Supreme Court to Hear Subsidies Case
Employee Benefit Advisors blogged Oct 9, 2013 and July 7, 2014 about court cases that had been falling under the radar. EBA said “These cases could dismantle health care reform as we know it.” Friday, Nov 7, 2014, the Supreme Court announced that they will take up the challenges to whether subsidies should be available […]
1 Month Orientation & 90 Day Waiting Periods
For plan years beginning in 2015, employers may require an employee to satisfy a one-month orientation/evaluation period in addition to a 90 day waiting period before he or she becomes eligible for benefits. The orientation period must be a reasonable and bonafide employment-based condition of eligibility in a position that is otherwise eligible for coverage […]
Voting? – Average Health Premiums “Skyrocketed” After ACA
The Washington Times is reporting that a new study of insurance policies before and after the implementation of the Affordable Care Act “shows that average premiums have skyrocketed, for some groups by as much as 78 percent.” Average premiums for the 23-year-old demographic rose “dramatically,” with men in that age group seeing a 78.2 percent […]
Useful App: Medfax (Listed as One of the Best New Apps)
Need an independent, unbiased source of medical information about doctors, drugs, medical devices and hospitals? MedFax can be used to verify doctors, prescription drugs, medical devices and hospitals. It provides reports that allow consumers to make well-informed decisions regarding their healthcare. One of the largest information sources of its kind, MedFax has combined and cross-referenced […]
Section 125 Plans Allow Additional Mid-Year Changes
The IRS announced two new situations in which a participant may revoke his or her cafeteria plan election in order to purchase coverage through a marketplace (Exchange) established under the ACA. These provisions do not apply to FSAs. Change is permitted provided: Employee Enrolls in Marketplace Coverage The employee is eligible for a special enrollment period […]
New Preventive Care Services Schedule Now Available
Interim Final Rules related to the coverage of preventive services under the Patient Protection and Affordable Care Act (PPACA) were recently published. A complete list of required preventive services is available from the U.S. Department of Health and Human Services. The following is a partial listing of preventive services required to be covered under Health […]
COBRA – Good News for Employers trying to Manage Loss Ratios
Employee’s eligible for Cobra can opt for “Marketplace coverage” instead of COBRA. Employees and their families eligible for, but not enrolled in, COBRA continuation insurance are able to enroll in Marketplace coverage outside of the normal open enrollment period, in most cases. It’s very possible employees eligible for COBRA continuation coverage could save on their […]
Fraud? – HDHP 50% Prompt-Pay Discount
Scenario: Employee has a HDHP and goes to Hospital. Hospital offer to discount the employee’s deductible by 50%. (i.e. Employee owes only half of the deductible, $3,000 debt is now $1,500.) The plan pays the full amount due above the deductible. Has fraud been committed (knowingly or not)? It is fraud because there’s a 3rd […]
W2 vs 1099 Worker – ACA Regulations make it Important to Get It Right
July 16th we blogged IRC 60566/6056 “will prove to be the most cumbersome and costly part of Obamacare.” We wrote: “Employers with part-time, seasonal and variable hour workers (someone working for a company with different job functions/classifications, thus hours under two different pay codes) will particularly have difficulties and will need a managed solution. This makes […]
What Makes a Great EAP?
Most employers now believe Employee Assistance Programs (EAP) are important elements in their total compensation and benefits offerings. They know the equation: by helping employees identify and solve personal concerns, EAPs create the opportunity for employees to focus and perform at their highest levels. The return for employers is proven time and again by staff […]