Given the enormous complexity of the Affordable Care Act (ACA), its understandable that theres confusion about the terms used to describe 3 key provisions scheduled to take effect in 2014. They are: Essential Health Benefits (EHB), Minimum Essential Coverage (MEC), and Minimum Value (MV). Each of these provisions has an important impact on employers, employees, and individuals. This week's post defines these terms and describes their impact in 2014 and beyond.
Starting in 2014, all non-grandfathered, fully insured individual and small-group health plans (covering up to 50 people) offered
For years, politicians, policy wonks, and various health insurance stakeholders have debated the merits of how the tax code encourages employer provided coverage, yet seemingly discourages the individual purchase of coverage outside of the workplace.
The primary example of this confounding situation is the fact that health insurance is tax deductible to an employer, yet not so to an individual who purchases coverage on their own, outside of the workplace. There are numerous tax incentives and benefits available to individuals who purchase health insurance, but virtually all of these incentives are attached to the purchase…
Last weeks post revealed the first 5 of my “Top 10 List of ACA Misconceptions”. This week I finish out the Top 10 list with nos. 6 – 10. There's a tremendous amount of information pertaining to the Affordable Care Act (ACA) that must be read, understood, translated, and communicated. I will continue informing and communicating as much as possible on this site; and I encourage readers to reach out to me with questions, comments, and suggestions.
Here are nos. 6 – 10 of my “Top 10 List”…
6. Insurance companies are cancelling certain health insurance policies that are not ACA compliant;
Over the course of the last 3 years, I have had both the honor and pleasure of discussing the Affordable Care Act (ACA) with a number of organizations, clubs, groups, and even a local radio show. Throughout this time, I have encountered a number of misconceptions and misunderstandings relative to several provisions of the law. So I decided to assemble a list of…you guessed it…the top 10 most common ACA misconceptions that I have come across to date. Here are the first 5:
1. The public health insurance marketplace/exchange is the only place to purchase individual health insurance in 2014 that is subject to the various ACA provisions.
Earlier today (11/14/13) the President announced that he will “allow 2014 sales of previously cancelled Individual Health Plans that don’t meet Affordable Care Act (ACA) guidelines”. Administration officials clarified that the exception would only be available to those who have lost their [individual health] insurance coverage. The announcement was lacking many of the details that are necessary in order to move forward with this exception. Among the few details mentioned were that Insurers will…
When people hear or see the acronym IRS they generally do not associate it with gift giving. But that is precisely what the IRS delivered on October 31, 2013 in the form of Notice 2013-71, which allows for a partial carryover of unused FSA funds (click – http://www.irs.gov/pub/irs-drop/n-13-71.pdf). The often cited “use it or lose it” rule deters many otherwise eligible Flexible Spending Account (FSA) enrollees from setting aside funds on a pre-tax basis for future use. However, with the issuance of Notice 2013-71, the IRS is allowing the option of a rollover of up to $500 at the end of the FSA plan year, even for 2013 plan years! This is great news for FSA plan participants and employers alike.
Over the course of the last several years, Consumer Driven Health (CDH) has grown in popularity, and effectiveness, as a way for employers to reduce their health insurance and health care related costs. CDH’s evolution has not come easy or without its detractors. However, both the empirical and anecdotal data collected over the last ten years point to CDH as a proven and effective method of true – “health care reform”! According to the Kaiser Family Foundation (KFF), the number of employers offering CDH plans has jumped from 4% in 2005 to 31% in 2012. KFF also released data indicating the average cost of family coverage is $1,500 less per employee on a CDH plan than a traditional PPO plan.
This weeks post is meant to be sort of a deep breath; or reset on where we’re at with respect to the Affordable Care Act (ACA). Clearly much is being said and written about the law, and in particular, its implementation. Those of us who are charged with explaining and implementing the various requirements of the law don’t have the luxury of questioning its content, complaining about its impact, or bemoaning its “unintended consequences”. Its full speed ahead with implementation and compliance, unless or until Congress, HHS, DOL, CMS, IRS, or someone in a position of authority tells us to STOP; and that is highly unlikely.
As medical costs and insurance premiums continue to escalate, and health care reform poses new and additional cost pressures, employers are seeking innovative ways to reduce the costs associated with group insurance programs. The solution for many employers has been the implementation of some form of self-funding.
SELF-FUNDING ALLOWS THE EMPLOYER TO ASSUME ONLY AS MUCH RISK OR EXPOSURE AS THE COMPANY CAN WITHSTAND, WITHOUT CAUSING FINANCIAL DISTRESS.
Health insurance is comprised of two (2) separate and distinct components of exposure: predictable claims and unpredictable claims.
Last weeks post provided an overview of Health Savings Accounts or HSAs. This weeks post is meant to provide an in depth understanding of the HSAs 1st cousin – the Health Reimbursement Arrangement or HRA.
In June of 2002 the IRS issued an important revenue ruling which created the HRA. The ruling created tremendous flexibility for the use of employer funded dollars set aside to pay for specific health care items. As this week's blog title suggests, HRAs are similar to HSAs, but are actually much more similar to Flexible Spending Accounts (FSAs). However, HRAs have distinct advantages for both employer and employee, over FSAs and HSAs.
