#aca – Page 13 – Total Benefit Solutions Inc

Trump’s First Executive Order Addresses the ACA

January 25, 2017January 25, 2017Ed MacConnell

Trump’s First Executive Order Addresses the ACA On January 20, 2017, President Trump issued an Executive Order to minimize the economic burden of the Affordable Care Act (“ACA”). This Order identifies the new administration’s policy for addressing and enforcing the ACA while Congressional Republicans craft legislation to repeal and replace it. The Order directs the agencies responsible for administration and enforcement of the ACA to exercise the authority and discretion available to them: Download Trump’s First Executive Order Addresses the ACA As always please contact your Total Benefit Solutions account manager at (215)355-2121 if you have any additional questions or concerns.

Trump Issues Executive Order To Curb Some Parts Of ACA.

January 23, 2017January 23, 2017Ed MacConnell

Trump Issues Executive Order To Curb Some Parts Of ACA. The New York Times (1/20, Davis, Pear, Subscription Publication) reported that on Friday, President Donald Trump issued an executive order to government agencies directing them “to scale back as many aspects of the Affordable Care Act as possible, moving within hours of being sworn in to fulfill his pledge to eviscerate Barack Obama’s signature health care law.” According to the Times, the one-page order “has symbolic as well as substantive significance, allowing Mr. Trump to claim he acted immediately to do away with a health care law he has repeatedly called disastrous, even while it remains in place and he… Read More

Update on the Status of the ACA

January 17, 2017Ed MacConnell

Update on the Status of the ACA With the impending inauguration, recent actions by the Senate and some confusing media reports, we wanted to provide a short Q&A to help you understand current events and what to expect as we head down the health care reform road in 2017… What’s the latest news? Download the bulletin for an update: Download Update on the Status of the ACA As always please contact your Total Benefit Solutions, Inc. account manager at (215)355-2121 if you have any questions or concerns.

Relief for Small Employers with HRAs

January 9, 2017Ed MacConnell

On December 13, 2016, President Obama signed into law the “21st Century Cures Act” which allows small employers without group medical plans to reimburse individual premiums and other medical expenses of employees under health reimbursement arrangements (“HRAs”), effective with the 2017 plan year, and provides relief from penalties to all small employers reimbursing individual premiums of employees for earlier plan years. In addition, the Cures Act provides a medical innovation package that funds medical research, accelerates cutting-edge treatments for rare diseases, and makes significant reforms to the mental health system. The Issue An employer cannot offer employees cash to reimburse the purchase of an individual policy, without regard to whether… Read More

Health Reform: 4th Quarter 2016 Compliance Compilation

December 29, 2016December 29, 2016Ed MacConnell

Download a digest of our fourth quarter compliance bulletins. This digest includes the following bulletins: Transitional Reinsurance Fee Form Now Available 10/14/2016 Final 2016 Forms 1094-C and 1095-C Available 10/25/2016 November 2017 Cost of Living Adjustments 11/01/2016 Relief Extended for Premium Reimbursement Programs for Student Employees 11/02/2016 Updates Regarding the NJ Small Employer Health Benefits Program 11/07/2016 Election Results and the ACA: Preliminary Thoughts 11/10/2016 16 Extension of Deadline for 2016 Forms 1095-C 11/21/2016 Adjusted PCOR Fee for Fifth Filing Year Released 11/22/2016 December Beware of Phishing Email Disguised as HIPAA Privacy Audit Letter 12/13/2016 Click here to download the 4th quarter compliance compilation

New Law Exempts Certain Small Employer HRAs From ACA Market Reforms

December 15, 2016December 14, 2016Ed MacConnell

New Law Exempts Certain Small Employer HRAs From ACA Market Reforms Gaddiel Gonzalez-Brown & Brown Consulting President Obama has signed into law the 21st Century Cures Act, which, among other things, allows small employers to offer new “qualified small employer health reimbursement arrangements” to reimburse employees for qualified medical expenses, including individual health insurance premiums, for years after December 31, 2016. Small employers are defined as those with fewer than 50 full-time equivalent employees who do not offer a group health plan. Background Under prior agency guidance, stand-alone HRAs (except for retiree-only HRAs and HRAs consisting solely of excepted benefits) and HRAs used to purchase coverage on the individual… Read More

IRS has provided a limited extension of time for employers to provide Forms 1095-C

December 14, 2016Ed MacConnell

The IRS has provided a limited extension of time for employers to provide Forms 1095-C (and carriers to provide Forms 1095-B) to individuals (but NOT to the IRS). Rather than January 31, 2017, the new deadline will be March 2, 2017. Download Extension of Deadline for 2016 Forms 1095-C

BREAKING NEWS: Texas Court Issues Injunction Blocking New December 1st Overtime Regulations

November 23, 2016Ed MacConnell

On November 22, 2016, a federal district court in Texas granted a preliminary injunction that temporarily blocks the U.S. Department of Labor (DOL) from implementing and enforcing its recently revised regulations on the white collar exemptions to the Fair Labor Standards Act (FLSA). The regulations, which were released in May and scheduled to go into effect on December 1, would more than double the minimum salary requirement certain executive, administrative, and professional employees must receive in order to be exempt from overtime. Click here to read the rest

Health Reform: Cost of Living Adjustments, Individual Penalty, HSA limits & more for 2017

November 21, 2016Ed MacConnell

On October 25 and 27, 2016, the IRS released cost of living adjustments for 2017 under various provisions of the Internal Revenue Code (the Code). Some of these adjustments may affect your employee benefit plans. These adjustments include but are not limited to the following: Cafeteria Plans Qualified Transportation Fringe Benefits Requirement To Maintain Minimum Essential Coverage (Individual Penalty) Highly Compensated Non-Grandfathered Plan Cost-Sharing Limits H.S.A. Annual contribution limitation, catch up contribution and minimum deductibles Key Employee Click here to download the bulletin As always if you have any additional questions or concerns, please contact your dedicated Total Benefit Solutions, Inc. account manager at (215)355-2121.

Health Reform: IRS Extends Due Date for Furnishing Form 1095-B/C.

November 19, 2016Ed MacConnell

IRS Extends Due Date for Furnishing Form 1095-B/C. As applicable large employers and employers with self-funded health plans are working on their Affordable Care Act compliance preparations, the IRS announced an extension of a key ACA deadline. Notice 2016-70 extends the due date for furnishing Form 1095-B and Form 1095-C from January 31, 2017 to March 2, 2017. The Notice also extends transition relief from penalties if an employer makes a “good faith effort” to comply with reporting requirements. This relief is welcome news for employers who are still working on their compliance approach. A copy of the notice can be downloaded here.

Election Results and the ACA

November 10, 2016November 10, 2016Ed MacConnell

With the outcome of the 2016 elections now official, the Republicans will hold the majority in both chambers of Congress and control of the White House beginning in 2017. Since President-elect Trump ran on a platform of “Replace and Repeal” of the Affordable Care Act (ACA), we anticipate that acting on this campaign promise will be one of the top priorities of the new Trump administration. We anticipate there will be significant disruption for individuals, employers, brokers and carriers across the country. Click here to read the latest bulletin

IBC: Plans to remove exclusions for gender reassignment surgery coverage

October 25, 2016October 25, 2016Ed MacConnell

In a July Independence Edge article, we shared that the U.S. Department of Health and Human Services (HHS) had issued a final rule for the nondiscrimination provision (section 1557) of the Affordable Care Act (ACA). While the nondiscrimination provision itself is not new, the final rule provides expanded clarity on coverage for gender reassignment surgery and related services. In addition, it provides guidance on treating individuals consistent with their gender identity, and not denying or limiting health services usually only available to individuals of one gender. Beginning with renewals on or after January 1, 2017, the exclusion for gender reassignment surgery has been removed from all commercial plans. Members… Read More

Individual and Family Open Enrollment-2017 Important Updates

October 25, 2016Ed MacConnell

As many people know by now there are many big changes with individual and family plans for open enrollment 2017. For anyone who is currently enrolled on one of the following your plan will NOT be renewed for 2017 and you will have to pick a new plan and/or a new insurer: Aetna: all plans cancelling in PA/NJ/NC/FL Aetna plans only remain in Delaware in our service area United Healthcare: All ACA plans cancelling. Short term plans are still available Oscar: All plans in NJ cancelling Health Republic: All plans in NJ cancelling Highmark and Capitol Blue Cross: No longer paying broker compensation Geisinger: No longer paying broker compensation Independence Blue… Read More

ACA Individual 2017 Open Enrollment Important Update

October 8, 2016October 27, 2016Ed MacConnell

2017 ACA ” Obamacare” plans open enrollment important update. The annual open enrollment period opens on November 1st 2016 and ends January 31st 2017. Independence Blue Cross will be the only insurer available in 2017 in the Philadelphia 5 County Area. With the passing of the Affordable Care Act changes come annually or even more often. Unfortunately not all of those changes are benefiting the consumer. This year here are some major changes that our clients on Individual Non Medicare plans need to be aware of… If you are a enrolled on an ACA compliant plan with Aetna or United Healthcare your plan is going away. Neither Aetna or United… Read More

Opt-Out Bonuses May Affect Affordability

September 14, 2016Ed MacConnell

The IRS recently issued proposed regulations that (among other things) address affordability determinations for individuals who are eligible for employer-sponsored health coverage. Building on earlier guidance, the proposed rules describe the effect an opt-out waiver has on affordability. Should you have any questions, please contact your Total Benefit Solutions account manager directly at (215)355-2121. Click here to download this bulletin

IBC: How to pay your health insurance bill

July 29, 2016July 29, 2016Ed MacConnell

Click to watch this quick video on payment options for Independence Blue Cross individual health insurance plans. As always if you have any questions please contact your dedicated Total Benefit Solutions individual account manager at (215)355-2121.

HR 360:Most Common Summary Plan Description (SPD) Mistakes

July 20, 2016Ed MacConnell

One of the most important documents participants must receive automatically when becoming covered under a health benefit plan that is subject to ERISA (the federal Employee Retirement Income Security Act) is a summary of the plan, called the Summary Plan Description or SPD. The fact is, many employers are confused about this very important ERISA-required disclosure, which can put them at risk. Click this link to download the publication

Notice of Subsidies in the Federal Marketplace

July 18, 2016July 18, 2016Ed MacConnell

The Affordable Care Act (“ACA”) requires each Health Insurance Marketplace (“Marketplace”) to notify any employer whose employee was determined to be eligible for Advance Premium Tax Credits (“APTC”) and Cost Sharing Reductions (“CSR”) because the employee attested that he or she was not: • enrolled in employer sponsored coverage, or • eligible for employer coverage that is affordable and meets minimum value requirements. In 2016, the Federally-Facilitated Marketplace (“FFM”) will begin issuing these notices to employers. State-based Marketplaces began this notification process in 2015. Click here to download the bulletin

ACA: Important Implementations & Delays in 2016

July 15, 2016July 17, 2016Ed MacConnell

As our third year of the ACA Open Enrollment Period arrived, it’s time to examine some of the new implementations in 2016. Some of the major components, especially those affecting businesses were delayed or deferred since the passage of the Affordable Care Act in 2010. This year is considered to be a big year due to the “full implementation” of the employer mandate as well as a number of changes, repeals, and moratoriums on other sections of ACA. Some of the key changes are listed below: CHANGES AND IMPLEMENTATIONS Full implementation of the Employer Mandate Currently it is not mandated that employers provide health care to their employees. Moving forward, however, if… Read More

FAQ Suggests Employers Include Marketplace Options with COBRA Notices

July 15, 2016Ed MacConnell

On June 21, 2016, the Departments of Labor, Health and Human Services, and the Treasury (collectively, the “Departments”) issued the 32nd Affordable Care Act (“ACA”) FAQ describing information that may be appropriate to include with COBRA notices. Many wondered if it were appropriate to provide information and if so, what kind of information could be provided about the Health Insurance Marketplaces/Exchanges (“Marketplaces”) so that COBRA-eligible individuals could consider health coverage alternatives available through the Marketplaces and possibly investigate whether they may be eligible for premium tax credits and cost-sharing reductions. Click the link to download the entire bulletin

Total Benefits & Healthiest You

July 13, 2016July 8, 2016Ed MacConnell

Healthiest You is more than a typical Teledoc benefit. Whenever members have questions or they are simply not feeling well, they can effortlessly connect to a 24×7 telehealth hotline for the diagnosis and treatment of illness, second opinions and consultations. They have board-certified, licensed physicians in every state waiting to provide exceptional care. They can even prescribe medication and save a trip to the doctor’s office, whether members are at home or on the road. Want more information? Click here to see the site.

Critically Important: Insurance for Serious Illness

July 11, 2016July 8, 2016Ed MacConnell

Good news: You’ve got health insurance (at least, all Americans are required to or pay a penalty). Bad news: It doesn’t cover everything. Especially if something really bad happens, like a heart attack or stroke. Yes, a decent major medical plan will cover many of the health-related expenses related to a serious illness. But you’d likely still be left with significant out-of-pocket costs for deductibles and copayments. Medical insurance also doesn’t usually cover other related costs, such as travel to treatment centers, child care during absences or recovery, home modifications or rehabilitation charges. And if you lose income while you’re unable to work, you could have a tough time paying… Read More

Limited Benefit Medical Plans

July 10, 2016July 8, 2016Ed MacConnell

Why Consider a Limited Benefit Medical Plan? When it comes to medical benefits, employers used to face two choices — comprehensive employer-paid medical plans or no insurance at all. However, with the inception of the Patient Protection and Affordable Care Act (PPACA), the option not to offer medical insurance no longer exists for some employers. Limited benefit medical plans can be powerful tools for recruiting and retaining employees in situations where traditional medical benefits are not offered or affordable. These plans can also be useful in increasing productivity through reduced absenteeism due to illness, improving employee morale and as a means to provide the level of coverage required by law.… Read More

Reminder: PCORI Fees Due August 1

July 9, 2016July 8, 2016Ed MacConnell

The annual Patient-Centered Outcomes Research Trust Fund (PCORI) fee is due to the IRS August 1, 2016. The fee, charged to certain health insurance policies, is used to support the activities of the Patient-Centered Outcomes Research Institute, a nonprofit, non-governmental organization (NGO) established by the Affordable Care Act (ACA). Fully- and self-insured group health plans ( Including HRA’s) are subject to PCORI fees. A health insurer will pay the fee on behalf of the employer if the plan is fully insured. Click here to read the bulletin from Primepay As always please contact your Total Benefit Solutions dedicated account manager at (215)355-2121 if you have any further questions or concerns.

Now Available from Total Benefit Solutions: Low Cost ERISA Wrap SPD Documents

July 8, 2016July 8, 2016Ed MacConnell

Wrap Summary Plan Description (SPD) If you offer group health insurance you’re now required by ERISA law, enforced by the Department of Labor and now the Affordable Care Act, to distribute a Wrap SPD within 120 days of the Plan’s effective date. The ERISA and ACA required Group Health Insurance Wrap SPD document is now available for a $99 one-time fee. You only update your Wrap SPD document as your benefit options change. The low cost Wrap SPD document is limited to fully insured group health insurance plans only. Here are the Wrap SPD document requirements by ERISA and the Affordable Care Act as succinctly as possible: If… Read More

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