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New Rule Gives People More Time to Elect COBRA

In a recent post, we mentioned that millions of people are losing their jobs and, as a result, their group health coverage because of the Coronavirus pandemic, and many of these individuals will qualify for COBRA continuation coverage.

The $500 FSA Rollover is Not Automatic

Employees love Flexible Spending Accounts, or FSAs. These tax-advantaged accounts give them the ability to set aside tax-free dollars to pay for qualified medical expenses, similar to an HSA. Unlike an HSA, though, an FSA can be paired with any type of health plan, including plans with up-front copayments for doctor visits and prescriptions. The drawback, of course, is the “use it or lose it” rule; employees whose FSA contributions exceed their annual medical costs must either go on a spending spree at the end of the year or risk losing any unspent funds.

Do you create employee packets for your group clients?

These days, employee communication is more important than ever. Obviously, the government requires that certain information be communicated and notices be provided to employees, but, even without that requirement, it’s critically important that employees understand their benefits. If they don’t, they won’t appreciate them, and the employer will not get the return on investment he or she was hoping for by offering benefits in the first place.

Self-Funding Can Provide Relief for Small-Business Employers

On April 9, 2018, the Centers for Medicare and Medicaid Services (CMS) announced that individuals and small employers can continue their transitional policies to the end of 2019; previously, these “grandmothered” plans were set to expire at the end of this year.

Transitional Plans Extended One More Year

On Monday, April 9, the Centers for Medicare and Medicaid Services announced that the transitional plans in the individual and small group markets, also known as “grandmothered” plans, will be extended one more year through the end of 2019. This is welcome news for clients who currently have a transitional policy, but it does feel a bit like the government is crying wolf. Every year, clients worry that they will need to search for another solution since they are likely to see their rates increase if they are forced to move to an ACA-compliant metallic plan, and every year they learn that they can hang on to their current coverage a little longer. This year is no different.

How do you fix falling individual medical sales? Go self-funded

We hear it every day - agents are struggling to find individual major medical plans that meet the needs of their small-business clients. Some of the more recent developments in the individual market, designed to keep premiums down, end up making plans less desirable. Deductibles are growing, networks are shrinking, and more prescription drugs are being moved to non-formulary – meaning they aren’t covered under the plan – and yet, premiums continue to rise. Some health care providers are even deciding to stop accepting plans purchased through the Marketplace. How do you fix falling individual medical sales? Go self-funded.

Congress Votes to Preserve Definition of Small Group

One of this fall’s “hot topics” highlighted in this month’s AHCP newsletter, was the definition of small group for purposes of the plan design and rating rules and how it varies and may change. One such change is that brought about by the Affordable Care Act. Starting in 2016, companies with 100 or fewer employees will be considered small employers and be subject to the essential benefits requirement and the modified adjusted community rating rules. Currently, every state sets the cutoff at 50 employees, rather than 100.

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