I doubt I’m going out on a limb by saying that the “kid in the candy store” perspective that insurance companies may have had about the Affordable Care Act has all but vanished. A new Standard & Poor’s report released this week supports that the “candy store” notion is now no more than illusion and provides further indications that ObamaCare is sputtering and may well be reaching a Tipping Point.
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- Tom Barrett
- December 18, 2015
- ACA, affordable care act, costs, coverage, employees, employers, exchange, health plans, healthcare reform, Narrow Networks, Obamacare, trends
- 0 Comments
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!”
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.
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.
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
Info for Part-time or Other Employees Currently Without Health Insurance
There’s lots of noise out there related to Obamacare’s individual mandate and the rapidly approaching March 31 open enrollment deadline. Here’s summary information for those part-time or other employees that currently do not have any health insurance:
- The deadline to sign up for individual health insurance is March 31 – less than a week away. This marks the end of the open enrollment period. After March 31, those without coverage will not be able to purchase an individual health plan (on or off the exchange) until the next open enrollment period beginning in November — unless they have a qualifying event such as marriage, birth of a child, loss of employer sponsored health coverage, move out of state, have a significant income change, etc. If that’s the case, then they can enroll during a special enrollment period.
- Extensions may be available based on information released just yesterday. According to latest reports if someone started to apply for coverage through the HealthCare.gov website but could not finish by March 31 or they experienced other glitches in trying to sign up, they will have until about the middle of April to seek an extension. Individuals can qualify for an extension by checking a blue box on the HealthCare.gov website indicating that they’ve tried to enroll before the deadline. The following are links to recent news stories that reported the extension that was officially announced yesterday:
- If someone goes without health coverage after March 31, they may be subject to health reform law’s tax penalty come tax time next April for not having coverage. The penalty this year is $95 or up to 1% of income, whichever is greater.
- Some financial assistance may be available. Individuals and families with incomes between 100 percent and 400 percent of the poverty level (about $11,490 to $45,960 for individuals) may qualify of premium tax credits (also referred to as premium subsidies). Tax credits are based on a percentage of household income and are applied on a sliding scale for those that qualify.
Individuals who want to obtain health care insurance before the March 31 deadline should visit Healthare.gov to begin their application process.