HHS
- The Individual Mandate penalties increase to $695 per adult ($347.50 per child) or 2.5% of household income, whichever is greater.
- The Employer Mandate expands to include all employers who have 50 or more employees.
- The Employer Mandate offer rate increases from 70% to 95%.
- Employer reporting related to the offer of coverage is due for the first time during Q1 2016.
PCORI Fees
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.
On June 26, 2014, the Department of Health and Human Services (HHS) issued proposed regulations on the renewal process for individuals that have purchased health coverage through the Exchange. The regulations aim to streamline the renewal process by auto-enrolling the vast majority of existing members into a health plan for the 2015 plan year.
Applies to those who have started the enrollment process and experienced an error
Last week, the Obama administration released several new Affordable Care Act (ACA) guidelines. Of particular note, any individual or small group with a non-ACA compliant plan will be able to keep that plan in place for additional time.
- The Department of Health and Human Services (HHS) has reported Exchange application submissions have exceeded 3 million.
- The Congressional Budget Office (CBO) has updated 2014 Exchange enrollment estimates to 6 million.
- Some reports are showing that 22,000 Exchange applicants were enrolled in the wrong plan or received a lower subsidy than expected, 15,000 Exchange applications were lost and only 11% of Exchange applicants were previously uninsured.
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