Producers
Each year the Department of Health and Human Services (HHS) issues a set of rules referred to as the “Notice of Benefit and Payment Parameters.” This set of rules generally addresses changes and new requirements that apply to certain provisions of the Affordable Care Act (ACA).
If you have an Illinois producer license, please be aware of the following changes that will apply when renewing your license.
The Illinois Department of Insurance (DOI) recently announced they will no longer mail renewal notices or licenses to producers.
Premium Only Plans (POP) can generally be defined as a type of Cafeteria Plan where the only pre-tax benefit available to employees are for those of insurance premiums. Now, whenever non-taxable benefits are involved, the IRS will usually have some strict rules in place that must be followed. For Cafeteria Plans, these are referred to as non-discrimination rules, and these rules are in place to ensure the plan doesn’t discriminate in favor of highly compensated and/or key employees.
Insurance companies are concerned that some people are abusing the Special Enrollment Period (SEP) that is available in the individual marketplace. They have indicated at least some people are delaying enrollment in coverage until they get sick, applying for coverage only once they need it, and then canceling the coverage after treatment. They further argue that there aren’t enough rules in place to verify if a person actually experienced a qualifying event which would trigger a SEP.
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