On April 18, 2017, the Department of Health and Human Services’ (HHS) Centers for Medicare & Medicaid Services (CMS) published its final rule regarding Patient Protection and Affordable Care Act (ACA) market stabilization. The rule amends standards relating to special enrollment periods, guaranteed availability, and the timing of the annual open enrollment period in the … Continued
A Summary of Benefits and Coverage (SBC) is four page (double-sided) communication required by the federal government. It must contain specific information, in a specific order, and with a minimum size type, about a group health benefit’s coverage and limitations. If an employer providing an SBC is a covered entity under the Section 1557 of … Continued
Most companies are fully aware of Form 5500 reporting requirements related to their 401(k) plans, but are less familiar with the Form 5500 reporting requirements for their health and welfare benefit plans. Requirements: Most employer-sponsored health and welfare benefit plans, including, but not limited to, group health, dental, vision, life insurance, disability insurance, voluntary worksite … Continued
One might describe the series of events leading to the death of the American Health Care Act (Congress’s bill to repeal and replace the Affordable Care Act) as something like a ballistic missile exploding at launch. The Patient Protection and Affordable Care Act (ACA) repeal debate began nearly a decade ago with former President Barack … Continued
In the first part of this two-part blog, I recommended a number of important items to keep in mind as you select a stop loss carrier. Additionally, here are a few other things you will want to look for, or ask about, when selecting a stop loss carrier. While this is not an exhaustive list, … Continued
In my last post, I discussed using employee engagement as a measurement of benefits communication success. We know employees have concerns about their financial well-being, and look to their employers for education about new and existing benefit options. This, of course, can present challenges at open enrollment, as well as year-round communication efforts. Common challenges … Continued
On February 23, 2017, the Department of Health and Human Services’ Centers for Medicare & Medicaid Services (CMS) released its Insurance Standards Bulletin Series, in which it re-extended its transitional policy for non-grandfathered coverage in the small group and individual health insurance markets. States may permit issuers that have renewed policies under the transitional policy continually … Continued
On March 6, 2017, the U.S. House of Representatives Ways and Means Committee released a proposed budget reconciliation bill, entitled the American Health Care Act, to replace portions of the Affordable Care Act (ACA). If enacted, the American Health Care Act would provide some relief from provisions of the ACA for employers and make other … Continued
I’ve looked at clouds from both sides now From up and down and still somehow It’s cloud illusions I recall I really don’t know clouds at all — Joni Mitchell, “Both Sides, Now” And like that song from 1969, it appears that most employees really don’t know cloud computing at all. In an article on … Continued
A fixed indemnity health plan pays a specific amount of cash for certain health-related events (for example, $40 per office visit or $100 per hospital day). The amount paid is neither related to the medical expense incurred, nor coordinated with other health coverage. Further, a fixed indemnity health plan is considered an “excepted benefit.” Under … Continued
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