health insurance
Last week, the U.S. Department of Treasury published final guidance on the Individual Shared Responsibility requirements, also known as the Individual Mandate. The Affordable Care Act (ACA) mandates that most U.S. citizens and permanent residents have a qualified health plan starting in 2014 or face financial penalties.
The House of Representatives, controlled by the Republican Party, voted earlier this month to delay the Individual Mandate by one year. It voted 251-174 in favor of delaying the requirement for most individuals to obtain health insurance until January 1, 2015.
This marks the 38th time that the House has tried to repeal or scale back the Affordable Care Act (ACA).
By this time you have probably already heard that the Employer Mandate has been delayed until 2015. In simple terms, no employer will be penalized in 2014 for failing to offer health insurance (or failing to offer affordable health insurance).
Here are 5 key ACA items for employers to know.
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.
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.
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.
Like the popular television commercials with children explaining their theories on what’s better (when asked if more is better than less), they want more. The concept is that simple. People, in general, do not want to settle for less.
Small businesses want more from a program that is named the Small Business Health Options Program or SHOP exchange. The government, however, has stripped away the “options” (at least for a year). If you’re a worker for a small business employer who is offered the SHOP exchange, you really don’t have anything to “shop” around for.
The Obama administration announced last week that parts of the Small Business Health Options Program (SHOP) would be delayed until 2015. This announcement has created a lot of confusion in the market.
The SHOP will be a new health insurance marketplace to provide exchange-based coverage to small businesses with up to 50 employees in most states. The SHOP is still expected to be launched as planned in 2014, but one of its key components will be delayed until 2015.
The U.S. Department of Health and Human Services (HHS) and the Internal Revenue Service (IRS) have jointly issued rules that define affordable coverage. Employers and employees still have several questions about how this affects penalty calculations and subsidy eligibility.
The following offers some insight on these key issues:
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