Insurance & Medical Industry News

It may be a nice gesture to a parting employee to pay COBRA as part of the severance package…unfortunately, under the ACA, you run the risk of doing the employee harm!!

Compliance Employee Benefits Healthcare Reform Large Employers Small Employers

Individuals are eligible to enroll in individual medical insurance outside of the annual Open Enrollment period if they experience a qualifying event. Loss of your company’s group medical insurance upon termination would be considered such a qualifying event and the former employee could enroll in individual coverage within 60 days. In some cases, the former…

October 2, 2014

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What is the Medical Loss Ratio (MLR) regulation and how is it helping to control your group medical rates?

Employee Benefits Healthcare Reform Individual Insurance Large Employers Small Employers

The Affordable Care Act requires health insurance carriers to submit information regarding the proportion of premium spent on clinical services and quality improvement, also known as the Medical Loss Ratio (MLR). It also requires them to issue rebates to enrollees if they do not spend at least 80% or 85% of premium dollars on medical…

October 2, 2014

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Employers required to report to IRS on group medical offerings! The WHO, WHAT, WHEN, HOW…

Compliance Healthcare Reform Large Employers

WHO: Employers with 50 of more FTE’s (remember, that means full-time equivalents, NOT number of full-time employees) WHAT: File forms 1094-C and 1095-C. The IRS created draft forms so you may review the information you will be required to provide 1095-C, 1094-C, draft instructions. WHEN: “There is no filing requirement for 2014; employers may file…

October 2, 2014

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Wellness outcomes schmoutcomes

Healthcare Reform In the News Large Employers Small Employers Wellness

The jury is still out on the ROI of various wellness program strategies, measurability and time frame of results. Some studies show a reduction in the number and size of claims mainly as a result of disease management programs. While other studies show great protection against shock claims by instituting biometric screening, exercise programs and…

July 18, 2014

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Hobby Lobby

Employee Benefits Healthcare Reform In the News Large Employers Small Employers

It’s hard to say whether Hobby Lobby is becoming more famous or infamous as a result of the recent contraceptive decision. In addition, the political argument has been twisted in many interesting ways in the media. Although some media outlets report that Hobby Lobby will not cover contraception for it’s employees, the methods of contraception…

July 18, 2014

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“I’ve had to reduce my waiting period because of Health Care Reform. So, what’s the story with this new 30 day Orientation Period that I can add to the waiting period and when can that start?”

Compliance Employee Benefits Healthcare Reform

“On June 20, 2014, the Departments of Labor (DOL), Health and Human Services (HHS) and the Treasury released new final regulations on application of the 30-day orientation period under the 90-day waiting period limit, [60 days in California]. The proposed regulations had provided that one month be the maximum allowed length of of any reasonable…

July 18, 2014

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Businesses are re-evaluating spousal coverage

Compliance Employee Benefits Healthcare Reform In the News Large Employers Small Employers

As employers continue to look for ways to control the cost of group medical insurance, the topic of spousal coverage is coming up more frequently. Each company views the issue differently and will implement different strategies. Some strategies include: eliminating spousal coverage offering spousal coverage but requiring spouses with access to medical insurance through their…

July 18, 2014

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Large employers, please read about the 27 reporting requirements of PPACA

Compliance Employee Benefits Healthcare Reform Large Employers

This is information you will need to know for reporting as a large employer under PPACA, also known as Obamacare, ACA and the Patient Protection and Affordable Care Act.

27 PPACA Reporting Obligations

July 18, 2014

Now your medical insurance plan covers pediatric dental and vision. So, should your employees remove their children from your dental and vision plan?

Employee Benefits Healthcare Reform Individual Insurance Large Employers Small Employers

The answer to this question depends, as it always does, on the needs of your employees’ families. Certainly, an employee may save money on a monthly premium basis by covering children only under the dental and vision coverage through the medical insurance plan. However, there can still be gaps in coverage and the children will…

July 18, 2014

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VERY IMPORTANT NEWS FOR SMALL EMPLOYERS!

Employee Benefits Healthcare Reform In the News Small Employers

Small employers with group medical renewals later this 2014 year, mostly Q4, will have the option to keep their current plan for another 12 month period. Prior to the recent passage of SB 1446, the ‘grandmothering’ bill signed by Governor Jerry Brown, small employers renewing in 2014 were required to change to new ACA compliant…

July 18, 2014

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