New Rules Allow Short-term Plans to Last up to Three Years

| posted in Blog, Newsletter

The Trump administration has taken another step in its effort to roll out short-term health insurance plans by extending the amount of time such plans can be in effect. Under the new rule, which was issued August 1, short-term plans can be purchased for up to 12 months and policyholders can renew coverage for a maximum of 36 months. These controversial plans, though, do not have to comport with the Affordable Care Act. A few examples include not covering the ACA’s “10 essential benefits” or pre-existing conditions – and they can even exclude coverage for medications. Possible Impact As a…
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New Rules Issued for Small Group, Individual Plans

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The Centers for Medicare and Medicaid Services (CMS) has released its final rules on giving states more power to regulate individual and small group health insurance markets. The new rules are part of the Trump administration’s effort to dismantle the Affordable Care Act after numerous GOP efforts to repeal the law failed in 2017. The rules give states more control over which essential health benefits plans must offer, scrap rules that require all rate hikes to be reviewed by regulators, and allow exchanges to grant more waivers for having to purchase health coverage. The move will have varying effects depending…
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Prepare Your Business for Increased I-9 Enforcement

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Homeland Security Investigations, the investigative office of U.S. Immigration and Customs Enforcement (ICE), is stepping up targeted inspections of employers nationwide as part of President Trump’s crackdown on illegal immigrants. The increased action is likely to continue over the course of the Trump administration and employers need to be prepared for possible inspections and know how to deal with them. These raids have two purposes: To audit I-9 forms, which are used to verify employment eligibility in the U.S. Arrest unlawful workers and employers who hired them knowing they were working illegally. Under the Immigration and Nationality Act, employers are…
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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!

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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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IRS in Full Swing on ACA Compliance Despite Uncertainty

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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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DOL Abandons Overtime Rule, Asks Court to OK Salary Threshold Concept

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If you remember, the Department of Labor last December was slated to implement a new white-collar overtime rule, but after business groups appealed, a federal judge in Texas issued an order temporarily blocking it days before it was due to take effect. The DOL had been continuing work on appealing the ruling but now that the Trump administration is in charge, the agency dropped its defense of the Fair Labor Standards Act (FLSA) overtime rule. The rule would have required employers to pay overtime to workers who make less than a new threshold of $47,476, regardless of their title. So…
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Trump Administration Writing Regs to Loosen Rules on Health Plan Tax Credits for Small Employers

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The Trump administration is crafting regulations that will allow small employers to bypass government-run exchanges to purchase coverage and still be eligible for a tax subsidy. Part of the Affordable Care Act provides for small employers to be eligible for a tax credit if they purchase health insurance for their workers on federally operated exchanges for small businesses. However, the Small Business Health Care Tax Credit is only available to employers that bought coverage on the Small Business Health Options Program (SHOP), leaving those who bought plans on the private market out of luck. Now the Centers for Medicare & Medicaid…
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DOL Withdraws Guidance on Independent Contractors

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The Trump administration has withdrawn guidance issued by the Department of Labor under President Obama that had tightened restrictions on joint employment and independent contractors. The move may give only the semblance of respite though, because the enabling regulations are still in place and so is established case law on the subject. The move only affects guidance that the DOL had issued to clarify regulations that were also codified during the last administration. In other words, for now the regulations remain in place and if the administration wants to tackle those, it would have to start from scratch in the…
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As Concern over Subsidies Looms, Fate of Exchanges Hangs in Balance

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Even though no legislation repealing the Affordable Care Act has been signed into law, inaction by the Trump administration on a major lawsuit is imperiling one of the key foundations of the law: the government-run exchanges. The administration has asked the court for three more months to decide whether to pursue an appeal against a U.S. district court’s ruling that the subsidies paid to help people purchase insurance on government-run insurance exchanges are illegal. The ruling was stayed pending an appeal first filed by the Obama administration. The added delay is causing concern – if not panic – among insurers…
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