Friday, August 23, 2013

ACA Compliance Strategy – Bare Bones Plan Offerings!

The Wall Street Journal first reported on the concept of “bare-bones”; or “skinny plans in May of this year (2013).
Then just this week (August 25, 2013), Kaiser Health News (KHN) published a story on the idea.
And since I have suggested the strategy to two of our clients to date (and mentioned it to untold numbers of colleagues and prospective clients), I thought I would make it the focus of this week’s blog post. Depending on the employer, the particular situation, or the industry, this strategy has the potential of saving affected employers thousands of dollars per year in associated ACA penalties.

Wednesday, August 21, 2013

ACA Compliance – Understanding Grandfathering and Self Funding

As the 2014 open enrollment season comes to a close (bringing an overwhelming sense of relief and joy to HR professionals and Benefits Brokers/Consultants throughout the land!), I thought I’d review the major Affordable Care Act (ACA) related compliance issues addressed in preparation for the new (benefits) year.
Early plan renewal 12/1/13: Since many of the ACA related changes affect plans on their first plan anniversary date on or after January 1, 2014;, several health insurers offered (and many employers accepted) to change plan anniversary dates to 12/1/13.

Wednesday, August 14, 2013

Understanding the ACA’s Modified Community Rating Requirements

This week’s post is dedicated to explaining one of the many new provisions of the Affordable Care Act (ACA) which is scheduled to be implemented in 2014 – MODIFIED COMMUNITY RATING (MCR for the rest of this blog post). Let me begin by stipulating which stakeholders this provision affects and which it does not:
MCR applies to health insurers in the Individual and non-grandfathered, fully insured, Small Group (less than 50 employees) markets, for plan/policy years effective on or after January 1, 2014.
MCR does NOT apply to large (50+ employees) fully insured groups, and partially self funded health plans of any size. (Note: once large group plans are permitted to be marketed in the exchanges/marketplaces…

Wednesday, August 7, 2013

Obesity is Now Officially a Disease!

– has roughly the same association with chronic illness as 20 years of aging
– is associated with a 36% increase in inpatient and outpatient healthcare spending
– is associated with a 77% increase in medications
– is the number two (2) cause of preventable death in the U.S!!!
But until just recently, obesity was NOT considered a DISEASE. In June of this year (2013), the American Medical Association’s (AMA) House of Delegates voted to officially declare obesity a disease. To quote AMA board member Dr. Patrice Harris,