Producers
Section 3210 of the Affordable Care Act (ACA) required nominal cost sharing to be added to Medicare Supplement Plans C & F. Under the current structure these Medicare Supplement plans eliminate nearly all of the cost sharing that is associated with Original Medicare.
It has been a common belief by many people that Plans C & F cause excessive and unnecessary utilization as a result of the limited cost sharing. The expectation was that Section 3210 would modify Plans C & F to include some form of a front-end deductible to encourage more appropriate uses of physician services.
Millions of Americans Countdown to October 1st
Less than 3 months from today marks the start of the 6 month open enrollment period under the Affordable Care Act (ACA). As officials scramble to promote the new healthcare reform enrollment season, we at Flexible Benefit Service LLC (Flex) have been keeping up-to-date with the fluid changes of rules and regulations contained within the growing law.
The U.S. Department of Treasury announced on Tuesday that the Employer Mandate will be delayed until 2015. This rule is also commonly referred to as the Employer Shared Responsibility requirement or the Pay or Play provision.
The Employer Mandate was set to impose financial penalties starting in 2014 on employers with 50 or more full-time equivalent employees that failed to offer health insurance to employees, as well as those employers that offered health insurance that was considered unaffordable.
Most health insurance professionals have some familiarity about the government subsidies that will be available next year to eligible individuals. These subsidies will reduce insurance premiums and out-of-pocket medical expenses for those that qualify, and will only be available to individuals that enroll in coverage through health insurance marketplaces, also known as the public exchanges.
Last week, Senator Ben Cardin (D-MD) and Senator Mike Enzi (R-WY) introduced S 9.66, the Medical FSA Improvement Act, to eliminate the Use-It or Lose-It rule by allowing individuals to cash-out unused Flexible Spending Account (FSA) balances with the amounts treated as taxable income.
View the legislative language >>
What could this mean for Americans?
Most employers will be required to provide a written notification to employees in regards to the ability to access coverage through the new Health Insurance Marketplaces, also known as the exchanges. Even employers that don't provide coverage to their employees will be required to provide this written notification.
The Center for Consumer Information and Insurance Oversight (CCIIO) published guidance on May 1, 2013 about the role of insurance producers in the Health Insurance Marketplaces, also referred to as the public exchanges.
The guidance suggests that insurance producers will play a valuable role in facilitating public exchange enrollments starting this October.
The Center for Medicare and Medicaid Services (CMS) issued a statement on April 30, 2013 that the public exchange applications, officially referred to as the Marketplace Consumer Applications, have been revised.
The Invidual Short Form is now just three pages in length. The Family Form is also said to have been reduced by about two-thirds its original length.
Recent guidance helped clarify some of the confusion about Patient-Centered Outcomes Research Institute (PCORI) fees applicable to Health Reimbursement
Arrangements (HRAs) and Flexible Spending Accounts (FSAs). It was originally thought that the fee would be applicable to all covered lives including spouses and dependents. That is no longer the case in some instances.
What will the exchanges look like? What are the exchange deadlines? How will subsidies and payments be processed? There constantly seems to be questions about the health insurance marketplaces, also known as the exchanges.
The Center for Medicare & Medicaid Services (CMS) released a progress fact sheet about the exchanges on April 22, 2013. This new information provides additional details about eligibility and enrollment, plan management, financial management, consumer support and more.
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