confusion

Definition of Predicament: People Who Don’t Have Access to Employer Coverage, Aren’t Medicare Eligible, and Don’t Qualify for Subsidies

Yes, this is a bit anecdotal. Nevertheless, I think it’s  worth reporting and some may find it interesting.

First, recently our team managed the annual open enrollment process for the group health plan of one of our employer clients. After a quick but thoughtful evaluation of options, one employee who was previously covered by an individual market policy opted to enroll on the employer’s group plan (family coverage) and terminate coverage under the individual market plan. Both the individual plan and the group plan were Qualified Health Plans (QHP) under ACA. The plans had similar benefits. And, they were underwritten by the same large insurance carrier.

Savings?

$600 a month in gross premium. That’s quite a spread.  Add in the employer contribution and the savings to the employee were even greater.

Letters From CMS (Medicare) to Employers Regarding Group Health Plan Reporting Are Causing Some Confusion

Many employers are receiving letters from CMS (Medicare) requesting information and it’s causing some confusion. The actual title of the letter reads “Requirement to Submit the Group Health Plan Report for the IRS/SSA/CMS Data Project”.

Here’s an overview that may help clarify for you.

This letter from CMS is separate and apart from the new ACA employer reporting requirements that recently went into effect (employers with 50+ employees). Employers are required to provide the requested information but it’s pretty basic and, other than complying with the request, not anything to really be concerned about.

In Case You Missed It – HHS Has Again Extended the Small Group “Keep Your Plan” Provision of the Affordable Care Act

We know you get updated on a lot of healthcare issues.  Just in case you missed our previous announcement this is worth repeating for those employers in the under 50 segment who have kept pre-ACA plans in place.

For our under 50 employee groups, we were ramping up to help construct ways to continue the option of keeping your current plan (unless something better becomes available).  In the past, we have had to shift renewal dates or juggle “grandfathering” vs. “grandmothering” your plan.

This year we will not have to do any such juggling.

HEALTHCARE COSTS: YOU WON’T BELIEVE THIS!

We read and hear a lot about the craziness and wild swings in pricing for common medical services. Some seem too incredulous to believe. Healthcare’s version of Ripley’s Believe It Or Not.

OK. So here’s a true story. Hot off the presses. Happened just this week to someone in our sphere.

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