Individual Mandate Repeal Could Spur Interest in Short-Term Plans

One of the likely consequences of the repeal of the Affordable Care Act individual mandate under the tax overhaul that President Trump signed into law right before Christmas is a migration to short-term health plans.

These plans are essentially low-cost, low-coverage plans that do not comply with the ACA’s protections and benefits. They are not your typical health insurance plans, as they are only really good for catastrophic coverage and do not cover run-of-the-mill medical procedures like doctors’ visits and the cost of medications.Read More

Fallout from GOP Tax Bill on Health Coverage

The GOP’s tax bill, which seems on its way to passage in Congress and eventual enactment, will have a number of spillover effects on the health insurance markets, for commercial and individual policies alike.

To get more Republicans on board, the Senate leadership added a provision that eliminates penalties for individuals who do not secure health coverage either through their employers or on their own on publicly run exchanges.Read More

Legislation Takes Aim at ACA Taxes, Penalties

House Republicans are taking another shot at dismantling the Affordable Care Act, this time taking aim at taxes and penalties related to the divisive health care law.

They have also inserted language into the joint-chamber tax bill that would eliminate ACA penalties for people who fail to secure health insurance if they do not get it from their employers.Read More

With Health Insurance Laws in Flux, Flexible Spending Accounts Can Save Your Workers Money

The Internal Revenue Service is reminding eligible employees that now is the time to begin planning to take full advantage of their employer’s health flexible spending arrangement for next year.

If you don’t offer a flexible spending account (FSA) for your employees, you should consider starting one as they allow them to use tax-free dollars to pay medical expenses not covered by their health plan, including deductibles, copays and any pharmaceuticals.Read More

IRS Sends out ACA Compliance Letters, Employers Have 30 Days to Respond

The IRS has started sending out letters to employers who have failed to comply with the Employer Shared Responsibility provisions under the Affordable Care Act for the year 2015.

The IRS seems to be moving forward with notifying employers after attempts to repeal and replace the ACA failed in Congress and since there has been no further rule-making, guidance or legislation that rolls back enforcement of the employer mandate.Read More

Employers Say Pharmacy Benefit Manager Contracts too Complex, Opaque

Three in five employers think their contracts with pharmacy benefit managers are overly complex and not transparent, according to a new study.

The study, which found that employers would prefer that PBMs are more transparent with their pricing and would like them to focus less on rebates and value-based designs, comes as PBMs are under increased scrutiny for their opaque pricing practices.Read More

Senate Works to Save CSR Payments, but Too Late for 2018

The Affordable Care Act requires insurers to reduce cost sharing (deductibles and copays) in silver-level plans for marketplace enrollees with incomes below 250% of the federal poverty line. Until now, insurers have relied on offsetting payments from the federal government to provide this feature.

These payments amounted to $7 billion for fiscal year 2017, $10 billion for 2018 and will reach $16 billion by 2027.Read More

Benefits Pro Magazine-Speaking from experience

BENEFITS PRO MAGAZINE- John W. Sbrocco

Manage expectations

Open enrollment is upon us! That means long days on top of sleepless nights and weekends just to keep up with the fourth quarter rush. Despite the fact that every year we tweak and tighten our procedures to make things go smoother, we’ve found that there’s no avoiding the stress of enrollment. While there are certainly a multitude of moving parts in this process, many of which are completely outside of our control, there’s always one tried and true practice we must keep in mind. That, of course  Click here to read more