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.

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.”

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.

Statement Of The Virginia Bureau Of Insurance Regarding Further Extension Of Individual And Small Group Health Insurance Plans

On March 5, 2014, the Obama Administration proposed a further suspension of the enforcement of certain provisions of the federal Affordable Care Act (ACA) and urged state insurance regulators to allow health insurance carriers to offer renewal of certain non-ACA compliant health insurance plans such that they could remain in effect into 2017.

Following this announcement, the State Corporation Commission's Bureau of Insurance (Bureau) has undertaken a legal and regulatory analysis of the extension proposal.

Virginia state insurance laws were changed to conform to various provisions of the ACA effective January 1, 2014. Therefore, in the absence of specific authorization by the General Assembly, insurance carriers remain subject to conforming Virginia law.

The Bureau previously encouraged carriers to offer policyholders the opportunity to "early renew" their existing insurance plans before January I, 2014, when the new Virginia provisions became effective. This allowed policyholders to continue existing coverage into 2014.

Policyholders with non-ACA compliant policies expiring in 2014 are advised to evaluate all available options tor health insurance coverage in 2014 to replace their coverage that may be expiring due to implementation of the ACA and conforming Virginia law.

Transitional Relief Extended through 2016

When the Obama Administration announced the transitional relief policy that allows individual and small group, fully insured, non-grandfathered policyholders to maintain their 2013 medical coverage through 2014, it indicated it would assess the policy and the specified timeframe.

The Centers for Medicare and Medicaid Services (CMS) issued a memo that it will extend the transitional policy for two years, for policy years beginning on, after or before Oct. 1, 2016, with the possibility of adding a one year extension then, if appropriate.

The transitional relief also applies to large businesses that currently purchase insurance in the large group market if, as of Jan. 1, 2016, they will be redefined by the Affordable Care Act (ACA) as small businesses purchasing insurance in the small group market.

As with the earlier transitional relief policy, State governments and health insurance issuers will have the option to offer the transitional relief or not participate.

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.

Rules on equal coverage delayed

WASHINGTON (Reuters) - The Obama administration is delaying enforcement of a provision of the new healthcare law that prohibits employers from providing better health benefits to top executives than to other employees, the New York Times reported on Saturday.

Tax officials said they would not enforce the provision this year because they had yet to issue regulations for employers to follow, according to the Times.

Internal Revenue Service spokesman Bruce Friedland said employers would not have to comply until the agency issued regulations or other guidance, the newspaper reported.

The IRS was not immediately available to confirm the Times story.

The rollout of the Affordable Care Act, known as Obamacare, has been marked by a number of delays in implementing certain parts of the law. In November, the administration announced a one-year delay in online insurance enrollment for small businesses.

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.

Regulatory change affecting Individual and Small Group business announced by President Obama

On 11/14/2013, President Obama announced that insurers may renew certain individual and small group health plans for 2014 without having to comply with new Affordable Care Act (ACA) requirements scheduled to take effect on January 1, 2014. Eligible policies include those with an effective date between January 1 and October 1, 2014 that would have otherwise been terminated.

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.

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.

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.

Health Care Reform & Group Imposed Waiting Periods for group insurance coverage

The Patient Protection and Affordable Care Act (PPACA) provides that for plan years beginning on or after Jan. 1, 2014, a group health plan or health insurance issuer offering group health insurance coverage shall not apply any waiting period that exceeds 90 days. A waiting period is defined by the Public Health Service Act as a “period that must pass before coverage for an employee or dependent who is otherwise eligible to enroll under the terms of a group health plan can become effective.”

An employer whose waiting period exceeds 90 days may be subject to penalties under Code 4980H, beginning in 2014, for every month the employer does not offer coverage if any employee obtains coverage through an exchange and is eligible for a premium tax subsidy.

Some employer plans provide that employees will become eligible for insurance coverage on the first of the month after 90 days (or longer). IRS guidance indicates that this plan design is not acceptable as it would typically exceed the 90-day limit. In these circumstances, employers would need to change their eligibility to the first of the month after 60 days or any other shorter waiting period that does not exceed 90 days to avoid penalties.

Five Myths About Obamacare You Probably Believe

Misconceptions and myths about the Affordable Care Act (ACA; aka Obamacare) abound. That’s not good, says Ron Pollack, the head of FamiliesUSA, an advocacy group based in Washington, D.C. That’s why Pollack’s group recently put together a list of myths, along with the correct information, about this important law and the changes it will soon bring:

• Myth #1: Starting in 2014, everyone must either have health insurance or pay a penalty—no exceptions.
• Myth # 2: If you’re insured through your employer, Obamacare won’t help you.
• Myth #3: All businesses will be required to provide health insurance to their employees.
• Myth #4: Undocumented immigrants will receive federal aid to buy health insurance.
• Myth #5: My state isn’t setting up its own health exchange, so it’s exempt from Obamacare.

Article:  Five Myths About Obamacare You Probably Believe

Small Businesses Pursue Health Law ‘Loophole’

Summary: Self-insurance, once the purview of only large companies, is becoming popular with small employers, too. But it could be a threat to the Affordable Care Act, since self-insured companies are exempt from many of the health law's requirements.

Article:  Small Businesses Pursue Health Law ‘Loophole’

Small Employers Are Clueless About Obamacare

Article:  http://www.businessweek.com/articles/2013-03-21/small-employers-are-clueless-about-obamacare