented by: Tim Dillingham, CLU Benefit Resource Group, Inc. 201 E Broad Street, Suite 1 Linden, MI 48451 810-735-6500 810-735-6610 (fax) tim@benefitresourcegroup.net

More information

Christy Tinnes, Brigen Winters and Christine Keller, Groom Law Group, Chartered

Christy Tinnes, Brigen Winters and Christine Keller, Groom Law Group, Chartered Preparing for Health Care Reform A Chronological Guide for Employers This Article provides an overview of the major provisions of health care reform legislation affecting employers and explains the requirements

More information

Health Insurance Providers Fee; Procedural and Administrative Guidance. This notice provides guidance for fee year 2016 on how the definition of

Health Insurance Providers Fee; Procedural and Administrative Guidance. This notice provides guidance for fee year 2016 on how the definition of Part III Administrative, Procedural, and Miscellaneous Health Insurance Providers Fee; Procedural and Administrative Guidance Notice 2016-14 SECTION 1. PURPOSE This notice provides guidance for fee year

More information

Health Care Reform How it Will Affect Employers and their Group Health Plans. Benecon Comments and Observations

Health Care Reform How it Will Affect Employers and their Group Health Plans. Benecon Comments and Observations Health Care Reform How it Will Affect Employers and their Group Health Plans This Health Care Reform Summary applies to all employers (including government and church plans) that provide health coverage

More information

Initial proposed guidance now available on Cadillac tax for higher cost health coverage

Initial proposed guidance now available on Cadillac tax for higher cost health coverage Vol. 16, 078 March 18, 2015 EY Payroll NewsFlash Initial proposed guidance now available on Cadillac tax for higher cost health coverage Currently, qualified employer group health coverage is generally

More information

Health Care Reform Frequently Asked Questions

Health Care Reform Frequently Asked Questions Health Care Reform Frequently Asked Questions On March 23, 2010, President Obama signed federal health care reform into law, also known as the Patient Protection and Affordability Act. A second, or reconciliation

More information

The Reformed New World of Health Insurance Exchanges. Arthur Lerner Barbara Ryland

The Reformed New World of Health Insurance Exchanges. Arthur Lerner Barbara Ryland The Reformed New World of Health Insurance Exchanges Arthur Lerner Barbara Ryland Introduction State Insurance Exchanges are a key component of the health reform legislation What are the Exchanges? What

More information

This notice requests public comments on the implementation of provisions of the

This notice requests public comments on the implementation of provisions of the Part III Administrative, Procedural, and Miscellaneous Request for Comments on Funding of Patient-Centered Outcomes Research Through Fees Payable by Issuers of Health Insurance Policies and Self-Insured

More information

Affordable Care Act FAQs

Affordable Care Act FAQs Note: This material is not intended to serve as legal advice and only constitutes Delta Dental s opinion on the subject matter contained herein based on its own review of available guidance. Delta Dental

More information

GUIDE TO HEALTH CARE REFORM S TAX PENALTIES

GUIDE TO HEALTH CARE REFORM S TAX PENALTIES The GUIDE TO HEALTH CARE REFORM S TAX PENALTIES Calculate Your Health Insurance Tax Penalty 2 Introduction The Affordable Care Act (ACA) requires certain employers and employees to purchase health insurance

More information

Health care reform at-a-glance. December 2013

Health care reform at-a-glance. December 2013 December 2013 Employer mandate Play or pay penalty for failing to offer coverage to at least 95% of all full-time employees (FTE) and children if any FTE gets subsidy in exchange $2,000 (indexed) times

More information

90-day Waiting Period Limit

90-day Waiting Period Limit Brought to you by Higginbotham 90-day Waiting Period Limit For plan years beginning on or after Jan. 1, 2014, the Affordable Care Act (ACA) prohibits group health plans and group health insurance issuers

More information

National Health Insurance Reform

National Health Insurance Reform JANUARY2011 National Health Insurance Reform Impact Year by Year With the passage of National Health Insurance Reform it is crucial that employers and plan sponsors have clear information about the impact

More information

Bankers Insurance, LLC Your Health Care Reform Partner

Bankers Insurance, LLC Your Health Care Reform Partner Bankers Insurance, LLC Your Health Care Reform Partner Are you in compliance with health care reform regulations? We can help you stay on top of health care reform to avoid penalties from legislative briefs

More information

Health Care Reform. Employer Action Overview

Health Care Reform. Employer Action Overview Health Care Reform Page 1 of 6 Health Care Reform Immediatemmediate Employer Action Required Notes Employers must provide a reasonable break time for employees who are nursing mothers to express breast

More information

Effective dates for provisions of the PPACA are spread out from 2010 through 2018. This document focuses on 2013 and 2014.

Effective dates for provisions of the PPACA are spread out from 2010 through 2018. This document focuses on 2013 and 2014. As part of our ongoing initiative to provide added value to our customers, this health care reform summary is being provided on an information only basis. This is NOT a legal document and is not intended

More information

Year-end Checklist for 2015 Compliance

Year-end Checklist for 2015 Compliance Brought to you by Fringe Benefit Plans, Inc. / (407) 862-5900 Year-end Checklist for 2015 Compliance The Affordable Care Act (ACA) has made a number of significant changes to group health plans since the

More information

The Small Business Health Care Tax Credit Kit

The Small Business Health Care Tax Credit Kit The Small Business Health Care Tax Credit Kit About the Small Business Health Care Tax Credit Kit This Kit is designed to assist small employers in understanding the Small Business Health Care Tax Credit,

More information

Managing Health Care Reform Benefit Changes within your Own Organization

Managing Health Care Reform Benefit Changes within your Own Organization ICCMHC Winter Conference February 17, 2011 Managing Health Care Reform Benefit Changes within your Own Organization John F. Gause, President jgause@apexbg.com Overview Health Care Reform - Short Term Impact

More information

Health Reform. Employer Penalty Delay: What are the Consequences? Impact of the Delay on Employers

Health Reform. Employer Penalty Delay: What are the Consequences? Impact of the Delay on Employers Health Reform Employer Penalty Delay: What are the Consequences? Martin Haitz (484) 270-2575 martin.haitz@marcumfs.com Issued date: 07/29/13 The employer penalty provisions and two reporting requirements

More information

Patient Protection and Affordable Care Act of 2009: Health Insurance Exchanges

Patient Protection and Affordable Care Act of 2009: Health Insurance Exchanges Patient Protection and Affordable Care Act of 2009: Health Insurance Exchanges Provision Notes Standards SUBTITLE D AVAILABLE COVERAGE CHOICES FOR ALL AMERICANS PART I Establishment of Qualified Health

More information

Effects of the PPACA Health Insurance Premium Tax on Small Businesses and Their Employees: An Update

Effects of the PPACA Health Insurance Premium Tax on Small Businesses and Their Employees: An Update Effects of the PPACA Health Insurance Premium Tax on Small Businesses and Their Employees: An Update Michael J. Chow March 19, 2013 The 2010 healthcare law contains a tax on the health insurance policies

More information

Proposed Rule: Health Insurance Providers Fee

Proposed Rule: Health Insurance Providers Fee Proposed Rule: Health Insurance Providers Fee Description: This document contains proposed regulations that provide guidance on the annual fee imposed on covered entities engaged in the business of providing

More information

Tax Practice Group. Business Tax Provisions of the Health Care Reform Act. May 2010

Tax Practice Group. Business Tax Provisions of the Health Care Reform Act. May 2010 May 2010 Business Tax Provisions of the Health Care Reform Act For more information, contact: Wayne Pressgrove +1 (404) 572 2722 wpressgrove@kslaw.com John Sweet +1 (212) 827 4382 jsweet@kslaw.com John

More information

Affordable Care Act FAQs

Affordable Care Act FAQs Note: This material is not intended to serve as legal advice and only constitutes Delta Dental s opinion on the subject matter contained herein based on its own review of available guidance. Delta Dental

More information

GRANDFATHERED STATUS FACT SHEET

GRANDFATHERED STATUS FACT SHEET GRANDFATHERED STATUS FACT SHEET INFORMED ON REFORM This Fact Sheet reflects the interim final regulations published by the Departments of Health & Human Services (HHS), Labor and Treasury on June 14, 2010

More information

Global Health Care Update

Global Health Care Update Global Health Care Update March/April 2013 This bimonthly Update summarizes recent legislative developments and trends related to health care and highlights recently passed and pending legislation that

More information

Employer Reporting of Health Coverage Code Sections 6055 & 6056

Employer Reporting of Health Coverage Code Sections 6055 & 6056 Brought to you by Hickok & Boardman HR Intelligence Employer Reporting of Health Coverage Code Sections 6055 & 6056 The Affordable Care Act (ACA) created new reporting requirements under Internal Revenue

More information

Your guide to health care reform provisions

Your guide to health care reform provisions Your guide to health care reform provisions February 2014 edition Since the Patient Protection and Affordable Care Act (PPACA) was enacted in March 2010, businesses have been impacted by federal health

More information

Answers about. Health Care REFORM. for your business

Answers about. Health Care REFORM. for your business Answers about Health Care REFORM for your business Since the time of its enactment in 2010, the health care reform law has remained controversial at least in part due to a constitutional challenge to the

More information

Coinsurance A percentage of a health care provider's charge for which the patient is financially responsible under the terms of the policy.

Coinsurance A percentage of a health care provider's charge for which the patient is financially responsible under the terms of the policy. Glossary of Health Insurance Terms On March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act (PPACA) into law. When making decisions about health coverage, consumers should

More information

Health Care Reform Impacts Grandfathered Employer-Sponsored Group Health Plans: Now What?

Health Care Reform Impacts Grandfathered Employer-Sponsored Group Health Plans: Now What? April 2010 EMPLOYEE BENEFITS & EXECUTIVE COMPENSATION UPDATE Health Care Reform Impacts Grandfathered Employer-Sponsored Group Health Plans: Now What? This bulletin discusses certain provisions of The

More information

Health Care Reform Update

Health Care Reform Update Beginning in 2018, the Patient Protection and Affordable Care Act imposes an excise tax on high-cost health plans. In addition to being a way to raise revenue for the government, the reason for this provision

More information

Affordable Care Act (ACA) Frequently Asked Questions

Affordable Care Act (ACA) Frequently Asked Questions Grandfathered policies Q1: What is grandfathered health plan coverage? A: The interim final rule on grandfathering under ACA generally defines grandfathered health plan coverage as coverage provided by

More information

Financial Management 101

Financial Management 101 Financial Management 101 DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS for MEDICARE & MEDICAID SERVICES Center for Consumer Information and Insurance Oversight State Exchange Grantee Meeting The material

More information

Health insurance Marketplace. What to expect in 2014

Health insurance Marketplace. What to expect in 2014 Health insurance Marketplace What to expect in 2014 Overview The Affordable Care Act (ACA) includes several provisions geared to extend greater access to health insurance benefits to more people. Beginning

More information

Health Care Reform New Restrictions on Tax-Favored Health Coverage for HRAs, FSAs, Premium Payment or Reimbursement Plans, and Cafeteria Plans

Health Care Reform New Restrictions on Tax-Favored Health Coverage for HRAs, FSAs, Premium Payment or Reimbursement Plans, and Cafeteria Plans Caring For Those Who Serve 1901 Chestnut Avenue Glenview, Illinois 60025-1604 1-800-851-2201 www.gbophb.org November 21, 2013 [updated July 29, 2015] Health Care Reform New Restrictions on Tax-Favored

More information

Health Insurance Providers Fee; Procedural and Administrative Guidance

Health Insurance Providers Fee; Procedural and Administrative Guidance Part III Administrative, Procedural, and Miscellaneous Health Insurance Providers Fee; Procedural and Administrative Guidance Notice 2015-29 SECTION 1. PURPOSE This notice provides guidance on how the

More information

Health care reform at-a-glance. August 2014

Health care reform at-a-glance. August 2014 Health care reform at-a-glance August 2014 Employer mandate Shared responsibility payment for failing to offer coverage to at least 95%* of all fulltime employees (FTE) and children if any FTE gets subsidy

More information

The Patient Protection and Affordable Care Act What Employers need to know

The Patient Protection and Affordable Care Act What Employers need to know The Patient Protection and Affordable Care Act What Employers need to know Presented by: Misty Baker mbake@iiat.org 800-880-7428 This update is based on the known provisions of the PPACA. This is not to

More information

HHS Issues FAQs on Essential Health Benefits

HHS Issues FAQs on Essential Health Benefits Brought to you by Employer Flexible HHS Issues FAQs on Essential Health Benefits The Patient Protection and Affordable Care Act (PPACA or Affordable Care Act) will require non-grandfathered health insurance

More information

Little-Noticed HIPAA Regulations Create New Burdens for Employers

Little-Noticed HIPAA Regulations Create New Burdens for Employers Little-Noticed HIPAA Regulations Create New Burdens for Employers Earlier this month the federal government released new regulations which could affect an employer's health plans, if those health plans

More information

Legislative Brief: COMPREHENSIVE HEALTH COVERAGE ESSENTIAL HEALTH BENEFITS PACKAGE

Legislative Brief: COMPREHENSIVE HEALTH COVERAGE ESSENTIAL HEALTH BENEFITS PACKAGE Laurus Strategies Legislative Brief: COMPREHENSIVE HEALTH COVERAGE ESSENTIAL HEALTH BENEFITS PACKAGE The Affordable Care Act (ACA) requires non grandfathered health insurance plans in the individual and

More information