ACA – Affordable Care Act – Free Choice Vouchers

Hello All

Part of the ACA (Affordable Care Act) was to require employers with more than 50 employees to provide a voucher to their employees equal to the highest contribution level the employer makes.   That employee can then take that money and buy their health insurance through the exchange using employer provided money.

Part of the new budget for 2011 that shows 38 billion in cuts also eliminates this “Free Choice Voucher”.  If the President signs it into law this provision will be gone.

While it does not do away with penalties it does make it easier to maintain the integrity of an employer’s group health plan.  The “Free Choice Voucher” could have contributed to anti-selection by the fact that group plans for employers over 50 employees are composite rated based on the losses and age and other demographics of the group.  The individual exchange will most probably have age rating.  This would cause young people to abandon the group for lower cost exchange premiums.  The employee would then be allowed to keep the difference in premiums for themselves thereby causing a higher premium for the remainder of the group whose average age and claim base increased do to lack of participation by the young healthy employees.

Dave Wiest
President
EMEX Benefit Systems

What will the Federally mandated exchange plans through the state exchanges look like?

Hello all

We all are wondering what the Federally mandated exchange plans through the state exchanges look like.  Well maybe not you but I sure am!

The Kaiser Foundation just ran an article projecting what these plans might look like.  There are 4 mandated plans, Bronze, Silver, Gold and Platinum.  I have included the link for you to read the article.

In the article it projects that these plans will all have high deductibles based on their actuarial values.  It also shows the percentage of people in the US that are currently enrolled in plans with deductible of at least $1,000.*

http://www.kff.org/pullingittogether/What-Conservatives-Won-In-Health-Reform.cfm

Dave Wiest
President
EMEX Benefit Systems

INSURED MEDICAL REIMBURSEMENT PLANS

Hello All

Some of you have “INSURED MEDICAL REIMBURSEMENT PLANS” in place.  The writing of new plans was suspended by ACA regulations in 2010.  HHS removed the discrimination language temporarily in December of 2010 therefore new plans can now be written.  These plans allow a company to reimburse claims for selected people within the company without running afoul of discrimination rules.  This is a valuable tool for recruitment and retention of key employees.  It is not known how long this reprieve will last so “GET EM WHILE THEY”RE HOT” and call us for an explanation and a quote.

Dave Wiest
President
EMEX Benefit Systems

 

Tax Relief Act Summary

Hello All

I have been asked several times what effect the Tax Relief Act that was passed in the waning days of 2010 would have on “me”.  Most of you have probably had contact with your accountants and have already seen some form of summary on the law.  If you have not.  Here is a link to a very good summary and analysis of the bill.  It consists of 14 pages and is quite informative.

http://emexbenefits.com/Tax%20Relief_Job%20Creation%20Act%20of%202010.pdf

Dave Wiest
President
EMEX Benefit Systems

 

Minnesota (HF479) Exchange

Minnesota (HF479) Exchange

Hello All

In recent weeks there has been a bill proposed to implement the “Exchange” in Minnesota (HF479).  This bill consists of a minimalist approach to the exchange requirement mandated to the states by the Obamacare legislation.  This bill is designed with as much private market protections as the Obamacare law allows.

Some staunch conservatives don’t want any bill creating an exchange to be passed.  They reason that since the Federal Court in Florida ruled the individual mandate to be unconstitutional and the law to be unseverable that the entire law is unconstitutional and cannot be enforced. The judge did not however formally enjoin the Federal government from continuing to implement the law.  Judge Roger Vinson has been asked formally by the Obama administration to specify whether they can continue the implementation process that they have already begun.  We should have an answer to this question in the next few weeks.

On the surface I would agree.  I abhor the idea of the exchanges and the costs involved in the implementation of such a requirement.

I think that any good plan includes dealing with the law as it is and working toward completely eliminating the law and implementing real reform that concentrates on the cost of healthcare and inequities in the system.  With this in mind hopefully the Federal government will be enjoined from implementation and the Supreme Court will strike down the law.  We cannot expect in Minnesota, since Mark Dayton is our governor and we have DFL attorney general, that we will follow suit with Florida and Alaska in refusing to implement, according to the law’s timeline, Obamacare.  I also do not believe that Governor Dayton will return the federal money sent to MN to establish the Exchange as Wisconsin, Florida, and Vermont have done (all Republicans).

In addition, if HF479 is not passed, Governor Dayton may decide to implement an exchange designed by him and his staff as five other governors’ have done with no input from their legislature.

To me designing these programs with a minimalist approach is like having seatbelts in your car.  We hope we will never need them but we have little control over what other drivers may do.  We need to drive our cars and we must protect ourselves and our loved ones to the best of our abilities.

Without these protections we leave ourselves open to disaster.

Please call your state representatives and senators to voice your support for HF479.

Dave Wiest
President
EMEX Benefits

“Health Insurance Exchange” in Minnesota

Hello All

We of the legislative committee of MAHU have finished drafting our version of the bill for the creation of the “Health Insurance Exchange” in Minnesota.  While I am not at liberty to discuss the details at this time I can assure you that the bill we presented is the best one we could devise based on the requirements of the PPACA.

The number of drafts that were made was quite extensive.  We initially surveyed employers throughout the State of Minnesota to get their ideas, concerns, and input on what should and should not be included in the exchange. We had meetings with the Counsel of Health Plans in Minnesota.  The Agents Coalition, which is comprised of the PIA (Professional Insurance Agents), NAIFA (Minnesota chapter of the National Association of Insurance and Financial Advisors, MAHU (Minnesota Association of Health Underwriters) and The MIIAB (Minnesota Independent Insurance Agents and Brokers).  And with our lobbyist Tim Wilkin as well as many legislators.

The approach we took was to create a minimalist approach to the creation of the exchange and to incorporate protection for employers and individuals based on the experiences of the Massachusetts exchange called The Connector.

This is the first time that an exchange that is being created has had input from both insurance professionals and the health plans themselves.  I can tell you that for the most part we are in agreement with the health plans but there are some significant differences in our final version and as such the plans will also be submitting a plan with the differences spelled out.

We will be having further legislative committee meetings to address the exchange and other legislative initiatives we support.  This will be a very busy legislative session.

As the process proceeds I will keep you informed on our successes and our defeats.  As an officer of MAHU and a member of the Legislative committee I feel it is my duty to keep you in the loop whenever possible.

If you have any comments or questions feel free to email, call or leave a comment.

Thanks,

Dave Wiest
President
EMEX Benefit Systems

 

Medicare part D (prescription drug coverage)

Hello All

Every November and December I get a lot of calls about Medicare part D (prescription drug coverage).  The new provisions in the law to shrink the donut hole will cost money.  Primarily to the participants.  In a couple of news articles in Kaiser Health News (KHN) they describe how the new discounts for brand drugs works and what the impact on the cost of Part D plans will be.  Please review both the article and the Q&A for a very well written explanation of what is and will be happening to Part D plans.

Some Seniors Are In For Sticker Shock On Drug Premiums

http://www.kaiserhealthnews.org/Stories/2011/February/11/Medicare-premium-increases.aspx

FAQ: The Shrinking Medicare Doughnut Hole

http://www.kaiserhealthnews.org/Stories/2011/February/11/doughnut-hole-FAQ.aspx

Dave Wiest
President
EMEX Benefit Systems

What are the penalties that can be assessed against employers and individuals?

Hello All

Many of you have asked me what are the penalties that can be assessed against employers and individuals.  I am including links to two documents from the Congressional Research Service.  They are titled “Individual Mandate and Related Information Requirements under PPACA” and “Summary of Potential Employer Penalties Under PPACA”.  These two reports answer quite a few of the question many of you have had.  Please refer to previous blogs and our website for additional information.  Or you are welcomed to call me directly for answers to other questions you may have.

Dave Wiest
President
EMEX Benefit Systems

Visit My Blog
Dave’s Blog

www.emexbenefits.com

dwiest@emexbenefits.com

881 Meander Court
Medina,  MN 55340
Phone: 763-478-9050

Toll Free 877-478-EMEX (3639)
Fax: 763-478-9014
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715-466-4105

Hello All

We at EMEX have been making a concerted effort to provide outstanding service to our clients and friends.  We have made available periodically Webinars on subjects from employee handbooks to FMLA to HRA/HSA’s and beyond.  I know taking the time to watch a webinar is difficult because of your busy schedules but please look at the list of archived webinars along with upcoming webinars to see if any of them can be of value to you.

UPCOMING WEBINAR:

Recent enforcement trends for FMLA and ADAAA compliance

Date: Thursday, February 17
Time: 10:00 AM – 11:30 AM CST
https://www2.gotomeeting.com/register/132973571

ARCHIVED WEBINAR RECORDINGS:

Click one of the links below the description of the webinar. Upon the completion of webinar recording request form, you will receive an email with a link to the recording.

Employee Handbooks: Issues That Need to be Addressed Webinar
Recorded January 27, 2011
Click this link to request the webinar recording.

Healthcare Reform OTC Restrictions Webinar
Recorded November 16, 2010
Click this link to request the webinar recording.

 

Independent Contractors: Are They or Aren’t They Webinar
Recorded October 20, 2010
Click this link to request the webinar recording.

FMLA Webinar
Recorded September 16, 2010
Click this link to request the webinar recording.

Developments in Healthcare Reform
Record August 25, 2010
Click this link to request the webinar recording.

COBRA: Back to Basics
Recorded July 15, 2010
Click this link to request the webinar recording.

Termination Mistakes You Can’t Afford to Make
Recorded June 16, 2010
Click this link to request the webinar recording.

Key Employer Developments in Healthcare Reform
Recorded May 11, 2010
Click this link to request the webinar recording.

FMLA: Know Your Employer Rights to Help Reduce Frustration
Recorded April 22, 2010
Click this link to request the webinar recording.

Fair Labor Standards Act
Recorded March 17, 2010
Click this link to request the webinar recording.

DOL Regulation: Participant Contributions Timeframes for 401k, HSA, etc.
Recorded February 25, 2010
Click this link to request the webinar recording.

COBRA Subsidy Extension
Recorded January 18, 2010
Click this link to request the webinar recording.

Recorded January 13, 2010
Click this link to request the webinar recording.

HRAs in CDHC
Recorded October 2009
Click this link to request the webinar recording.

HRA vs. HSA
Recorded June 2009
Click this link to request the webinar recording.

SCHIPRA (CHIP)
Recorded May 2009
Click this link to view this webinar recording.

COBRA Subsidy
Recorded April 2009
Click this link to request the webinar recording.

January 16, 2009 updated FMLA regulations
Recorded March 2009
Click this link to request the webinar recording.

Let us know if you intend on using or have used this service.

Thanks,

Dave Wiest
President
EMEX Benefit Systems, Inc.

Health and Human Services decide discrimination rules–applied to fully insured plans–too vague.

Hello All

I apologize for the lack of activity in my blog over the past several weeks.  I have been quite busy dealing with Obamacare and its impact on my friends and clients and have not had the time to keep you updated.

On December 22, 2010 Health and Human Services decided that the discrimination rules that would be applied to fully insured plans on 1-1-11 were too vague. Many employers were quite confused by many of the provisions.

Essentially the regulation would apply the discrimination rules that have applied to self funded group medical plans to fully insured plans.

Basically the rules since 1974 that have applied to self funded plans say that access to health insurance plans and eligibility for health insurance plans have to be the same across all classes.

In the past those rules have meant that an employer must offer the same plans with the same probationary period and other eligibility such as hours worked, etc.,  must be the same across all classes of employees.  However since 1974 many plans have differentiated in employer contribution levels between classes.

The primary question then is can an employer contribute differently to different classes?  Some lawyers have advised “no”, and others have advised “yes”.  This confusion along with the unanswered requests for clarification from HHS caused the delay in implementation.

At this point we don’t know when or if these new regulations will apply.

Stay tuned!

Dave Wiest
President
EMEX Benefit Systems