IRS Releases Notice 2014-55 Providing for Additional Election Changes Events (Cafeteria Plan)

The IRS released Notice 2014-55 which provides additional permitted election changes for health coverage under Code Section 125 cafeteria plans. This notice provides two specific situations in which a cafeteria plan participant may wish to revoke, during a plan year, the employee's election for employer-sponsored health coverage under the cafeteria plan in order to purchase a Qualified Health Plan through a Marketplace.

New Law Repeals Deduction Limits for Small Employer Insured Health Plans

On April 1, 2014, President Obama signed the "Protecting Access to Medicare Act of 2014" into law. The new law mainly focuses on Medicare reimbursement rates for doctors. A small, easily-overlooked provision of the law retroactively eliminates the Affordable Care Act's (ACA) annual deductible limit for health plans in the small group market.

Employer Mandate Delayed for some Employers

On February 10th, 2014, the Obama administration announced that it would postpone enforcement of a federal requirement for medium-size employers to provide health insurance to employees and allow larger employers more flexibility in how they provide coverage.

The "employer mandate," (also known as the “Play or Pay” requirements) which was originally supposed to take effect last month, had already been delayed to January 1st, 2015, and now the administration says that employers with 50 to 99 employees will not have to comply until 2016.

In addition, the requirement would be put into effect gradually for employers with 100 or more employees. Employers in this category will need to offer coverage to 70 percent of full-time employees in 2015 and 95 percent in 2016 and later years, or they will be subject to tax penalties.

Please review the attached Health Care Reform Hot Topic for more information. 
Highlights:

• No mandate for small group employers (2-50) is scheduled at this time.
• Compliance for medium-sized group employers (50-99) is delayed until 2016.
• Compliance for large-sized group employers (100+) is still delayed until 2015.
• Certain 2014 transition relief is extended, including relief for non-calendar year plans.
• The requirement to offer coverage to 95 percent of full-time employees will be phased in over two years.
• Full-time status is clarified for certain groups.

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.

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

Health Insurance Exchange Notices Deadline 10/1/2013

As a reminder …

 

Notices about the health insurance exchanges have to be given to current workers no later than Oct. 1, 2013. Starting Oct. 1, the notices have to be given to new workers on the day they are hired. 　

 

The notices must:

1. tell workers about exchanges, including a description of the services provided and how they can contact exchanges;
2. let workers know they may be eligible for a premium tax credit if the employer plan’s does not cover at least 60% of the total allowed cost of benefits, and the worker buys a qualified health plan through an exchange;
3. explain that if the worker buys a qualified health plan through an exchange, he or she may lose the employer contribution (if any) to any health benefit plan the employer offers, and that all or part of the contribution may be excluded from income for federal tax purposes.

The notices (Exchange Model Notices (For Employers who offer a health plan and Employers who do not offer a health plan) and the Revised Model COBRA Election Notice), along with further guidance, can be found at www.dol.gov/ebsa. Please review the attached Health Care Reform Hot Topic for more information on the Model Notices Explanation.

Employer Mandate Delayed Until 2015

Bloomberg: Health-Law Employer Mandate Said to Be Delayed to 2015
Businesses won't be penalized next year if they don't provide workers health insurance after the Obama administration decided to delay a key requirement under its health-care law, two administration officials said. The decision will come in regulatory guidance to be issued later this week. It addresses vehement complaints from employer groups about the administrative burden of reporting requirements, though it may also affect coverage provided to some workers (Dorning and Wayne, 7/2).

The Washington Post: White House Delays Employer Mandate Requirement Until 2015  The Obama administration will not penalize businesses that do not provide health insurance in 2014, the Treasury Department announced Tuesday. Instead, it will delay enforcement of a major Affordable Care Act requirement that all employers with more than 50 employees provide coverage to their workers until 2015 (Kliff, 7/2).

What’s not changing as a result of these delays:

• The Exchanges/Marketplaces
• The individual mandate
• Individuals’ access to premium tax credits
• Any other PPACA provision

Here is the announcement by the Treasury Department made on 7/2/2013: http://www.treasury.gov/connect/blog/Pages/Continuing-to-Implement-the-ACA-in-a-Careful-Thoughtful-Manner-.aspx.

Please review the attached Health Care Reform Hot Topic for more information.

Health Insurance Exchange and Revised COBRA Model Election Notices Released

The Affordable Care Act (ACA) added a section to the Fair Labor Standards Act (FLSA) that said an applicable employer must provide a written notice to each existing employee no later than March 1, 2013, and to new hires beginning on that date. But on January 24, 2013, the Department of Labor (DOL) put out an FAQ that recognized that was an unrealistic deadline.

On May 8, 2013, the DOL provided an update with temporary guidance and templates of the required Exchange Model Notices (For Employers who offer a health plan and Employers who do not offer a health plan) and the Revised Model COBRA Election Notice. Starting on October 1, 2013, the notices have to be given to new employees on the day they are hired. The notices have to be given to existing employees no later than October 1, 2013.

The notices, along with further guidance, can be found at www.dol.gov/ebsa. Please review the attached Health Care Reform Hot Topic for more information on the Model Notices Explanation.

Health Care Reform Update – Summary of Benefits and Coverage

Effective for plan/policy years and open enrollments (OEs) beginning on or after September 23, 2012, health insurers and self-insured group health plans will be required to provide a standard Summary of Benefits & Coverage (SBC) to enrolled members.

The group administrator is responsible for distributing SBCs to plan participants at least 30 days prior to renewal date (during the first day of OE), at initial enrollment, during special enrollments, 60 days prior to a material modification, and upon request.

Under the SBC requirements, willful failure to comply could result in up to a $1,000 fine per plan participant or beneficiary for each failure. HHS or the DOL can also issue an additional fine of $100 per day per affected person until the SBCs are properly issued.


For a more comprehensive overview on SBCs, please review the Reform Update 10/1/2012 - SBC Explanation and the SBC Sample. Current clients can log in to MyBasicGuru to access the Employer Notifications Checklist & Guide as well as Carrier specific information and instructions on obtaining SBCs.

Small Business Tax Credit IRS Guidance Released

The Internal Revenue Service issued new guidance on May 17, 2010 to make it easier for small businesses to determine whether they are eligible for the new health care tax credit under the Affordable Care Act and how large a credit they will receive. The guidance makes clear that small businesses receiving state health care tax credits may still qualify for the full federal tax credit. Additionally, the guidance allows small businesses to receive the credit not only for regular health insurance but also for add-on dental and vision coverage.

Attached is an overview of the Small Business Tax Credit IRS Guidance.