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 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 News for 2013

With the Supreme Court Ruling and the Elections behind us, the majority of the obstacles to the implementation of the Affordable Care Act (ACA) have been cleared. The question is no longer if, but when and how ACA will be established in each state.

Please review the Health Care Reform News for some key provisions for Health Care Reform new in 2013 and provisions from prior years impacting 2013:

• Exchange/Marketplace Creation,
• Employer Exchange Notices—DELAYED,
• New Taxes, Limits, and Fees,
• Uniform Summary of Benefits and Coverage (SBC) Forms and Notice of Material Modifications,
• Women's Preventive Services,
• Medical Loss Ratio Rebate,
• W-2 Reporting, and
• Small Business Health Care Tax Credit—available through 2013.

Welcome to our Health Care Reform News Feed!

As part of our ongoing commitment to keep you informed, Sterling Benefits has added a resource to release the latest updates in a timely manner without inundating you with emails. We encourage you to read our News Feed at your leisure or you may subscribe to the “blog” to receive a digest of any communications.

We have populated the News Feed with past communications to better assist you.

We’ll continue to send out updates as they become available, but we encourage you to review the information and utilize our website and office as a resource in addressing questions and concerns. The website includes previous Sterling publications, hot topics, resource links, highlights, timelines and calendars.  Please feel free to share this website and invite people to sign up for electronic Reform updates!

As always, we appreciate the opportunity to be of service.

Thank you,
Christina & Brenda

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.

Supreme Court Ruling & Health Care Reform Update for 2012

Attached please find the update for Health Care Reform in 2012 that includes the following topics:

• Supreme Court Ruling;
• Politics & Ongoing Issues;
• ACA Already in Effect;
• ACA Next Steps;
• 2012 - Medical Loss Ratio Rebate, Women's Preventive Services, and Summary of Benefits and Coverage (SBC) Forms.
• 2013 – FSA Contribution Limit, Additional Medicare Tax, Medical Expenses Itemized Deduction, Exchange Notices, and Comparative Effectiveness Research Plan Fees.

 

Health Care Reform News for 2012

Attached is an overview of some of the key provisions for Health Care Reform in 2012: 

• W-2 reporting,
• Small Business Health Care Tax Credit—available through 2013,
• Uniform Summary of Benefits and Coverage (SBC) Forms and Notice of Material Modifications—DELAYED,
• Medical Loss Ratio Rebate,
• Quality of Care Reporting,
• Comparative Effectiveness Research Plan Fees, and
• Women's Preventive Services.

Other topics addressed:

• Reform Lawsuits & Decisions
• Virginia Health Reform Initiative
• Pre-existing Condition Insurance Plan
• PPACA Grandfathered Plan Notice

Health Care Reform News for 2011

Attached is an overview of some of the key provisions for Health Care Reform in 2011: 

• Small Business Tax Credit
• Health Coverage and Older Children
• Changes to Over-the-Counter Drugs
• HSA Tax Penalty
• Nondiscrimination Testing Delayed
• W2 Reporting - Optional in 2011
• Pre-existing Condition Insurance Plan
• Virginia Health Reform Initiative
• Reform Lawsuits & Decisions
• PPACA Notices
• New Reform Website

Health Care Reform September 23, 2010 Requirements/Provisions

Attached is an overview of the Health Care Reform requirements effective September 23, 2010.

Items addressed include:

• Grandfathered plans
• Grandfathered vs. Non-Grandfathered Provisions Chart
• Provisions effective 9/23/10 (Dependent coverage to age 26, removal of pre-existing condition exclusions for children, annual & lifetime limits, recissions, preventive care visits, and patient protections)
• Required PPACA notices

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.

Health Care Reform FAQ's

As a follow-up to our post on 4/16/10 regarding the Patient Protection and Affordable Care Act (PPACA), attached are some Frequently Asked Questions that we've been hearing about employee concerns, COBRA, employer responsibilities, and the Small Business Tax Credit. 

INTRODUCING...Our new resource website on Health Care Reform - http://www.sterlingbenefit.com/section8.cfm?&disclaimer=accept. 

We’ll continue to send out updates as they become available, but we encourage you to review the information and utilize our website and office as a resource in addressing questions and concerns. The website includes Sterling publications, hot topics, resource links, highlights, timelines and calendars. Please feel free to share this website and invite people to sign up for electronic Reform updates!

As always, we appreciate the opportunity to be of service.

Health Care Reform Overview

A few weeks ago, President Obama signed into law the Patient Protection and Affordable Care Act (PPACA). PPACA presents challenges and opportunities unlike anything we have seen over the years in the health insurance industry. 

At Sterling Benefits, we are proactively working with multiple resources to dissect the various facets of the law and to understand the guidelines and timelines it presents to our clients. You can expect that we will provide ongoing communications and information as interpretation and implementation details continue to unfold from the government.

Our priority at Sterling Benefits is to stay focused on delivering value and quality customer service to our customers as we work together with health care reform. Significant changes will take place in 2014. In the meantime, there are some items that will require attention much sooner. We will keep you posted as details and clarifications from the government are made available. 

Attached is an overview of the Health Care Reform. We encourage you to review this information and utilize our office as a resource in addressing questions and concerns.