Forecasters say a Patient Protection and Affordable Care Act pricing rule may increase premiums for 65 percent of the affected small groups.
The effects of the PPACA pricing rule on large-group plans will be negligible, the forecasters say.
Analysts at the Office of the Actuary at the Centers for Medicare and Medicaid Services come to those conslusions in a new report to Congress on the effects of PPACA private health insurance requirements on group health premiums.
PPACA includes many provisions that could affect group health prices either directly or indirectly. In the new report, the CMS actuaries looked only at the effects of the PPACA Fair Health Insurance Premiums section. The fair premiums section requires insurers in the small-group market to offer coverage on a guaranteed-issue, guaranteed-renewable basis, with an adjusted community rating system.
The fair premiums section exempts large groups.
Because the Health Insurance Portability and Accountability Act of 1996 already required insurers to sell small-group coverage on a guaranteed-issue, guaranteed-renewable basis before PPACA came along, the community rating requirement is the only fair premiums provision likely to affect small-group rates, the CMS actuaries say.
The PPACA adjusted community rating rules let carriers charge up to three times more for coverage for the oldest insureds than they charge for the youngest, but insurers can no longer use gender, health status or claims as rating factors.
Independent experts told the CMS actuaries that they thought the community rating rules would increase rates for about 60 percent to 67 percent of the fully insured small groups subject to the new rules.
In the real world, the effect will probably be much narrower this year, because so many small groups renewed coverage early and are not yet affected by the PPACA requirements that took effect Jan. 1, actuaries said. Many of these small group plans opted for the Dec 1, 2013 early renewal option. Watch for all of these groups to renew Dec 1, 2014 with these large increases.
Tuesday, February 25, 2014
Wednesday, February 19, 2014
Additional delays for Large Group Employer Mandates
The Federal Government announced on February 10, 2014, that it will delay enforcing certain provisions of the Affordable Care Act (ACA). The delays affect the employer shared responsibility requirement for groups with 50 to 99 eligible employees, as well as groups with 100 or more employees.
50 to 99 Groups
Employers with 50 to 99 eligible employees will have until their first plan year on or after January 1, 2016 to provide employees who work more that 30 hours a week with healthcare coverage that meets minimum value and affordability rules.
100+ Groups
While the Federal Government had already delayed the coverage requirement for 100+ groups until 2015, these groups will now only have to cover 70% of their eligible employees in 2015. The earlier 95% coverage requirement is now delayed until 2016.
Please note that Employers with plan years that start after January 2, 2014, will not be subject to compliance requirements until the start of their plan years in 2015.
The updated regulations also provide clarification regarding how full-time status should be calculated for certain categories of employees and occupations. Some key categories include:
50 to 99 Groups
Employers with 50 to 99 eligible employees will have until their first plan year on or after January 1, 2016 to provide employees who work more that 30 hours a week with healthcare coverage that meets minimum value and affordability rules.
100+ Groups
While the Federal Government had already delayed the coverage requirement for 100+ groups until 2015, these groups will now only have to cover 70% of their eligible employees in 2015. The earlier 95% coverage requirement is now delayed until 2016.
Please note that Employers with plan years that start after January 2, 2014, will not be subject to compliance requirements until the start of their plan years in 2015.
The updated regulations also provide clarification regarding how full-time status should be calculated for certain categories of employees and occupations. Some key categories include:
- Volunteers: Bona fide volunteers for government or tax-exempt entities (volunteer firefighters or emergency responders) will not be considered full-time employees.
- Educational employees: Teachers and other educational employees will not be treated as part-time for the years simply because their school is closed or operating on a limited schedule during the summer.
- Adjunct faculty: Adjunct faculty can receive credit for two hours and 15 minutes of service per week for each hour of teaching or classroom time.
Tuesday, February 18, 2014
Options-Life Insurance
7 in 10 Women think everyone should have Life Insurance, yet 43% have no coverage at all.
YOUR OPTIONS:
There are many kinds of Life insurance, but they generally fall into two categories:
Term Insurance and Permanent Insurance.
Term Insurance , the most affordable type of insurance when initially purchased, is designed to meet temporary needs. It provides protection for a specific period of time (the "term") and generally pays a benefit only if you die during that "term". This type of insurance often makes sense when you have a need for coverage that will disappear at a specific point in time. For instance, you may decide that you only need coverage until your children graduate from college or a particular debt is paid off, such as your mortgage.
Permanent Insurance, by contrast, provides lifelong protection. As lon as you pay the premiums and no loans, withdrawals or surrenders are taken the full amount will be paid. Because it is designed to last a lifetime, permanent life insurance accumulates cash value and is priced for you to keep it over a Long period of time. It's impossible to say which type of Life Insurance is better because the kind of coverage that's right for you depends on your unique circumstances and financial goals. Often, a combination of term and permanent insurance is the right solution.
YOUR OPTIONS:
There are many kinds of Life insurance, but they generally fall into two categories:
Term Insurance and Permanent Insurance.
Term Insurance , the most affordable type of insurance when initially purchased, is designed to meet temporary needs. It provides protection for a specific period of time (the "term") and generally pays a benefit only if you die during that "term". This type of insurance often makes sense when you have a need for coverage that will disappear at a specific point in time. For instance, you may decide that you only need coverage until your children graduate from college or a particular debt is paid off, such as your mortgage.
Permanent Insurance, by contrast, provides lifelong protection. As lon as you pay the premiums and no loans, withdrawals or surrenders are taken the full amount will be paid. Because it is designed to last a lifetime, permanent life insurance accumulates cash value and is priced for you to keep it over a Long period of time. It's impossible to say which type of Life Insurance is better because the kind of coverage that's right for you depends on your unique circumstances and financial goals. Often, a combination of term and permanent insurance is the right solution.
Life Insurance answers family finance issues
86% say that they haven't bought Life Insurance because it's too expensive, yet overestimate its true cost by more than 2x.
It's a subject no one really wants to think about. But if someone depends on you financially, it's one you cannot avoid. In the event of a tragedy, Life Insurance proceeds can:
It's a subject no one really wants to think about. But if someone depends on you financially, it's one you cannot avoid. In the event of a tragedy, Life Insurance proceeds can:
- Pay for funeral costs
- Help pay the bills and meet ongoing living expenses
- Pay off outstanding debt, including credit cards and the Mortgage
- Continue a family business
- Finance future needs like your children's education
- Protect a spouse's retirement plans
Tuesday, February 11, 2014
Medium Sized Employers until 2016
WASHINGTON POST
The Obama administration announced Monday it would give medium-sized employers an extra year, until 2016, before they must offer health insurance to their full time workers.
Firms with at least 100 employees will have to start offering this coverage in 2015.
By offering an unexpected grace period to businesses with between 50 and 99 employees, administration officials are hoping to defuse another potential controversy involving the 2010 health-care law, which has become central to Republicans' campaign to make political gains in this year's midterm election.
Even the nation's largest employers got a significant concession: They can avoid a fine by offering coverage to 70% of their full-time employees in 2015 and 95% starting in 2016. Under an earlier proposal, employers with at least 50 employees would have been required to offer insurance, beginning 2015, to 95% of those who work 30 hours or more a week, along with their dependents.
The regulation finalized by the Treasury Department involves one of the biggest issues surrounding the Affordable Care Act: how the law's employer mandate plays out in practice. The mandate has enormous ramifications for how businesses classify their employees and how much these men and women work.
Initially, these requirements-which affect firms employing 72% of all Americans-were supposed to take effect this year, at the same time that most individuals faced a new obligation to obtain health insurance or risk a tax penalty. Last July, the administration announced it would delay the regulation for a year after many employers and some unions complained about the law's reporting requirements and classification system for workers.
A senior administration official, who briefed reports on the proposal on the condition of anonymity because the rule was not yet public, said the Treasury Department decided to allow medium-sized businesses more flexibility because they "need a little more time to adjust to providing coverage."
The coverage must encompass a core set of benefits and be affordable-which the law defines as premiums costing no more than 9.5% of an employee's income-and the employer must pay for the equivalent of 60% of the cost of coverage for workers but not their dependents.
Until now, the government had not defined exactly which workers should be considered full-time. Nor had it spelled out important details of the insurance benefits that employer-sponsored health plans must cover, given that they are not the same as the "essential benefits" required of health plans that are sold to individuals or small businesses through the federal insurance exchange.
"This final rule may seem like an obscure accounting matter, but it gets to the heart of whether and how employers hire new workers-and whether these workers will have the opportunity to transition from part-time to full-time or seasonal to permanent employment," Haile said. "This rule hits on a core question as to how employment is structured in the United States."
Administration officials said that organizations with a large number of volunteer employees-such as firefighters and first responders-would not have to provide coverage, along with those hiring seasonal employers who work six months or less in a given year.
Teachers will not be considered part-time just because they do not work for three months during the summer, officials added, while the status of adjunct faculty will be calculated on a formula where they would receive credit for 2 1/4 hours of service per week for each hour they spent teaching or in the classroom.
The Obama administration announced Monday it would give medium-sized employers an extra year, until 2016, before they must offer health insurance to their full time workers.
Firms with at least 100 employees will have to start offering this coverage in 2015.
By offering an unexpected grace period to businesses with between 50 and 99 employees, administration officials are hoping to defuse another potential controversy involving the 2010 health-care law, which has become central to Republicans' campaign to make political gains in this year's midterm election.
Even the nation's largest employers got a significant concession: They can avoid a fine by offering coverage to 70% of their full-time employees in 2015 and 95% starting in 2016. Under an earlier proposal, employers with at least 50 employees would have been required to offer insurance, beginning 2015, to 95% of those who work 30 hours or more a week, along with their dependents.
The regulation finalized by the Treasury Department involves one of the biggest issues surrounding the Affordable Care Act: how the law's employer mandate plays out in practice. The mandate has enormous ramifications for how businesses classify their employees and how much these men and women work.
Initially, these requirements-which affect firms employing 72% of all Americans-were supposed to take effect this year, at the same time that most individuals faced a new obligation to obtain health insurance or risk a tax penalty. Last July, the administration announced it would delay the regulation for a year after many employers and some unions complained about the law's reporting requirements and classification system for workers.
A senior administration official, who briefed reports on the proposal on the condition of anonymity because the rule was not yet public, said the Treasury Department decided to allow medium-sized businesses more flexibility because they "need a little more time to adjust to providing coverage."
The coverage must encompass a core set of benefits and be affordable-which the law defines as premiums costing no more than 9.5% of an employee's income-and the employer must pay for the equivalent of 60% of the cost of coverage for workers but not their dependents.
Until now, the government had not defined exactly which workers should be considered full-time. Nor had it spelled out important details of the insurance benefits that employer-sponsored health plans must cover, given that they are not the same as the "essential benefits" required of health plans that are sold to individuals or small businesses through the federal insurance exchange.
"This final rule may seem like an obscure accounting matter, but it gets to the heart of whether and how employers hire new workers-and whether these workers will have the opportunity to transition from part-time to full-time or seasonal to permanent employment," Haile said. "This rule hits on a core question as to how employment is structured in the United States."
Administration officials said that organizations with a large number of volunteer employees-such as firefighters and first responders-would not have to provide coverage, along with those hiring seasonal employers who work six months or less in a given year.
Teachers will not be considered part-time just because they do not work for three months during the summer, officials added, while the status of adjunct faculty will be calculated on a formula where they would receive credit for 2 1/4 hours of service per week for each hour they spent teaching or in the classroom.
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