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.

Do You Speak Healthcare?

Do You Speak Healthcare?

If you do an Internet search for the acronym, ACA, you are likely to find over 200 possible definitions. (I found 213 on one page alone!)

When referring to ACA in the healthcare industry, ACA stands for the Affordable Care Act, commonly referred to as Obamacare. ACA is just one of the newer acronyms that you hear in the healthcare industry. ACO, CIN, and PCMH are also newer terms that you will begin to hear more about.

ACO stands for Accountable Care Organization. A CIN is a Clinically Integrated Network and a PCMH is a Patient Centered Medical Home. All of these are clinical models in the healthcare industry designed to improve the health outcomes of the patients and members that they serve.

Want to learn more? We can help you navigate the ACA, CIN, EOB, and SBC of it all!

View a Glossary of Common Healthcare Words as well as Abbreviations and Acronyms

Article courtesy of Optima Health.

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.”

Protect your Marketplace Account - Change your password

Recently, you may have heard about a new internet security weakness, known as Heartbleed, which is impacting some websites. HealthCare.gov uses many layers of protections to secure your information. While there’s no indication that any personal information has ever been at risk, we have taken steps to address Heartbleed issues and reset consumers’ passwords out of an abundance of caution. This means the next time you visit the website, you’ll need to create a new password. We strongly recommend you create a unique password – not one that you’ve already used on other websites.

Grace Period Provided for Payment of Premiums

Question: Must health plans participating in the exchanges provide individuals who purchase subsidized insurance coverage through the exchanges a 90-day grace period before terminating the coverage for non-payment of the premiums?

Answer: Yes. Under 45 CFR 156.270, individuals who purchase subsidized coverage through the exchanges must be provided a 90-day grace period before their coverage is cancelled for non-payment.

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.