Benefits Buzz

ACA Guidance Update

Posted on March 14th, 2014

Last week, the Obama administration released several new Affordable Care Act (ACA) guidelines. Of particular note, any individual or small group with a non-ACA compliant plan will be able to keep that plan in place for additional time.

The guidance states that this transitional rule applies for plan years on or before Oct. 1, 2016. This means non-ACA compliant plans can be kept in force as late as October of 2017 (depending on the renewal date). It should be noted that this extension also has to be approved at the state level, and this is optional for insurance companies to implement.

In addition, the new guidelines have extended the next annual enrollment period for individual health plans by one month. The next annual enrollment period will now occur from Nov. 15, 2014 to Feb. 15, 2015. During this time period anyone can sign up for an individual health plan or make changes to their existing coverage without a qualifying event. 

The new guidance also provides the 2015 limits for ACA compliant plans.  The breakdown is listed below:

  • Small group deductible limits:  $2,050 individual / $4,100 family
  • Out-of-pocket limits for all market segments:  $6,600 individual / $13,200 family

The annualized reinsurance fee for 2015 has also been set at $44 per member. These fees are paid by health insurance issuers and certain self-insured group plans. 

The U.S. Department of Health and Human Services (HHS) has published a fact sheet with details on all of the new regulations.

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The materials contained within this communication are provided for informational purposes only and do not constitute legal or tax advice


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