Individuals

Posted October 8th, 2015 in Employers, Producers, Individuals

The open enrollment period (OEP) in the individual market will begin on November 1, 2015 and end on January 31, 2016.

During this time period, just about anyone can enroll or make plan changes to coverage in the individual market.

Here are some helpful reminders as the OEP approaches:

Who is eligible for a subsidy?

There are a number of factors that affect eligibility or can disqualify an individual for a subsidy, such as:

Posted October 7th, 2015 in Producers, Employers, Individuals

On October 1, 2015, the medical industry launched ICD-10 in the U.S.  ICD-10, which stands for the International Classification of Diseases, 10th revision, is a medical classification system adopted by the World Health Organization (WHO). Simply put, it’s an international coding system that requires physicians, hospitals and other medical providers to assign a unique number for every patient disease, diagnosis, abnormal finding, cause of injury, etc.

Posted August 7th, 2015 in Producers, Employers, Individuals
In a perfect world we would all save as much money as we could for retirement, but the reality is the average person has a limited amount they can save for the future. That being said, some Health Savings Account (HSA) advocates are saying employees should consider funding an HSA before a 401(k) or other retirement savings vehicle. Advocates stress that HSAs have one leg up on 401(k) plans because of a triple tax advantage feature.
 
  1. HSA contributions are tax deductible……just like 401(k) contributions.
Posted July 2nd, 2015 in Producers, Employers, Individuals
On June 25, 2015, the Supreme Court of the United States (SCOTUS) ruled 6-3 in favor of the federal government and their ability to provide subsidies in Exchanges. The plaintiffs had contested the federal government’s interpretation of the healthcare law citing language in the Affordable Care Act (ACA) which specifically says subsidies can only be provided by an Exchange “established by the state.”  
 
Posted June 19th, 2015 in Producers, Employers, Individuals

What happens to Health and Dependent Care FSAs when a merger or acquisition occurs?  

 
Of course the Cafeteria Plan regulations do not specify how this should be treated, but the IRS has provided some guidance in the form of Revenue Ruling 2002-32. Fortunately, for employees, the IRS has taken a position that employees should not be punished as a result of a merger or acquisition, and the guidance suggests two possible options that would be acceptable in their eyes. Both options maintain the salary reduction of the employee and preserve the annual election.
Posted June 12th, 2015 in Producers, Employers, Individuals
There’s an interesting story developing in Texas which may have a carryover effect to other states. The Texas House of Representatives and Senate have approved House Bill 1514, which would require the letters “QHP” to be included on ID cards of any health plan purchased through the Exchange. QHP, which stands for Qualified Health Plan, would help doctors and medical providers understand the type of coverage a patient has prior to providing any services.
Posted June 5th, 2015 in Producers, Employers, Individuals
The Supreme Court is expected to rule on the King vs. Burwell case at the end of this month. This is the court case that is challenging whether or not the federal government can provide subsidies to Exchange enrollees in the 37 states in which it operates. Media coverage of the case implies that the judges are evenly split and a ruling could go either way.
Posted June 1st, 2015 in Producers, Employers, Individuals
The Affordable Care Act (ACA) has created a great deal of change in the healthcare market. Individuals, employers, insurers, doctors, hospitals, pharmaceutical companies and many others have all experienced change in one way, shape or form. Next on the list is the restaurant industry, and that’s because the food you eat can have an impact on your overall health.  
 
Posted May 22nd, 2015 in Producers, Employers, Individuals

The Affordable Care Act (ACA) established a maximum out-of-pocket limitation for single and family coverage. The limit established for 2016 is $6,850 for single coverage and $13,700 for family coverage. The Department of Health and Human Services (HHS) issued an FAQ document on May 8, 2015 which indicates a health plan that covers a family cannot impose an out-of-pocket maximum of more than $6,850 for any single family member covered under the plan.

Benefits Buzz

Enter Your Email

Tag Cloud

Archives

Stay Connected