health insurance

Posted May 13th, 2013 in Producers

The Center for Consumer Information and Insurance Oversight (CCIIO) published guidance on May 1, 2013 about the role of insurance producers in the Health Insurance Marketplaces, also referred to as the public exchanges.

The guidance suggests that insurance producers will play a valuable role in facilitating public exchange enrollments starting this October.

Posted April 30th, 2013 in Individuals, Employers, Producers

What will the exchanges look like? What are the exchange deadlines? How will subsidies and payments be processed? There constantly seems to be questions about the health insurance marketplaces, also known as the exchanges.

The Center for Medicare & Medicaid Services (CMS) released a progress fact sheet about the exchanges on April 22, 2013. This new information provides additional details about eligibility and enrollment, plan management, financial management, consumer support and more.

Posted April 22nd, 2013 in Individuals, Employers

Like the popular television commercials with children explaining their theories on what’s better (when asked if more is better than less), they want more. The concept is that simple. People, in general, do not want to settle for less.

Small businesses want more from a program that is named the Small Business Health Options Program or SHOP exchange. The government, however, has stripped away the “options” (at least for a year). If you’re a worker for a small business employer who is offered the SHOP exchange, you really don’t have anything to “shop” around for.

Posted April 15th, 2013 in Individuals, Employers, Producers

The Obama administration announced last week that parts of the Small Business Health Options Program (SHOP) would be delayed until 2015. This announcement has created a lot of confusion in the market.

The SHOP will be a new health insurance marketplace to provide exchange-based coverage to small businesses with up to 50 employees in most states. The SHOP is still expected to be launched as planned in 2014, but one of its key components will be delayed until 2015.

Posted March 22nd, 2013 in Individuals, Employers, Producers

The U.S. Department of Health and Human Services (HHS) and the Internal Revenue Service (IRS) have jointly issued rules that define affordable coverage. Employers and employees still have several questions about how this affects penalty calculations and subsidy eligibility.

The following offers some insight on these key issues:

Posted March 18th, 2013 in Individuals, Employers, Producers

The U.S. Department of Health and Human Services (HHS) has published a draft version of the individual application that will be used for public exchange enrollments starting on October 1, 2013. The application may be as long as 21 pages for some families.

Estimates indicate the online application process will take a minimum of 45 minutes to complete, and it could be even longer for individuals applying for coverage with dependents. Social Security Numbers, citizenship and residency status and employment and income verification are among the items that will need to be disclosed. A recent AP news article indicated the application process "could be as daunting as doing your taxes."

Posted March 14th, 2013 in Employers, Producers

The U.S. Department of Health and Human Services (HHS) released final regulations on March 1, 2013 about the Transitional Reinsurance Program. This new program will require insurance companies and some employers to fund a program that will provide partial reimbursements to commercial insurers that provide coverage to high risk individuals.

Posted March 11th, 2013 in Employers, Producers

ACA Participation RequirementsThe U.S. Department of Health and Human Services (HHS) released final regulations on February 22, 2013 in regards to various health insurance market rules. The new guidance includes information about minimum participation requirements in the small employer marketplace. In most states, small employers are defined as those with 50 or fewer employees.

Insurance companies today require a minimum percentage of employees to enroll in coverage. This is referred to as the participation requirements and helps insurance companies avoid adverse selection. Minimum participation requirements can be up to 75% today.

Posted March 7th, 2013 in Employers, Producers

Small employers able to provide simple, effective program with defined contribution strategy and online insurance marketplace.

InsureXSolutions® recently announced more small businesses in the Chicagoland area are looking to adopt a private health insurance exchange as an alternative to increasing healthcare costs. Through a defined contribution benefits strategy and the use of a private insurance exchange, businesses can now take control of their healthcare spending and offer a personalized insurance buying experience for employees.

Approximately 75 percent of Illinois employers have fewer than 50 employees, according to Kaiser Family Foundation. Of those employers, only a third currently offer group health coverage due to expensive premiums, participation requirements or other challenges that exist in today’s marketplace.

Posted February 28th, 2013 in Individuals, Employers, Producers

The U.S. Department of Health and Human Services (HHS) released the final regulations about Essential Health Benefits (EHB) on February 20, 2013. The guidance defines the benefits that must be included with all fully insured plans sold inside and outside of the public exchanges in 2014. This will impact all individual health plans and most small group health plans. Grandfathered plans and self-insured plans are exempt from the EHB requirements; however, self-insured plans that cover any EHB must provide coverage without any annual or lifetime dollar limits.

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