News and Exchanges

 

Health Insurance Premium Subsidy Calculator

 

 What is form 1095A – Frequently Asked Questions 

 

Questions and Answers on Employer Shared Responsibility Provisions Under the Affordable Care Act

 

The fee you pay if you don’t have health coverage

 

Key dates for the Health Insurance Marketplace

 

 Employee Notices

Good Morning to all, Back in March 2013 there was an employer mandate that the employer was to issue a letter to all qualified employees about the “Exchanges”. It was then delayed, until the Dept of Labor could figure out what they wanted in this letter. It is now available and will be needed to be distributed to all qualified employees by Oct 1st 2013. It should also be given to all qualified employees at time of hire.

Due to market demand, the Department of Labor published Technical Release 2013-02, Guidance on the Notice to Employees of Coverage Options Under Fair Labor Standards Act, on May 8, 2013. This document provides temporary guidance about the Affordable Care Act’s requirement that employers notify employees of their coverage options, particularly coverage options available through the Exchanges. The guidance provided in the Technical Release should be followed until the department issues other regulations or final guidance. Any future guidance will allow adequate time to comply with additional or different requirements.

According to the Technical Release, applicable employers (i.e., those subject to the Fair Labor Standards Act, or FLSA*) must give employees at the time of hire (or by October 1, 2013, for current employees), a written notice to:

The Technical Release announces the availability of two model notices:

 

UPDATE: Federally Mandated Fees Impacting Employers

The Affordable Care Act (ACA) calls for a number of federally mandated fees related to health insurers and plan sponsors. These fees impact groups differently depending on the size or funding structure of a group, and include the following:

PCORI Fee

The Patient-Centered Outcomes Research Institute (PCORI) f supports clinical effectiveness research. The PCORI fee began in 2012 and will expire in 2019. For the first plan year (ending after September 30, 2012), the fee was $1 per member per year. For the next plan year, the fee is $2 per member per year. The fee will increase for inflation each year until 2019. This fee impacts all groups regardless of size or funding.

Market Share Fee

The market share fee funds tax subsidies for low-income individuals and families who buy insurance through the public marketplace. This permanent fee, which begins in 2014, is based on how much premium each health insurer collects. This fee impacts all fully insured groups, regardless of size.

Transitional Reinsurance Program Fee

The transitional reinsurance program fee will help fund a three-year program designed to stabilize the individual marketplace by offsetting the higher claims costs insurance carriers may have. The fee is $63 per member per year in 2014 and is expected to decrease in 2015 and 2016. It is scheduled to expire in 2016. This fee impacts all groups, regardless of size or funding.

Risk Adjustment Program Fee

The risk adjustment fee funds the Risk Adjustment Program, which is designed to help stabilize both the individual and small group insurance marketplaces. The program assists insurance carriers covering high-risk individual and small group members. The fee is $1 per member per year in 2014. This fee only impacts non-grandfathered, fully insured plans in metal tier products.

 

HSA CONTRIBUTION LIMITS 2016 to 2017

A comparison of the 2016 and 2017 limits is shown below:

Contribution and Out-of-Pocket Limits for Health Savings Accounts and High-Deductible Health Plans
For 2016 For 2017 Change
HSA contribution limit (employer + employee) Self-only: $3,350

Family: $6,750

Self-only: $3,400

Family: $6,750

Self-only: +$50

Family: no change

HSA catch-up contributions (age 55 or older)* $1,000 $1,000 No change**
HDHP minimum deductibles Self-only: $1,300

Family: $2,600

Self-only: $1,300

Family: $2,600

Self-only: no change

Family: no change

HDHP maximum out-of-pocket amounts (deductibles, co-payments and other amounts, but not premiums) Self-only: $6,550

Family: $13,100

Self-only: $6,550

Family: $13,100

Self-only: no change

Family: no change

* Catch-up contributions can be made any time during the year in which the HSA participant turns 55.

** Unlike other limits, the HSA catch-up contribution amount is not indexed; any increase would require statutory change.

Affordable Care Act Timeline

 

Affordable Care Act Tax Provisions