Drug Costs Starting to Drive Group Plan Inflation

| posted in Blog

Under the Affordable Care Act, group health insurance costs have been rising at a much slower rate than they had during the decade preceding its passage. In fact, the rate of annual premium growth in the group market has hovered around 5% – more than half of what it was between 2001 and 2010. Also, health care’s share of the national economy actually fell from 17.4% in 2010 to 17.2% by 2013. However, that trend hasn’t lasted and in 2016 the share was 17.9%. There has been a lot of debate about why rates have been increasing and some pundits…
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Top 10 Laws, Regulations and Trends for 2018

| posted in Blog, Newsletter

In this article, we focus on the top 10 laws, regulations and trends going into 2018 that employers need to be aware of. New Parent Leave Act Effective Jan. 1, 2018, employers in California with 20 or more workers will be required to provide eligible employees with 12 weeks of unpaid, job-protected leave to bond with a new child. This builds on a 20-year-old law that required only employers with 50 or more staff to provide employees with time off for child bonding. Like the current law, the New Parent Leave Act applies to newborns or a child placed with…
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New Summary of Benefits and Coverage Template Must Be Used Now

| posted in Blog, Newsletter

There is a new Summary of Benefits and Coverage template that health plans will be required to use during open enrollment for the 2018 plan year. The new templates were introduced in 2016 and took effect for plan year or open enrollment periods beginning on or after April 1, 2017. The new template is the first major revision of the SBC template since 2012, the first year that health plans were required to use them as required by the Affordable Care Act. The new template has a number of changes that you should know about: There is a new row…
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With Health Insurance Laws in Flux, Flexible Spending Accounts Can Save Your Workers Money

| posted in Blog

The Internal Revenue Service is reminding eligible employees that now is the time to begin planning to take full advantage of their employer’s health flexible spending arrangement for next year. If you don’t offer a flexible spending account (FSA) for your employees, you should consider starting one as they allow them to use tax-free dollars to pay medical expenses not covered by their health plan, including deductibles, copays and any pharmaceuticals. Now that the year is winding down, even if your employees were using an FSA this year, they must decide again how much they want to set aside pre-tax…
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IRS Sends out ACA Compliance Letters, Employers Have 30 Days to Respond

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The IRS has started sending out letters to employers who have failed to comply with the Employer Shared Responsibility provisions under the Affordable Care Act for the year 2015. The IRS seems to be moving forward with notifying employers after attempts to repeal and replace the ACA failed in Congress and since there has been no further rule-making, guidance or legislation that rolls back enforcement of the employer mandate. The IRS will send Letter 226J to applicable large employers (ALEs) if it determines that at least one full-time employee received a subsidy in 2015 in a marketplace to purchase qualified…
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Senate Works to Save CSR Payments, but Too Late for 2018

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The Affordable Care Act requires insurers to reduce cost sharing (deductibles and copays) in silver-level plans for marketplace enrollees with incomes below 250% of the federal poverty line. Until now, insurers have relied on offsetting payments from the federal government to provide this feature. These payments amounted to $7 billion for fiscal year 2017, $10 billion for 2018 and will reach $16 billion by 2027. However, the Trump administration in August moved to end the controversial set of payments to the insurance industry designed to encourage carriers to remain in the ACA exchanges. These payments – known as “cost-sharing reduction…
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More Breaking News From the White House!

| posted in Blog

Last night, the White House issued a statement that the Administration would no longer make payments to insurers for the ACA’s cost-sharing reduction (CSR) program, citing agency guidance that the subsidies were illegal because they were never appropriated by Congress as required by the Constitution. These CSRs – which are separate from the ACA’s larger advanced premium tax credits (APTC) for households up to 400% of the Federal Poverty Level (FLP) – help offset out-of-pocket expenses for silver-tiered plans purchased through ACA marketplaces like CoveredCA, for households with incomes under 250% of the FPL.  CoveredCA prepared for this possibility by…
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After IRS Tweak Be Careful that You’re Complying with Affordability Test

| posted in Blog

Now that the final attempt (this year) at dismantling the Affordable Care Act came to a quiet end in the last week of September, employers need make sure that they stay on track with compliance. First and foremost is that the ACA’s employer mandate and shared responsibility provisions still stand. That includes the affordability test, to which employers need to pay special attention, as increases in premium can put some of your employees over the edge into “unaffordable” coverage territory. And this year there’s a twist that you need to be aware of. As it’s almost time for open enrollment,…
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IRS in Full Swing on ACA Compliance Despite Uncertainty

| posted in Blog

Despite the lull in activity in Washington on the future of the Affordable Care Act and the threats by President Trump to sink the law by not enforcing regulations, the IRS is in full swing in ensuring compliance. The agency in August released new draft IRS forms for use by applicable large employers (ALEs – or companies with 50 or more full-time or full-time equivalent employees) to report health insurance information for their workers. The agency also released the filing schedule for reporting employee health insurance data as required by the ACA for the 2017 tax year. Furthermore, the IRS…
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Employers Seek New Ways to Reduce Health Insurance Inflation

| posted in Blog

As employers anticipate that their employee health insurance costs will rise 5.5% for the 2018 policy year, they are also planning to step up their cost management efforts in new areas, according to a new study. And despite the maelstrom in Washington over how to deal with the Affordable Care Act, 92% of employers surveyed said they are “very confident” their organization will continue to sponsor health benefits in five years, according to the “Willis Towers Watson 2017 Health Care Employer Survey.” Employers will try to contain costs by exploring new strategies like emerging health care delivery systems, and arrangements…
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