Special Health Insurance Sign-Up for Tax Filers Owing Fees

Do you have to pay a penalty? 
If you learn as you do your taxes that you owe a fee for not having health insurance last year, avoid having to pay this fee next year. Find out if you are eligible to sign up for health insurance for 2015, even though open enrollment has closed. If you are - you’ll avoid bigger penalties next year, and may receive subsidies that make the insurance premiums more affordable. This special enrollment period runs from March 15 to April 30.

HHS To Allow Automatic Re-Enrollment Under ACA

The majority of those who enrolled in the Patient Protection and Affordable Care Act plans through the exchanges will be auto-enrolled in the same health plan they selected in 2014 this coming enrollment period, as well as receive the same subsidies, if applicable, the administration said Thursday.

The rule was proposed by the Centers for Medicare and Medicaid Services.

“As we plan for open enrollment in year two and continue to build a sustainable long-term system, we are committed to simplifying the experience for consumers by allowing auto-enrollment,” HHS Secretary Sylvia Mathews Burwell said in a news release. “We are working to streamline the process for consumers wishing to remain in their current plan.”

Basically, under the new guidelines, most of the law’s customers “would be able to renew subsidized health insurance coverage without filing an application and without going back to HealthCare.gov, the website that frustrated millions of consumers last fall.” New HHS Secretary Sylvia Mathews Burwell, who issued the rules Thursday, said, “We are working to streamline the process for consumers wishing to remain in their current plan.”

Health Reform Questions - Reimbursing Individual Market Premiums

Question: Can an employer reimburse its employees for premiums on a pre-tax basis for purchasing individual market medical coverage?

Answer: No. In IRS Notice 2013-54 & Technical Release 2013-3, the IRS and DOL prohibit the reimbursement of premiums for individual medical policies from health reimbursement arrangements and premium only plans.

Recently, the IRS issued a Frequently Asked Questions (FAQ) list that reiterates earlier guidance disallowing pre-tax employer reimbursements for employee health care premiums. The FAQ also calls attention to the $100 per day, per employee penalty for non-compliance.

Administration announces proposal to clarify availability of Health Insurance Marketplace coverage to workers eligible for COBRA

On May 2, 2014, the Obama administration announced updates to model notices informing workers of their eligibility to continue health-care coverage through the Consolidated Omnibus Budget Reconciliation Act. The updates make it clear to workers that if they are eligible for COBRA continuation coverage when leaving a job, they may choose to instead purchase coverage through the Health Insurance Marketplace.

“In many cases, workers eligible for COBRA continuation coverage can save significant sums of money by instead purchasing health insurance through the Marketplace,” said Assistant Secretary of Labor for Employee Benefits Security Phyllis C. Borzi. “COBRA continues to play an important role in helping workers and families maintain coverage after a job loss, and it is important that workers know that in some cases there is a Marketplace option as well.”

Health Insurance Open Enrollment Ends March 31

If you are seeking health coverage through the Health Insurance Marketplace, be sure to apply before the end of the open season on March 31, 2014.

If you haven't enrolled by March 31, you won't be able to apply until the next open season, unless you qualify for a special enrollment period. The next open enrollment is proposed to run from November 15, 2014 through January 15, 2015.

There's no limited enrollment period for Medicaid or the Children's Health Insurance Program (CHIP) -- you can enroll at any time.

Final 2015 Notice of Benefit and Payment Parameters and Actuarial Value Calculator

On March 6, the Department of Health and Human Services (HHS) provided the 2015 actuarial value calculator and issued final regulations on the 2015 Notice of Benefit and Payment Parameters. While HHS changed a few items from the proposed rule – namely the open enrollment period and cost-sharing limits – many provisions remain the same.

Open Enrollment Period
The 2015 open enrollment period for individual and family plans has been extended by 30 days and will be held November 15, 2014 – February 15, 2015.

2015 Cost-Sharing Limits
The 2015 maximum annual out-of-pocket limits for all non-grandfathered plans will increase by 4.21 percent, lower than originally proposed. The confirmed 2015 amounts are $6,600 for individual coverage and $13,200 for family coverage. The maximum 2015 deductibles for insured non-grandfathered small group plans are $2,050 individual and $4,100 family.

HHS Releases 2014 Federal Poverty Level Guidelines

HHS has released 2014 federal poverty guidelines.  Updated annually for inflation, the 2014 guidelines will set the income thresholds for subsidy eligibility on exchanges for 2015. The threshold (in the 48 contiguous states and DC) for one person will be $11,670, an $180 increase over the 2013 level.  An employee's receipt of exchange subsidies could trigger an employer shared responsibility penalty starting in 2015.  IRS proposed rules include an employer affordability safe harbor based on the federal poverty level.

U.S. judge upholds subsidies pivotal to Obamacare

WASHINGTON (Reuters) - A judge on Wednesday upheld subsidies at the heart of President Barack Obama's healthcare overhaul, rejecting one of the main legal challenges to the policy by conservatives opposed to an expansion of the federal government.

A ruling in favor of a lawsuit brought by individuals and businesses in Texas, Kansas, Missouri, Tennessee, West Virginia and Virginia would have crippled the implementation of the law by making health insurance unaffordable for many people.

In his ruling, U.S. District Judge Paul Friedman in Washington D.C. wrote that Congress clearly intended to make the subsidies available nationwide under the 2010 Patient Protection and Affordable Care Act.

Marketplace Enrollment Numbers

The U.S. Department of Health and Human Services released the most detailed information on people who enrolled in health plans through either the federally run marketplace or exchanges operated by 15 states and the District of Columbia.

Almost 2.2 million people enrolled in health plans through Dec. 31 in the federal and state marketplaces. (No data has been released on how many enrollees have secured their enrollment with their first premium payment.) Most residents enrolled in December.

Of the almost 2.2. million:

24 Hour ACA Extension - Sort Of

Monday December 23rd, 2013 is the last day to sign up for health insurance on the federal exchange for coverage that starts Jan. 1, but government techies have built in a little wiggle room.

People have until midnight tonight to get started. But just to be safe, the administration has sneaked in an extra 24-hour buffer, the Washington Post first reported, giving people until midnight Tuesday night to get enrolled if they start the process by midnight Monday.

Remember when enrolling online, please be sure to include us as your Broker so we can be of further assistance in the future:

Brenda D. Cutting
National Producer Number (NPN) = 6998229
Federally-Facilitated Marketplaces (FFM) ID = bcutting

Happy Holidays!

Statement of the Virginia Bureau of Insurance Regarding Extension of Individual and Small Group Health Insurance Plans

Virginia regulators say they may not have legal authority to require insurers to extend cancelled health policies as long as two years, as President Barack Obama requested last week.

The Bureau of Insurance instead asked insurance carriers today to give individual and small group market customers the option of renewing their existing policies early to extend coverage into 2014, as insurers already have done in many cases for people with policies that do not comply with higher standards under the Affordable Care Act.

Individual mandate penalty delayed

The part of the Affordable Care Act (ACA or health care reform law) with the biggest impact – the individual mandate – is getting a lot of attention lately. Under the law and regulation as written, people who buy health insurance as individuals (an individual plan) can go three months without health insurance and not have to pay the individual mandate penalty. Now that individual market open enrollment goes until March 31, 2014, coverage can start as late as May 1. The Obama Administration felt like it needed to fix the problem where someone who buys insurance in the last 45 days of open enrollment still would have ended up paying part of the penalty. Because of a change to the regulation this week, this will no longer be the case in 2014. As long as people buying individual plans are signed up for insurance by March 31, 2014, they will not get hit with the penalty.

The Centers for Medicare and Medicaid Services put out guidance on October 28 that gives more information on the “hardship exemptions” for the individual mandate penalty. The Department of Health and Human Services is putting such an exemption in place for people who sign up for insurance before the open enrollment period ends on March 31, 2014. Without this exemption, individuals would have had to be covered by health insurance by March 31, meaning they would have had to sign up for it by February 15, 2014. Now, people who have signed up by March 31 will be able to claim a “hardship exemption” (without asking for it from the marketplace) on their taxes and not pay the penalty for the months in 2014 that they did not have health insurance.

Here's Why So Many Americans Are Getting Letters Saying Their Health Insurance Is Canceled

"If you like your health care plan, you can keep your health care plan." This was one of President Obama's key talking points when selling the Affordable Care Act, and it was never true — as many of the 14 million Americans currently covered by individually-purchased health plans are now learning.

As Kaiser Health News reports, individual market insurers are sending out rafts of cancellation notices, telling subscribers they have to change to new plans starting in 2014. Here's why:

Top 4 Obamacare Complaints

The debut of the Obamacare health insurance exchanges has been anything but smooth.

Three weeks after the exchanges opened, Americans are still having a tough time signing onto the Obamacare websites. And once they manage to get in, many aren't so happy with what they're finding.

Subsidy Calculator - Premium Assistance for Coverage in Exchanges

This tool illustrates health insurance premiums and subsidies for people purchasing insurance on their own in new health insurance exchanges (or “Marketplaces”) created by the Affordable Care Act (ACA). Beginning in October 2013, middle-income people under age 65, who are not eligible for coverage through their employer, Medicaid, or Medicare, can apply for tax credit subsidies available through state-based exchanges.

Take a deep breath....

Today at 8 a.m. ET the Marketplace opened for the very first time. There have been technical difficulties, glitches, delays, and at times, it has gone down completely. Today is just the first day, take a deep breath, let the dust settle, and remember that we are here to help you. The Open Enrollment Period is October 1, 2013–March 31, 2014.  As long as you enroll by December 15, 2013 and make your first premium payment, your new health coverage will be effective January 1, 2014.

Since March 23, 2010 when the Affordable Care Act (ACA) was passed into law, we have all been on a journey to understand how the law will impact each of us. This is still true today as we continue to work through final regulations and the opening of the Marketplace. However, one element of the law is clear. Health care reform does nothing to sever the Client / Broker relationship and our ability to help you. Under ACA, Sterling Benefits, LLC will continue to be able to advise and assist clients with their benefit needs as we move into 2014.

As acknowledged by President Obama, ACA is complex and the implementation will be "bumpy".  Some of you may be able to access government subsidies to help obtain quality health insurance at affordable rates. Others will continue to access health care from their current method. Health care reform will change many aspects of our current system but it will not affect our ability as a Broker to work on your behalf.  We want to assure you we are Marketplace Certified and will be able to provide all of our clients with the help needed to find the best solution for your specific situation.

Thank you for the opportunity to be of service.

Sincerely,
Christina & Brenda

Brenda D. Cutting
National Producer Number (NPN) = 6998229
Federally-Facilitated Marketplaces (FFM) ID = bcutting

Christina M. Brunner
National Producer Number (NPN) = 8659135
Federally-Facilitated Marketplaces (FFM) ID = cbrunner

Things to Know About Health Insurance Today

Today begins the biggest expansion of health insurance since Medicare. According to the Congressional Budget Office (PDF), an estimated 7 million Americans will buy private health plans through the new online marketplaces known as insurance exchanges, which are now opening nationwide. That number is expected to more than triple in the years ahead.

 

It could be a bumpy launch, with technical problems and public confusion.

 

Here are 10 things you need to know about the insurance exchange program:

Animation Explains Changes Coming for Americans Under the Affordable Care Act

2014 is coming--are you ready for Obamacare? Join the YouToons as they walk through the basic changes in the way Americans will get health coverage and what it will cost starting in 2014, when major parts of the Affordable Care Act, also known as "Obamacare," go into effect.

Courtesy: The Henry J. Kaiser Family Foundation.

HHS Releases a Report of Health Insurance Marketplace Premiums for 2014

HHS released a report that summarizes the health plan choices and premiums that will be available in the Health Insurance Marketplace. It contains new information, current as of September 18, 2013, on qualified health plans in the 36 states in which the Department of Health and Human Services (HHS) will support or fully run the Health Insurance Marketplace in 2014. Plan data is in final stages but is still under review as of September 18 and may be revised in HHS systems before being displayed for consumers, so this information is subject to change. 

Online enrollment for federal SHOP will be delayed

In the latest setback for the rollout of Obamacare, the U.S. Department of Health and Human Services announced Thursday that small businesses in 36 states can’t enroll their workers into health coverage through the new federally run insurance marketplaces until at least Nov. 1 – one month later than previously announced.

The delay appears to be the result of computer and information technology problems in the Small Business Health Option Program, known as SHOP, an online insurance marketplace specifically for small employers.

Employers still will be able to compare coverage options and begin the application process on Oct. 1, but they won’t be able to sign up workers for coverage until November.