Question: What are the Employee Retirement Income Security Act (ERISA) rules about nondiscrimination in benefits plan designs to assist with creating benefit class carve-outs? Answer: Under the Health Insurance Portability and Accountability Act (HIPAA, which is governed by ERISA) and I.R.C. § 125 plan rules, employers are allowed to offer different contribution levels or benefit […]
Posted by Linda Rowings Beginning in 2015, large employers must offer affordable, minimum value coverage to their full-time employees or potentially pay a penalty. Some companies have been marketing a plan that they state satisfies the minimum value requirement (an actuarial value of 60%), based upon a calculator provided by the Department of Health and […]
Question: Are we required to have employees complete wellness reward screenings which impact health care premiums, prior to the new plan year beginning? Answer: While some employers do take this approach, it may be possible for employers to apply premium reductions for those who complete the required screenings mid-year. The challenge relates to compliance with […]
Posted by Carol Taylor On November 6, 2014, the collective Departments of Health and Human Services (HHS), Labor (DOL) and the Treasury released three Frequently Asked Questions (FAQs) directed at employer payment plans for the purchase of individual insurance. While the departments had previously released several other pieces of guidance about these arrangements, this latest […]
Posted by Linda Rowings The Department of Labor (DOL), the IRS, and the Department of Health and Human Services (HHS) have jointly issued a FAQ that addresses how “reference-based pricing” works with the Patient Protection and Affordable Care Act’s (PPACA) restrictions on out-of-pocket maximums. PPACA limits the out-of-pocket maximum a non-grandfathered plan may impose, and […]
By Linda Rowings On Friday, October 31, 2014, the Department of Health and Human Services (HHS) quietly updated its Health Plan Identifier information page to delay the requirement that insurance carriers and self-funded health plans obtain a health plan identifier (HPID). The delay is in effect until further notice. Plans that have already obtained their […]
Posted by Linda Rowings The transitional reinsurance fee (TRF) applies to fully insured and self-funded major medical plans for 2014, 2015, and 2016. The purpose of the fee is to provide funds to help stabilize premiums in the individual insurance market in view of uncertainty about how the Patient Protection and Affordable Care Act (PPACA) […]
Nov 3, 2014 Posted by briobenefits in Health News, Surveys | Comments Off Top Health Care Statistics | NY Employee Benefits By: Peter Freska, MPH, CEBS, Benefits Advisor The LBL Group A UBA Partner Firm We field many calls to review, speak, and comment on a variety of topics. Of course, the generally pertain to […]
By Carol Taylor, Employee Benefit Advisor D&S Agency, a UBA Partner Firm The United Benefit Advisors (UBA) annual Health Plan Survey for 2014, which contains validated data on 16,467 plans for 9,950 employers, shows minor average change for plans in the last year. The survey contains information on plans that renewed predominantly between June 2013 […]
By Linda Rowings We field a lot of questions from employers about wellness programs and how they comply with PPACA. Here are two of the most common ones from UBA’™s “Frequently Asked Questions (FAQ) About Wellness Programs’™ Legal Requirementsâ€: Q: How does a wellness program affect affordability calculations? A: The proposed regulations provide that when […]