Wednesday, July 15, 2015

ACA 2016 Maximum Out of Pocket Limit and CDH Plans

Recent guidance issued by the trilogy of Affordable Care Act (ACA) compliance and enforcement -Departments of Labor/Treasury/Health Human Services; could have a major impact on many of the Consumer Driven Health Plans (CDHPs) currently in force, starting in 2016. In short, the recently published guidance (released in the form of an FAQ) indicates that the annually published ACA out of pocket maximums affect so called aggregate family deductibles that are a part of many CDHPs. CDHPs that utilize embedded family deductibles and grandfathered plans would not be impacted by the change. Here’s what all of this means…

Wednesday, July 8, 2015

Supreme Court Rulings Affecting Employee Benefits

The Supreme Court of the United States (SCOTUS) recently issued separate rulings affecting the health insurance and employee benefits sectors. The “King v. Burwell” decision assures that health insurance subsidies will continue to be provided to eligible individuals in all states, even those that don’t have a “state based health insurance exchange”. And the “Obergefell v. Hodges” ruling held that state laws (in 14 states) banning same sex marriages were unconstitutional. While the former ruling affecting ACA subsidies will primarily assure continuation of previously implemented aspects of the law, and prevent what could have been serious disruption, chaos, and premium rate impact; the later ruling will require examination of, and changes to many policies and procedures. Here’s a brief overview of the more pertinent areas deserving attention…