group health plans
In just a very short period of time, the Coronavirus Disease (COVID-19) is impacting health plans and health care throughout the country. Here are some key examples of recent developments:
Offer an Affordable Group Medical Products to an Untapped Market
Everyone wants health insurance, but not everyone can afford it or they might not have access to quality coverage. Some employers struggle with the offer requirements related to the Employer Mandate, or they have employees--such as part-time or 1099 workers--who are not eligible for traditional benefits.
Last year, the Trump administration issued new regulations relating to Association Health Plans (AHPs). The primary intent of the regulations was to allow small employers to more easily band together to purchase health insurance coverage. The regulations not only allowed for AHPs to be established by employers in the same industry, but the regulations also allowed AHPs to be established by employers in a similar geographic location (e.g. city, state, metropolitan area).
Annual Medicare Part D reporting is required for all employers who provide health benefits with prescription drug coverage. The reporting is an online filing to the Centers for Medicare & Medicaid Services(CMS), and it lets CMS know if the prescription drug coverage available on the employer’s health plan is “creditable.”
Many employers offer a cash payment to employees who waive health insurance coverage. These cash payments are always taxable to employees who waive health insurance coverage, but did you know employees who elect the health insurance coverage may be subject to paying taxes on the cash payment that they didn’t receive?
Wait! What?
This fourth quarter has been like no other. Finally, health insurance renewals aren’t coming in with double digit rate increases like they have in recent years. For once, you don’t have to tell your clients that their premiums will be going up by 20%-30% next year. It’s a sigh of relief, but that doesn’t mean you should just coast through the fourth quarter. We’ve got 3 tips to make this year one of your best years yet.
It’s that time of year again. The days are getting shorter, the trees are mostly bare, the holidays are just around the corner and open enrollment is in full swing. If you’re like most benefits professionals, you probably head into open enrollment with a mixture of enthusiasm and dread.
The Affordable Care Act (ACA) created a research institute known as the Patient-Centered Outcomes Research Institute (PCORI). The goal of PCORI is to help patients and those who care for them make better-informed decisions about healthcare choices. PCORI is funded by fees which are charged to health plans.
The following information is designed to help employers understand their upcoming payment obligations.
ERISA Section 607 defines the term group health plan as an employee welfare benefit plan providing “medical care” to participants or beneficiaries: