Question:
In 2014 will an employee's non-working spouse be eligible for a premium credit or subsidies on the Exchange if
1) the employee's employer does not offer medical coverage to employee's spouse or
2) the employer offers medical coverage to the employee spouse's but does not pay for any portion of the premium for such spouse's coverage?
Answer:
Under Treasury Regulations Section 1.36B-2(c)(3)(v)(A)(2), an eligible employer-sponsored plan will be affordable for related individuals (family members) if the cost of self-only coverage does not exceed 9.5% of the employee's household income.
In other words, for purposes of determining whether family members are eligible for premium tax credits, the cost of family coverage is no taken into account-all that matters is whether the cost of self-only coverage is affordable to the employee.
Therefore, if an employer offers coverage to the employee's spouse, but does not pay for any part of his or her premium, he or she will not be eligible for credits and subsidies if the coverage offered to the employee is affordable.
If an employer does not offer coverage to the employee's spouse, he or she would be eligible for credits and subsidies depending on the family's household income.
Wednesday, November 27, 2013
Friday, November 22, 2013
Round 2 of ObamaCare Enrollment Delayed
The Obama administration plans to delay the start of next year's ObamaCAre enrollment period, a move pitched as a way to give consumers and insurance companies more time to study their options-but which also conveniently pushes the second round of enrollment past the 2014 midterm elections.
The decision does not affect those trying to enroll this year, despite the myriad problems with the launch of the law and HealthCare.gov. It only affects those who will sign up late next year for 2015 coverage.
This move will allow consumers to start signing up on Nov 15, 2014 as opposed to Oct 15. Enrollment will last until Jan 15, 2015 instead of Dec. 7th.
By pushing off next year's enrollment period, the administration coveniently pushes off the possibility of any ObamaCare hicccups until after the midterm elections. Some of the biggest critics of the current roll out have been Democrats up for reelection next year.
The decision does not affect those trying to enroll this year, despite the myriad problems with the launch of the law and HealthCare.gov. It only affects those who will sign up late next year for 2015 coverage.
This move will allow consumers to start signing up on Nov 15, 2014 as opposed to Oct 15. Enrollment will last until Jan 15, 2015 instead of Dec. 7th.
By pushing off next year's enrollment period, the administration coveniently pushes off the possibility of any ObamaCare hicccups until after the midterm elections. Some of the biggest critics of the current roll out have been Democrats up for reelection next year.
Friday, November 15, 2013
Final Rules on Workplace Wellness Programs
The Affordable Care Act (ACA) includes provisions to encourage the use of wellness programs related to group health
coverage. Effective for plan years beginning on or after Jan. 1, 2014, ACA adopts the existing HIPAA
nondiscrimination requirements for health-contingent wellness programs, while also increasing the maximum reward
that can be offered under these programs.
On May 29, 2013, the Departments of Labor, Health and Human Services and the Treasury (Departments) released
final regulations that implement ACA’s nondiscrimination requirements for wellness programs. The final regulations
clarify and reorganize the rules outlined in previous proposed regulations. They are intended to ensure that every
individual participating in a wellness program can receive the full amount of any reward or incentive, regardless of any
health factor.
Specifically, the final regulations:
Formally adopt the proposed nondiscrimination rules for health-contingent wellness programs, such as giving
individuals an opportunity to qualify for the reward each year and providing an alternative standard or waiver
for individuals with health conditions;
Divide health-contingent wellness programs into two categories: activity-only wellness programs and
outcome-based wellness programs; and
Increase the permissible reward for meeting a health-related standard to 30 percent of the total cost of
employee-only coverage (or 50 percent, if the program is designed to prevent or reduce tobacco use).
The regulations apply to both grandfathered and non-grandfathered group health plans and group health insurance
coverage for plan years beginning on or after Jan. 1, 2014.
Friday, November 8, 2013
Obamacare Mandate YouTube
ACA "Obamacare" Mandate Under the Affordable Care Act you are required to Purchase health insurance for 2014. You may be eligible for a advanced federal premium subsidy which will be paid to the insurer you choose To offset the total monthly premium for your insurance you may also be eligible for a cost sharing subsidy to pay expenses required by your new health plan. View Vidio: http://youtu.be/AU7rgN7DEXw
www.millerlewishemahelp.com
Monday, November 4, 2013
What is the Medicare Plan Star Rating
"Stars" is a Center for Medicare and Medicaid Services (CMS) program to improve quality for Medicare Advantage members. This program measurers how well plans perform on over 50 measurers.
Medicare uses information from member satisfaction surveys, plans, and health care providers to give overall performance star ratings to plans. A plan can get a rating between 1 and 5 stars. a 5-star rating is considered excellent. These ratings help you compare plans based on quality and performance. The ratings are updated each fall and can change each year.
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