Wednesday, February 26, 2014

90 Day Waiting Period Guidelines Issued

Last week (02/20/2014), the ACA’s “trinity” of compliance and enforcement (i.e., departments of Health/Human Services; Labor; Treasury) jointly issued both FINAL and PROPOSED regulations pertaining to the ACA provision addressing new hire waiting period limitations. This week's post will focus primarily on the FINAL regulations.
Let me start by defining what it is that we received guidance on – the so called “90 day waiting period limitation”. The waiting period is the period of time allowed to pass before health insurance coverage can become effective for an otherwise eligible employee (and his/her dependents).

Friday, February 21, 2014

Gallup Healthways Well-Being Grades for 2013

There is an old expression – “Figures don’t lie, liars do figure”. We all rely on data for various purposes, and the health care industry is no exception in its use of data to explain, defend, describe, or refute various measures. In fact, there is a relatively quiet movement underway to establish health care standards to better enable providers to utilize a standardized, “best practices” method of delivering care. If you want to understand this movement better, google – “patient centered outcomes research institute” or PCORI, and check it out. (By the way, the Affordable Care Act (ACA) requires health insurers and self funded plans to fund the PCORI at a rate of $2 per insured member per year in 2014.)

Tuesday, February 11, 2014

Employer Mandate – Delay and Final Regulations

This past Monday (February 10, 2014) the Treasury Department issued long awaited FINAL REGULATIONS pertaining to the Affordable Care Act’s (ACA) “employer mandate”, aka “employer shared responsibility”; or “pay or play”. There is a great deal of information and guidance contained in these regulations, thus, I will not attempt to address all of it in this post. Rather, I’ll provide some of the highlights, and embed some links to direct you to more comprehensive details.
It is imperative that readers/stakeholders understand there are two (2) aspects to this release:
1. A delay of the employer mandate for otherwise affected employers with 50-99 full-time employees until – “the first plan year beginning on or after JANUARY 1, 2016”.

Tuesday, February 4, 2014

ACA Replacement Bill Proposed ~ C.A.R.E. Act

From the time the Affordable Care Act (ACA) was signed into law on March 23, 2010, after having been passed by congress on a 100% partisan basis by the Democrat party, the Republican party has largely expressed opposition to the law. In fact, the Republican controlled House of Representatives has passed upwards of 40 bills seeking to completely repeal the ACA. However these bills never made it to the Democrat controlled Senate floor for a full vote, and thus “died on the vine”. Perhaps no other issue facing our country has seen the level of opposition and discourse than has health care “reform”.