MONDAY, OCTOBER 13, 2014
While the Patient Protection and Affordable Care Act (also known as the "ACA" or "Obamacare") brought about some positive changes to our healthcare system, it has also stirred up some changes that are less than positive for many Americans.
Before the ACA took effect, approximately 86% of Americans were covered by some form of health insurance including individual or employer plans, Medicare, Medicaid, or a host of others. Of the remaining 14%, a certain number of people living in the US are not eligible for Obamacare. The primary goal of the new law was to make health insurance affordable and available to those who are uninsured and eligible - less than 10% of Americans. Of this eligible group, many were not insured because they couldn't afford health insurance and others were not insured because they simply did not want to purchase insurance.
Most Americans are now aware that the burden of making insurance affordable to this eligible but uninsured group of Americans has come at the expense of the 86% who were insured and happy with their insurance. There are also numerous hidden taxes that have and will be coming into effect to cover the cost of government subsidized health insurance and the broadened Medicaid program.
The first wave of major changes took effect on January 1, 2014. Individuals were mandated to purchase health insurance and the ACA specified the plans that had to be made available to individuals and families - either on the HealthCare.gov website or by going directly to insurance companies. Because of this, many insured on INDIVIDUAL health insurance plans found they were not able to keep the plan they had, and many insurance companies were forced to cancel all of their policyholders and offer completely new plans that met the new government requirements. Many who had been insured found their premiums to be higher AND that their out-of-pocket costs within the plan were much higher.
The second wave of major changes had been scheduled to take effect on January 1, 2015 - when the small business mandate was to take effect. This change may affect the largest group of people in the country - more than the group of individuals or those employed by large businesses. The effective date of this mandate has been pushed back until 2016 and many believe the primary reason was to avoid a new level of angst to Americans just prior to the mid-term elections.
Another thing that has been quietly changed behind the scenes is the open enrollment period to purchase health insurance for the 2015 calendar year. October 15 had been the date for open enrollment to begin but, with elections on November 4, the date has been pushed back until November 15, 2014. USA Today has an interesting article on this, titled "Obamacare is in Hiding Until After the Election". You may recall that, prior to 2014, a person could purchase health insurance at any time. With limited exception, Obamacare allows only a window of time that will run from November 15, 2014 to February 15, 2015 to purchase health insurance for the 2015 calendar year.
We're all hoping that the enrollment process will function more smoothly this year. If you have questions or need health insurance contact us online or call us at 800-220-5582.
Image source: vitasamb2010 / freedigitalphotos.net
WEDNESDAY, JULY 3, 2013
While the PPACA (Patient Protection and Affordable Care Act, aka "Obamacare") has many positive attributes, the new law's complexity and countless rules are certain to cause a degree of angst to many employers. Remember, the PPACA law fills more than 2,700 pages and has various components that will phase in between the time it was passed in March, 2010 and 2020.
Many new responsibilities are placed on employers regardless of whether or not the business offers health insurance to its employees. One example is the requirement to provide a notice to employees by October 1, 2013 that provides information about the Health Insurance Marketplace Coverage Options. The Department of Labor has two sample forms that can be used, one for employers that do not offer health insurance, and the other for employers that do offer health insurance. The samples can be found in the Employee Security Benefits Administration' s section of the Department of Labor's website: http://www.dol.gov/ebsa/healthreform/.
Employers need to be diligent in learning all they can about the PPACA and how it affects their business. The law affects nearly all businesses - both for-profit and non-profit. There are even requirements for small businesses that fall below "50 full time equivalent" threshold that mandates an employer to offer "affordable" health insurance that meets "minimum value" standards to its "full time employees and their dependents". Businesses should consult their insurance professional, attorney and accountant to begin planning for 2014.
With respect to insurance, the PPACA may affect more than just the health insurance a business provides for its employees, such as Errors & Omissions (E&O), Employment Practices Liability (EPL), Employee Benefits Liability (EBL) and Directors' & Officers Liability (D&O). Now would be a good time to review these policies with your insurance professional to determine if coverage may need to be adjusted.
The professionals at INSURANCE PLANNING SERVICE are here to answer questions you may have regarding your health insurance or other lines of your business insurance. Contact us on the web or call us at 800-220-5582 today!
FRIDAY, DECEMBER 21, 2012
Last Friday marked the deadline for states to declare whether they will establish and run their own health insurance exchanges under the Patient Protection and Affordable Care Act (PPACA). In all, 18 states and the District of Columbia declared their intentions to operate their own state exchanges and submitted the required applications to federal officials.
Health insurance exchanges are seen by many observers as the centerpiece of the PPACA. These are the online marketplaces for individuals and employers to purchase coverage through preapproved qualified health plans with specific levels of covered benefits. In addition, the exchanges will be used to determine eligibility for new subsidies for taxpayers with incomes of up to 400% of the poverty level, as well as Medicaid and the Children’s Health Insurance Program.
The Department of Health and Human Services must now approve, conditionally approve or deny applications submitted by the 19 jurisdictions:
- District of Columbia
- New Mexico
- New York
- Rhode Island
These decisions must be made no later than Jan. 1, 2013. Each exchange must be ready for open enrollment on Oct. 1, 2013, and fully operational on Jan. 1, 2014.
HHS has already granted conditional approval for Colorado, Connecticut, the District of Columbia, Kentucky, Massachusetts, Maryland, New York, Oregon and Washington to run their own exchanges. The other states seeking approval to operate their own exchanges have made varying levels of progress in enacting necessary legislation and satisfying the requirements imposed on exchanges by the PPACA.
It is possible that the applications of at least some states will be denied.
Most states have chosen not to pursue the establishment of a state-based exchange, so the federal government will establish an exchange in these remaining states and in any jurisdiction whose application is denied by HHS.
The states that have elected not to create exchanges cite a variety of reasons for their decision, such as a lack of clear guidance from the federal government and the prohibitive cost associated with running an exchange. For many states, the bigger issue was the political liability of appearing to comply with an unpopular law.
These states may establish their own exchanges at a later date. However, there is a one-year waiting period before one will be permitted to be operational.
States with federally operated exchanges have the option of performing plan management and/or consumer assistance functions for the exchanges, under the “partnership exchange” model. Or, they may allow the federal government to operate the exchange without any significant state involvement through the “federally-facilitated exchange” model.
States that intend to cooperate with HHS on the operation of a partnership exchange must submit an application for approval by Feb. 15, 2013.
Several states—including Arkansas, Delaware, Illinois, Iowa, Michigan, North Carolina and West Virginia—appear likely to seek such approval to operate one or both of the areas of responsibility available to states under the partnership model.
Source: Independent Agent Magazine
FRIDAY, JUNE 29, 2012
Countless opponents and critics of the Patient Protection and Affordable Care Act were hoping that at least certain elements of the law would be struck down, but [yesterday's] U.S. Supreme Court decision means the sweeping health care reform measure remains the law of the land.
Congress may revisit, revise or repeal the law at some future time, but many constituencies are either already facing the effects of the law or will soon be impacted.
Many agents and brokers, for example, are already feeling the adverse effects of the PPACA’s medical loss ratio requirements. The MLR mandates contained in the reform law have forced many health insurers to dramatically reduce compensation paid to producers. Additionally, many of these professionals have been compelled to reduce the range of services they provide or leave the health marketplace altogether.
As agents are forced to reduce or eliminate the level of service and advocacy that they provide, consumers will likely pay the price.
The PPACA’s state health insurance exchange requirements are among the measure’s most notable provisions and are likely to become the object of significant attention in the weeks to come. State policymakers across the country must quickly decide whether to create their own exchanges or allow the federal government to establish and run these new marketplaces.
Many states—perhaps optimistic that the justices would eliminate the need to act—delayed any meaningful action or decision-making on these issues pending the Supreme Court’s decision.
State exchanges must be fully operational by Jan. 1, 2014, but state officials must assess how they will move forward in the very near future. States that wish to operate their own exchanges when the requirements take effect in 2014 must show that they will be operationally ready for the initial open enrollment period that begins Oct. 1, 2013, and secure approval from the Department of Health and Human Services in the coming months. A state seeking to operate its own exchange in plan year 2014 must submit an application to HHS for consideration by Nov. 16.