General Insurance Issues

Lots of Medicare Questions From Employers and Employees This Year

…Here are the ABC’s (and Part D)

For whatever reason – aging workforce, increasing costs, heightened awareness because of ACA – we’re getting lots and lots of questions from clients and their employees about Medicare this year. Way more than in years past. The vast majority of questions are about the basics.

And, it’s easy to get confused about what’s what. So thought it might be helpful to put together a cheat sheet of sorts about the basics. Here’s a quick summary of the ABC’s (and Part D’s)…

Stripped Down Plans without Any Hospital Benefits?  “Not so fast my friend!”

In last week’s Did You Know Series on Obamacare we pointed out a major glitch or loophole in the healthcare law that actually may allow large employers to avoid health-law penalties by offering stripped down plans that have no hospitalization coverage. Well, in the words of colorful former college football coach and current ESPN College Game Day host Lee Corso “Not so fast my friend!”

STOP

While there’s no official word yet, it sure sounds like this loophole was a screw up, is now on the administration’s radar screen and is likely to be fixed soon. We’ll continue to keep you posted on developments as they unfold. For more about this, here’s the link to a recent article on this topic from Kaiser health News that also appeared in The Washington Post.

Obamacare…Did you know? #3

I’m doing a series on things I think you should know about Obamacare. Here is installment #3…

There’s a major glitch or loophole in the healthcare law that actually allows large employers to avoid health-law penalties by offering stripped down plans that are devoid of any hospital benefits. That’s right. No hospital benefits at all. Obamacare regulators created an online calculator to certify whether plans offered by large self-insured employers that pay their own medical claims meet the Affordable Care Act’s toughest standard. The Obamacare calculator is used to test “minimum value” for adequate benefits. Many, including your 2-Minute Drill author, were surprised to read in a recent Kaiser Health News story that the calculator approves these plans lacking any hospital benefits.

ObamaCareGlitchesCartoon

Word is that numerous large, low-wage employers with high turnover that haven’t offered medical coverage in the past — retailers, hoteliers, restaurants and other businesses with high worker turnover and lower pay — are considering driving a truck through this loophole by offering plans without any hospitalization coverage. By doing so, they thus protect themselves from some of the employer mandate penalties that come into play next year. Some of the talking heads in the industry claim the calculator was purposely designed this way by the administration. However, I tend to agree with respected consultant Bob Laszewski.  He’s quoted as saying “That’s baloney. Nobody said we’re going to have health plans out there that don’t cover hospitalization. That was never the intention…I think they just screwed up.”  Stay tuned for more on this.

Obamacare…Did you know? #1

Obamacare…Did you know? #2

Obamacare…Did you know? #2

I’m doing a week-long series “Obamacare…Did you know?”

Last week I talked about how as we move into the open enrollment phase for 2015, more complexities arise and more computer glitches are expected. Read my post Obamacare…Did you know? #1

Judge Slams His Gavel and American Flag Table Reflection.

Just recently a federal judge in Oklahoma ruled that subsidies can’t go to those who purchased health coverage through a federal exchange (most states). This decision adds to a mix of rulings on whether individuals in states utilizing the federal marketplace can legally be provided with premium subsidies. Many expect that this subsidy issue, which is a major component of the Affordable Care Act, will wind up before the U.S. Supreme Court. In July, two U.S. appeals courts issued conflicting rulings on health-law subsidies, raising questions about the fate of tax credits/premium subsidies provided to several million Americans.  While this issue makes its way through the courts, subsidies remain available.

Read more about this in an article on Politico

Stay tuned for more this week on Obamacare…Did you know?

Facebook Iconfacebook like buttonTwitter Icontwitter follow buttonVisit Our LinkedIn Profile