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Here are some headlines you’re nor hearing unless you’re paying really close attention to the ACA (Affordable Care Act), aka Obamacare.

12 failed co-ops which were created under the Affordable Care Act could cost taxpayers $1.2 billion – Four of the remaining co-ops created under the Affordable Care Act are experiencing weak enrollment, which is another indication that the startups remain on shaky ground. Data show these four co-ops have not yet signed up a minimum of 25,000 members, a crucial threshold which allows them to cover costs.

UnitedHealthcare to Drop Obamacare Exchanges in most states by 2017 – UHC expects to loose $650mm this year.

Despite ACA, Patients Still Subject To Surprise Medical Bills – Surprise medical bills happen most often in an ER visit when a hospital contracts with medical providers – including doctors, surgeons, anesthesiologists, lab technicians – that do not accept the same insurance plans the hospital does.

The maximum out-of-pocket costs will rise – Consumers can expect to pay more for healthcare costs. OOP expenses will rise to $7,150 for an individual / $14,300 for a family. Placing a significant financial burden on middle-income Americans who need a substantial amount of care.

State Medicaid Agencies Want Congress to Repeal ACA Insurance Tax – Medicaid agencies want lawmakers to permanently repeal the tax on health insurers. The article says “most private health insurance plans have had to pay the tax themselves,” but “states that contract with Medicaid managed-care plans have had to cover the premium tax to ensure that the health plans receive actuarially sound rates.” Some 38 states and Washington, DC contract with Medicaid managed-care plans.

HealthCare.gov Continues To Be Vulnerable To Hackers – The GAO reports that security flaws ‘will likely continue to jeopardize the confidentiality, integrity and availability of HealthCare.gov.

It’s been six years since the ACA was signed into law. How’s it going?

Employee Benefit Advisors provides employee benefits, tax-advantaged healthcare, compliance guidance for ACA and Health & Welfare DOL Audits, and PEO Advisory & Consulting Services. We can customize a wellness plan for your budget and culture.

Sixty-four year-old grandfathers incur nine times more medical expenses than their eighteen year-old grandsons. But under small group ACA adjusted community rating, their health premiums can be no more than three times the cost charged to their second generation progeny, who now pay more to subsidize their forefathers.

Female rates have always been within the 3:1 age ratio due to the expenses of childbearing years. So the major impact of ACA adjusted community rating falls on the cost of young men.

The ACA also eliminated health risk rating for small groups. Thus small employer groups composed chiefly of young male or healthy employees are paying much higher health premiums than necessary to cover their risk.

Many small employers are migrating from fully-insured plans that are priced by adjusted community rating to partially self-funded plans that are priced for their own employees’ actual age, gender, and health risk profile.

Employee Benefit Advisors can help you with Level Funding, Traditional Self-Funding, and Employer Group Stop Loss Captives. Employee Benefit Advisors provides employee benefits, tax-advantaged healthcare, compliance guidance for ACA and Health & Welfare DOL Audits, and PEO Advisory & Consulting Services.

A special thanks to TCC Benefits Administrators for the content in this blog.