The Obama Administration announced on July 2, 2013 that the employer mandate under the Patient Protection and Affordable Care Act (Affordable Care Act) will be delayed until 2015, thus giving employers an extra year to comply with the law’s complicated hours-tracking and health insurance reporting rules.
Under the Affordable Care Act, an employer with 50 or more full-time equivalent employees is liable for monetary penalties if the employer does not offer affordable, minimum value health care coverage to a full-time employee and that employee obtains subsidized health care coverage from a health insurance exchange. Under yesterday’s announcement, those penalties, along with the insurance reporting requirements imposed on employers under the Affordable Care Act, will not be enforced against employers until 2015.
The delay means that employers will have an additional year to offer health insurance coverage to their full-time employees before the Internal Revenue Service (IRS) will assess penalties, known as the employer shared responsibility payment. Employers also will have an additional year to comply with the information reporting provisions required under the Affordable Care Act. These provisions require employers to provide information to the IRS regarding the health insurance coverage offered to their full-time employees. That information will, in part, determine whether those employees are entitled to subsidized health insurance and whether employers are liable for an employer shared responsibility payment. Proposed rules on these reporting requirements are expected to be published later this summer.
The announcement does not delay the effective date for other provisions of the Affordable Care Act, such as the requirement that individuals purchase health insurance or pay a penalty.
Official guidance on this transition relief will be published within the next week, according to the Treasury. - Aon Hewitt
CMS Issues Final Rule on MLR Requirements for Medicare Advantage and Medicare Prescription Drug Program; Updates Reporting Deadline to December
CMS Issues Final Rule on MLR Requirements for the Medicare Advantage and Medicare Prescription Drug Program; Updates Reporting Deadline to December
On May 17, 2013, the CMS released a final rule that implements new medical loss ratio (MLR) requirements for the Medicare Advantage Program and the Medicare Prescription Drug Benefit Program (Part D) established under the Affordable Care Act. The MLR represents the percentage of revenue used for patient care, rather than administrative expenses or profit. Under the final rule, Medicare Advantage and Part D sponsors are subject to financial and other penalties for failing to meet an MLR of at least 85%. The final rule primarily follows the proposed rule released in February 2013. However, CMS did agree with commenters on the proposed rule who recommended that the reporting deadline should be December, not July. In the final rule, CMS states that “We agree with the commenters that the best balance between beneficiary protection and calculating MLRs based on the most complete data is to require that, in general, MLR reporting for a contract year will occur in the December following the contract year, on a date and in a manner specified by CMS.” The final rule becomes effective on July 22, 2013. --AON Hewitt
CMS Releases Frequently Asked Questions on Health Insurance Exchanges
On May 14, 2013, the Centers for Medicare and Medicaid Services (CMS) released frequently asked questions (FAQs) on health insurance Exchanges (marketplaces). The federal and state Exchanges are to become operational in 2014 and are intended to provide individuals and small businesses with the opportunity to purchase affordable, quality health insurance options, as part of the Patient Protection and Affordable Care Act (Affordable Care Act). The FAQs address:
- The oversight of premium stabilization programs, advance payments of the premium tax credit, and cost-sharing reductions;
- Issuers’ ongoing compliance with Exchange-specific standards and oversight;
- State-based Exchange reporting requirements;
- Privacy and security standards for state-based Exchanges and non-Exchange entities (e.g., Navigators, agents, brokers, etc.);
- Cost-sharing reductions and health savings accounts (HSAs);
- Eligibility and enrollment; and
- Issuer withdrawal from the small group or large group market. -- AON Hewitt
We've been hearing about Health Care Reform for some time. Most business, both big and small, are confused and concerned about what the changes will mean to them. The following are some of the ways health care reform will begin to impact your business, you, and your family:
- Adult children on your policy.
- Pre-existing conditions.
- “Grandfathering” for all policies.
- Changes to Health Care Savings Accounts.
- Subsidies for employers with Health Care plans.
How do you know what to expect? Where do you turn? Well, look no further! Vanasek Insurance Services has just released Reform Readiness Review™. This is a proprietary, complimentary, and no obligation service. Your personalized Reform Readiness Review™should take no longer than 3-5 minutes to complete. Once we recieve your information, we will be contacting you within 2-3 business days to review your Health Care Reform report customized for you and your company.
Information is Power! Know your rights! Find out exactly how this reform wil be impacing you, your business, and your family TODAY!
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