Changing health care regulations and rising costs are creating benefit gaps and knowledge gaps. To help you and your clients with these issues, we’ve partnered with Colonial Life & Accident Insurance Company. At no direct cost to your business, Colonial Life can help you save time, fill gaps and add value to your benefits program.
Colonial Life will provide:
1-to-1 benefits counseling and education on all benefits – including wellness.
Consolidated enrollment for core and voluntary benefits with its award-winning Harmony® enrollment system.
Extensive product portfolio with options and premiums to fit almost any need.
CCH HRAnswersNow access, a valuable online HR library.
Hassle-free benefits administration through secure, web-based services.
Imagine the time and resources you could save with:
Fewer questions and hours spent educating employees about their benefits.
Better informed and educated employees – which means a greater appreciation for their benefits and you.
Better educated health care consumers – which can save costs through use of generics, saving the emergency room for emergencies, health screenings, self-examination, living a healthier lifestyle, etc.
Less financial risk for employees – because voluntary benefits help fill the gaps in their medical plans and provide disability and life insurance protection.
Increased employee satisfaction and retention – which means being able to attract and retain top talent.
Colonial Life’s voluntary benefits, such as accident, cancer, hospital confinement indemnity, and critical illness, are designed to help employees pay for what their health insurance doesn’t and add financial protection for their future. Employees choose the benefits that best meet their individual and family needs.
Colonial Life’s coverages share important features:
Benefits are paid directly to the employee, unless specified otherwise, regardless of insurance the employee may have with other insurance companies.
Employees can keep most plans when they retire or change jobs with no increase in premiums.
https://mb-wp-uploads.s3.us-east-1.amazonaws.com/2024/04/MichBusiness-logo.png00michbusinesshttps://mb-wp-uploads.s3.us-east-1.amazonaws.com/2024/04/MichBusiness-logo.pngmichbusiness2013-03-05 16:00:252015-10-08 00:00:00Colonial Life Has A Way For You To Help Your Clients And Their Employees Understand And Appreciate The Value Of Their Employee Benefits
With the October 1st, 2013 date of open enrollment approaching for individuals wanting to participate on the federal healthcare exchange only 7 months away, many people are feverishly scanning the draft enrollment process to get a feel for what lies ahead.
At first blush, the process for a family of three is a 15 page application. The outline of the online version has 21 steps, with some having additional questions. After submitting your application, the plan then is sent through three major federal agencies, including the IRS, who examines your paperwork, double checking your identity, income, and citizenship. The analysis of your application is supposed to happen in real time, if you apply online.
The initial application process is step one, as this lets you and the federal government know if you qualify for any financial assistance. Since the PPACA is means-tested, the lower income individuals will qualify for the most financial support when paying premiums. If you or your spouse had a change in financial status that the federal government isn’t aware of, that might qualify you or disqualify you for financial assistance, additional paperwork would have to be submitted and additional questions answered.
After the financial portion is complete, then the individual, family, or business, moves onto choosing which health plan suits them best. Choosing a health plan will require additional steps, and a general knowledge of insurance terminology. The federal government states that this process should take individuals on average 30-45 minutes to complete, with the ability to walk away from their computer to gather needed materials, and save their place on the program.
The unanswered question still remains, will individuals be able to navigate on the web portal themselves, or out of frustration will they opt out and go back to the private market. The general feedback is that this application and choosing one’s own healthcare will be more complex and take more time to fill out than the estimated 30-45 minute time frame. This then beckons to question the necessity for the insurance agent’s role both on and off the exchange to help navigate individuals towards the right plans for them, their families, and/or their business.
From what we have seen thus far, the role of the insurance agent will be needed now more than ever before, to help guide an individual, a family, or a business both on and off the exchange. As we move closer to the January 1st, 2014 deadline, more details will become available, and we will share those with you.
As always, please contact our government relations team at bbochniak@michbusiness.org or by phone at 586-393-8800.
https://mb-wp-uploads.s3.us-east-1.amazonaws.com/2024/04/MichBusiness-logo.png00michbusinesshttps://mb-wp-uploads.s3.us-east-1.amazonaws.com/2024/04/MichBusiness-logo.pngmichbusiness2013-03-05 16:00:202015-10-08 00:00:00On the Exchange or Off the Exchange, That is the Question
By Liz Festa www.lifehealthpro.com Rep. Marsha Blackburn wants to curtail perceived ill effects of the ACA on agents, health insurance market. (AP photo/Harry Hamburg) Rep. Marsha Blackburn, R-Tenn., vice chair of the House Energy and Commerce Committee today told the National Association of Health Underwriters (NAHU) to keep its eye on her committee as […]
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Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient montes, nascetur ridiculus mus. Donec quam felis, ultricies nec, pellentesque eu, pretium quis, sem. Nulla consequat massa quis enim. Donec pede justo, fringilla vel, aliquet nec, vulputate eget, arcu. In enim justo, […]
https://mb-wp-uploads.s3.us-east-1.amazonaws.com/2015/02/cafe.jpg10001500michbusinesshttps://mb-wp-uploads.s3.us-east-1.amazonaws.com/2024/04/MichBusiness-logo.pngmichbusiness2013-02-25 14:41:412013-02-25 14:41:41Recruiting has begun
February 2013 – Since January, the federal government has been busy crafting regulations and guidance to ensure that many Affordable Care Act (ACA) provisions “go live” in 2014. Here are several highlights:
1. What will the HealthCare Marketplace look like?
The federal government released guidance (found at http://cciio.cms.gov/resources/files/partnership-guidance-01-03-2013.pdf) on how healthcare marketplaces or exchanges would look when states choose to “partner” with the feds to execute. This is important to Michigan, as it declared that it would operate a state-federal partnership exchange. In this model, the federal government oversees and operates the partnership exchange, but Michigan has the option to oversee certain functions. Ultimately, the feds hope the partnership exchange enables states to transition and launch their own healthcare exchange or marketplace.
In the partnership exchange, Michigan businesses will likely have the same purchasing options that they would under a Michigan-run marketplace. Michigan has the option to be the main point of contact for consumers, insurance carriers, and independent agents. The federal government will oversee all operational aspects of the marketplace including enrollment, eligibility, payment, and maintenance of the web portal.
• How does an employer know if the employee health benefits offered are “affordable?” In late January, the Department of the Treasury issued a final regulation (see http://www.ofr.gov/OFRUpload/OFRData/2013-02136_PI.pdf) detailing who qualifies for federal subsides to purchase health insurance via the marketplace. This information is critical to determining whether a Michigan business is subject to the health insurance penalty. A penalty is in play if a business has 50 or more employees and at least one receives federal subsidies via the exchange. But, this penalty is imposed only when an employer fails to offer minimum, affordable coverage or does not offer coverage at all. How do you measure this? Well, we know the ACA defines affordable coverage as that where the employee pays no more than 9.5 percent of their modified adjusted gross income. In this guidance, the federal government clarifies that the employer is only on the hook for affordable employee-only coverage not family coverage.
The feds also clarified that employers may use an employee’s W-2 as the basis for gross income and affordability calculations. This allows employers to evaluate whether the coverage offered is sufficient.
• How does an employer know whether it offers minimum coverage? The federal government plans to create a minimum value calculator that allows employers to answer this question. This calculator will allow businesses to input info about the employee benefit plan (deductibles and co-pays) to determine if it covers at least 60 percent of total expect costs. This is the standard for minimum coverage.
3. How can employers use Health Reimbursement Accounts (HRAs) in the future?
The ACA prohibits annual dollar coverage on healthcare benefits. This is a problem for HRAs as they are limited contributions on a pre-tax basis that employers often use to help employees purchase individual health coverage. In 2010, the federal government clarified that when HRAs are offered on an integrated basis with a health benefits plan, they do not violate the ACA’s annual limit prohibition. However, it was still unclear whether employers could offer HRAs independent of a health benefits plan. The Department of Labor addressed this issue (among others) in a recent FAQ (see http://www.dol.gov/ebsa/faqs/faq-aca11.html), stating that HRAs would violate the ACA if offered on a stand-alone basis. Keep in mind that this issue is not completely resolved; regulations will be issued soon. (Editor’s note: All the Dept. of Labor FAQs are on our website in the Compliance Tools section, under FAQs.)
4. When must businesses notify employees of the healthcare marketplace or exchange?
While the ACA states that this must happen by March 1, 2013, the Department of Labor has suspended this requirement in a recent FAQ (see http://www.dol.gov/ebsa/faqs/faq-aca11.html). Why? Well, the federal government has not yet issued regulations on the topic. Stay tuned for updates.
5. What happens if a Michigan business wants to offer employee health insurance, but doesn’t want to cover contraception?
The federal government recently spoke out again on this controversial issue, releasing a proposed regulation (see http://www.ofr.gov/OFRUpload/OFRData/2013-02420_PI.pdf) and fact sheet (see http://cciio.cms.gov/resources/factsheets/womens-preven-02012013.html). Generally churches are already exempt from providing contraception services, but what about nonprofit religious organizations that object to contraceptive coverage? The federal government proposed in this regulation that an eligible organization would self-certify to a health insurer and the insurer would automatically provide separate, individual market contraceptive coverage at no cost for plan participants. As a result, the contraception coverage would not come directly from the religious organization that objects to that coverage.
There is no exemption for businesses that philosophically oppose contraceptive services. Keep in mind this is a proposed regulation and open for comment until March 2013 before final guidance is provided.
Claudine Swartz is a Senior Consultant at Day Health Strategies. She is a health care policy and government affairs consultant with nearly 20 years of experience. Swartz has worked throughout the health care industry, helping providers, payers, and stakeholders understand and influence complicated healthcare policies and develop related business strategies. She has worked directly for the University of California Health System, the National Association of Public Hospitals, and Delta Dental of Massachusetts.
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February 2013 - Liquor license renewal season is quickly approaching and the Michigan Liquor Control Commission (MLCC) is stressing the importance of renewing on time. Renewal packages will be mailed March 1, 2013 and all licenses are to be renewed by May 1, 2013. All licenses expire on April 30 of each year and new […]
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Michigan Transportation Team The Michigan Transportation Team (MTT) is a partnership of businesses, associations and citizens linked with the common goal of improving Michigan’s transportation infrastructure. Our Top Priorities I. Action The MTT’s number one priority is to encourage Michiganders to call on their legislators to invest in Michigan’s crumbling roads, bridges and infrastructure – […]
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The Michigan Business and Professional Association (MBPA) is actively lobbying against language included in the Executive Budget recommendation that would increase health insurance costs for Michigan businesses and consumers by expanding the newly-enacted Health Insurance Claims (HICA) Tax. We oppose this uncompetitive tax increase to employers who are struggling to continue to provide health insurance […]
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By Joe Haveman State Representative A new legislative term has just gotten underway, and that means the annual adventure of crafting the state budget is right around the corner. Number crunchers, reform advocates, grand bargainers and plain old budget wonks are all gathering to pore over the numbers and help lay a foundation for another […]
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Both returning members and new members are listed in the link below, along with their pictures. We welcome them on behalf of the business community and look forward to working together to continue the progress in making Michigan an attractive place to do business and reside. Download a PDF here courtesy of Gongwer News Service
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By Kristi R. Gauthier, Esq. Clark Hill PLC February 2013 – One of the new notices requirements the Patient Protection and Affordable Care Act (PPACA) imposes on employers is the Notice of Coverage Options Available through the Exchanges (Notice). What is the Purpose of this Notice? The purpose of the Notice is to: Inform […]
By Don McAnelly CPA/ABV/CGMA Rehmann February 2013 – It’s hard to believe we are nearing the three-year mark of President Obama’s signing of the Patient Protection and Affordable Care Act of 2010 (PPACA). Even more concerning is the fact that this piece of legislation appears to still have some surprises in store for us all. […]
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CMS Publishes Proposed Registration Process for Exchange Agents and Brokers The Michigan Business and Professional Association (MBPA) want to keep you up to date as new information pertaining to the federal healthcare law is released that affect the agent community. You can count on us for dependable and accurate information. In hopes […]
Health Care Reform Connect™ – Two New Compliance Tools! • Small Business Health Care Reform Guide • Tax Credit Estimator With the 2014 deadline looming for implementation of the Affordable Care Act, you likely have many questions about how the ACA will affect you, your business and your employees. Health Care Reform Connect™ was […]
With as many as 795,000 Michigan residents soon to be eligible for health care coverage as a result of the 2010 Affordable Care Act (ACA), the Michigan Business and Professional Association (MBPA) is hosting a Health Care Reform Conference. The conference will take place Tuesday, April 9, 2013 from 8:30 a.m. until 1:00 p.m. at […]
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The Blues are committed to providing association members with the best online experience possible. With that in mind, when you visit bcbsm.com or MiBCN.com today, you’ll see a completely new site. We’ve combined MiBCN.com and bcbsm.com into one website, so you can explore all that the Blues have to offer in one location. […]
https://mb-wp-uploads.s3.us-east-1.amazonaws.com/2024/04/MichBusiness-logo.png00michbusinesshttps://mb-wp-uploads.s3.us-east-1.amazonaws.com/2024/04/MichBusiness-logo.pngmichbusiness2013-02-05 16:00:502015-10-08 00:00:00Introducing The New, Improved and Easy BCBSM.com
February 2013 – The IRS issued a final regulations on when an employer-sponsored plan is considered “affordable” for an individual related to the employee for purposes of eligibility for a premium tax credit. Under Health Care Reform, employees may be eligible for a premium tax credit to purchase health insurance through the future health insurance exchanges if, among other reasons, the employer plan is deemed unaffordable.
The final regulations clarify that for taxable years beginning before January 1, 2015, an eligible employer-sponsored plan is affordable for related individuals if the portion of the annual premium the employee must pay for self-only coverage does not exceed 9.5% of the taxpayer’s household income.
An employer plan will be affordable for 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 whether family members are eligible for tax credits, the affordability of family coverage is not taken into account; all that matters is that the cost of self-only coverage is affordable to the employee.
For purposes of applying the affordability exemption from the individual mandate in the case of related individuals, the required contribution is based on the premium the employee would pay for employer-sponsored family coverage.
For an employee eligible under an employer plan, affordability (for individual mandate exemption purposes) will be based on whether the cost of self-only coverage exceeds 8% of the employee’s household income. For a related individual (such as a spouse or child), however, affordability for this purpose will be based on whether the cost of family coverage exceeds 8% of household income. Under these rules, members of an employee’s family may qualify for an individual mandate exemption, even though the offer of affordable employer coverage to the employee would require the employee to enroll or risk paying a penalty.
These final regulations apply to taxable years ending after December 31, 2013.
For More Information: If you have any comments or questions regarding any of above information, please do not hesitate to call me at (708) 717-9638 or e-mail at larry@larrygrudzien.com.
By Marlena Reigh International Voice Image Specialist You have impressive visuals, the latest technology — you look great and your topic is hot, but have you invested time and energy in the most important of all personal tools — your voice? I know you have seen it. A presenter has all the “bells […]
https://mb-wp-uploads.s3.us-east-1.amazonaws.com/2024/04/MichBusiness-logo.png00michbusinesshttps://mb-wp-uploads.s3.us-east-1.amazonaws.com/2024/04/MichBusiness-logo.pngmichbusiness2013-02-05 16:00:402015-10-08 00:00:00Your Voice: The Most Powerful Personal Tool In Making Presentations
Over the last five years or so networking – that is, meeting other professionals with which to do business – has evolved into making connections in order to build relationships. With the old model, you arrived at an event, passed out your cards to as many people as possible while giving them your best impression of how great your product is, and hoped that some of the tactics would get results. Some people would even rate their success by how many cards they gave away.
But now, because more and more people sell the same products or service at comparably the same prices, competition is hot and building relationships is essential. The truth is that what we are selling is ourselves. Our appearance counts for 55% of first impressions and the quality of our voice counts for 37%. Words only count for 18%. Yes, we can be remembered by how we look, but what is even more powerful in being remembered by how we use our voice and how we’ve treated others.
One evening I went to a networking event in a different city. In the elevator I had a conversation with a woman. As we chatted, she asked me if I was going the networking event. I answered, “Yes, it’s my first time” in which she then asked me about my business and the kind of clients I was looking for. Tamera (her real name with her permission) was a regular and when we arrived she said, “Let me introduce you to the people I know.”
As Tamera took me around the room, she not only introduced me to others but also mentioned my expertise to each person. She used her voice in an enthusiastic and engaging way that opened up conversations. Her posture and eye contact were strong and confident as though I was someone special and they were special too, yet she was genuine. I felt Tamera was part of my team. It turns out she knew just about everyone there. In my eyes Tamera was a star, a people connector. She gained my admiration, respect, and I wanted to get to know her better so I could be on her team too.
That day I left the event truly inspired to take networking to a higher level. Building connections through helping others build connections, not by only introducing them, but by sharing what I know about them. Someone who others could count on as a connector and resource; Someone to be remembered and with which to stay connected.
7 Tips On How You Too Can Be A Networking Star:
Before the event warm up your voice and practice out loud.
Think of yourself as the host of “the party” making sure everyone is having a good time including you.
When you meet people look for ways to connect them to others.
Make networking about the other person. Talk less, listen more.
Have a voice that is genuine and truly interested in helping others.
Take risks. Meet at least five new people at each networking event.
If you see someone who is alone, introduce yourself and then introduce him or her to others.
In networking the goal is to increase your sphere of influence, helping others, increasing the opportunity to improve lives with your products, and assisting in more prosperity and success for all.
By the way, because of this encounter I got a radio interview, contracted a new client and secured a presentation, which Tamera attended and I then could acknowledge her to the audience thus giving her the kudos she deserved.
Marlena Reigh, international voice image specialist since 1992, teaches unique, effective and powerful voice communication techniques which are critical in getting results in any speaking situation. www.MarlenaReigh.com 2359 Prairie Street, Ann Arbor, MI 48105 Marlena@marlenareigh.com (734)395.3553
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By Joyce Weiss M.A., CSP Despite the gloom and doom economic picture presented in the media, now is when we must be most positive in order to persevere. With this attitude, what results can you expect? Benefit 1: You’ll Discover Opportunities for Growth When a challenge comes, people naturally want to focus […]
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Colonial Life Has A Way For You To Help Your Clients And Their Employees Understand And Appreciate The Value Of Their Employee Benefits
/in Agent CommunityChanging health care regulations and rising costs are creating benefit gaps and knowledge gaps. To help you and your clients with these issues, we’ve partnered with Colonial Life & Accident Insurance Company. At no direct cost to your business, Colonial Life can help you save time, fill gaps and add value to your benefits program.
Colonial Life will provide:
1-to-1 benefits counseling and education on all benefits – including wellness.
Consolidated enrollment for core and voluntary benefits with its award-winning Harmony® enrollment system.
Extensive product portfolio with options and premiums to fit almost any need.
CCH HRAnswersNow access, a valuable online HR library.
Hassle-free benefits administration through secure, web-based services.
Imagine the time and resources you could save with:
Fewer questions and hours spent educating employees about their benefits.
Better informed and educated employees – which means a greater appreciation for their benefits and you.
Better educated health care consumers – which can save costs through use of generics, saving the emergency room for emergencies, health screenings, self-examination, living a healthier lifestyle, etc.
Less financial risk for employees – because voluntary benefits help fill the gaps in their medical plans and provide disability and life insurance protection.
Increased employee satisfaction and retention – which means being able to attract and retain top talent.
Colonial Life’s voluntary benefits, such as accident, cancer, hospital confinement indemnity, and critical illness, are designed to help employees pay for what their health insurance doesn’t and add financial protection for their future. Employees choose the benefits that best meet their individual and family needs.
Colonial Life’s coverages share important features:
Benefits are paid directly to the employee, unless specified otherwise, regardless of insurance the employee may have with other insurance companies.
Employees can keep most plans when they retire or change jobs with no increase in premiums.
Most plans offer spouse and dependent coverage.
Let Us Make Your Business Better
Contact us at: Phone 888-277-6464 or Fax 586-393-8810 www.michbusiness.org
On the Exchange or Off the Exchange, That is the Question
/in Agent Community, Implementation Connection, Political Landscape, Political UpdateBy Bonnie Bochniak
MBPA Government Relations
With the October 1st, 2013 date of open enrollment approaching for individuals wanting to participate on the federal healthcare exchange only 7 months away, many people are feverishly scanning the draft enrollment process to get a feel for what lies ahead.
At first blush, the process for a family of three is a 15 page application. The outline of the online version has 21 steps, with some having additional questions. After submitting your application, the plan then is sent through three major federal agencies, including the IRS, who examines your paperwork, double checking your identity, income, and citizenship. The analysis of your application is supposed to happen in real time, if you apply online.
The initial application process is step one, as this lets you and the federal government know if you qualify for any financial assistance. Since the PPACA is means-tested, the lower income individuals will qualify for the most financial support when paying premiums. If you or your spouse had a change in financial status that the federal government isn’t aware of, that might qualify you or disqualify you for financial assistance, additional paperwork would have to be submitted and additional questions answered.
After the financial portion is complete, then the individual, family, or business, moves onto choosing which health plan suits them best. Choosing a health plan will require additional steps, and a general knowledge of insurance terminology. The federal government states that this process should take individuals on average 30-45 minutes to complete, with the ability to walk away from their computer to gather needed materials, and save their place on the program.
The unanswered question still remains, will individuals be able to navigate on the web portal themselves, or out of frustration will they opt out and go back to the private market. The general feedback is that this application and choosing one’s own healthcare will be more complex and take more time to fill out than the estimated 30-45 minute time frame. This then beckons to question the necessity for the insurance agent’s role both on and off the exchange to help navigate individuals towards the right plans for them, their families, and/or their business.
From what we have seen thus far, the role of the insurance agent will be needed now more than ever before, to help guide an individual, a family, or a business both on and off the exchange. As we move closer to the January 1st, 2014 deadline, more details will become available, and we will share those with you.
As always, please contact our government relations team at bbochniak@michbusiness.org or by phone at 586-393-8800.
Agent-Friendly MLR Bill Could Be Revived In Expanded Form
/in Agent CommunityBy Liz Festa www.lifehealthpro.com Rep. Marsha Blackburn wants to curtail perceived ill effects of the ACA on agents, health insurance market. (AP photo/Harry Hamburg) Rep. Marsha Blackburn, R-Tenn., vice chair of the House Energy and Commerce Committee today told the National Association of Health Underwriters (NAHU) to keep its eye on her committee as […]
Recruiting has begun
/in NewsLorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient montes, nascetur ridiculus mus. Donec quam felis, ultricies nec, pellentesque eu, pretium quis, sem. Nulla consequat massa quis enim. Donec pede justo, fringilla vel, aliquet nec, vulputate eget, arcu. In enim justo, […]
News from the Feds
/in Expert Advice, Health ReformBy Claudine Swartz
Day Health Strategies
February 2013 – Since January, the federal government has been busy crafting regulations and guidance to ensure that many Affordable Care Act (ACA) provisions “go live” in 2014. Here are several highlights:
1. What will the HealthCare Marketplace look like?
The federal government released guidance (found at http://cciio.cms.gov/resources/files/partnership-guidance-01-03-2013.pdf) on how healthcare marketplaces or exchanges would look when states choose to “partner” with the feds to execute. This is important to Michigan, as it declared that it would operate a state-federal partnership exchange. In this model, the federal government oversees and operates the partnership exchange, but Michigan has the option to oversee certain functions. Ultimately, the feds hope the partnership exchange enables states to transition and launch their own healthcare exchange or marketplace.
In the partnership exchange, Michigan businesses will likely have the same purchasing options that they would under a Michigan-run marketplace. Michigan has the option to be the main point of contact for consumers, insurance carriers, and independent agents. The federal government will oversee all operational aspects of the marketplace including enrollment, eligibility, payment, and maintenance of the web portal.
2. How does a Michigan business know if it is subject to the employer penalty?
This issue is tough to keep up with as it is being addressed in several pieces. Fortunately, on Dec. 28, 2012, the Treasury Department and the IRS issued proposed regulations (found at http://www.irs.gov/pub/newsroom/reg-138006-12.pdf) on the ACA’s Employer Shared Responsibility. Comments are due by March 18, 2013. The federal government also issued a simplified Q&A document (found at http://www.irs.gov/uac/Newsroom/Questions-and-Answers-on-Employer-Shared-Responsibility-Provisions-Under-the-Affordable-Care-Act). Below is a sampling of key issues addressed:
• How does an employer know if the employee health benefits offered are “affordable?” In late January, the Department of the Treasury issued a final regulation (see http://www.ofr.gov/OFRUpload/OFRData/2013-02136_PI.pdf) detailing who qualifies for federal subsides to purchase health insurance via the marketplace. This information is critical to determining whether a Michigan business is subject to the health insurance penalty. A penalty is in play if a business has 50 or more employees and at least one receives federal subsidies via the exchange. But, this penalty is imposed only when an employer fails to offer minimum, affordable coverage or does not offer coverage at all. How do you measure this? Well, we know the ACA defines affordable coverage as that where the employee pays no more than 9.5 percent of their modified adjusted gross income. In this guidance, the federal government clarifies that the employer is only on the hook for affordable employee-only coverage not family coverage.
The feds also clarified that employers may use an employee’s W-2 as the basis for gross income and affordability calculations. This allows employers to evaluate whether the coverage offered is sufficient.
• How does an employer know whether it offers minimum coverage? The federal government plans to create a minimum value calculator that allows employers to answer this question. This calculator will allow businesses to input info about the employee benefit plan (deductibles and co-pays) to determine if it covers at least 60 percent of total expect costs. This is the standard for minimum coverage.
3. How can employers use Health Reimbursement Accounts (HRAs) in the future?
The ACA prohibits annual dollar coverage on healthcare benefits. This is a problem for HRAs as they are limited contributions on a pre-tax basis that employers often use to help employees purchase individual health coverage. In 2010, the federal government clarified that when HRAs are offered on an integrated basis with a health benefits plan, they do not violate the ACA’s annual limit prohibition. However, it was still unclear whether employers could offer HRAs independent of a health benefits plan. The Department of Labor addressed this issue (among others) in a recent FAQ (see http://www.dol.gov/ebsa/faqs/faq-aca11.html), stating that HRAs would violate the ACA if offered on a stand-alone basis. Keep in mind that this issue is not completely resolved; regulations will be issued soon. (Editor’s note: All the Dept. of Labor FAQs are on our website in the Compliance Tools section, under FAQs.)
4. When must businesses notify employees of the healthcare marketplace or exchange?
While the ACA states that this must happen by March 1, 2013, the Department of Labor has suspended this requirement in a recent FAQ (see http://www.dol.gov/ebsa/faqs/faq-aca11.html). Why? Well, the federal government has not yet issued regulations on the topic. Stay tuned for updates.
5. What happens if a Michigan business wants to offer employee health insurance, but doesn’t want to cover contraception?
The federal government recently spoke out again on this controversial issue, releasing a proposed regulation (see http://www.ofr.gov/OFRUpload/OFRData/2013-02420_PI.pdf) and fact sheet (see http://cciio.cms.gov/resources/factsheets/womens-preven-02012013.html). Generally churches are already exempt from providing contraception services, but what about nonprofit religious organizations that object to contraceptive coverage? The federal government proposed in this regulation that an eligible organization would self-certify to a health insurer and the insurer would automatically provide separate, individual market contraceptive coverage at no cost for plan participants. As a result, the contraception coverage would not come directly from the religious organization that objects to that coverage.
There is no exemption for businesses that philosophically oppose contraceptive services. Keep in mind this is a proposed regulation and open for comment until March 2013 before final guidance is provided.
Claudine Swartz is a Senior Consultant at Day Health Strategies. She is a health care policy and government affairs consultant with nearly 20 years of experience. Swartz has worked throughout the health care industry, helping providers, payers, and stakeholders understand and influence complicated healthcare policies and develop related business strategies. She has worked directly for the University of California Health System, the National Association of Public Hospitals, and Delta Dental of Massachusetts.
Michigan Liquor Control Commission Reminds Licensees about the Importance of Renewing Liquor Licenses on Time
/in Legislative InfluenceFebruary 2013 - Liquor license renewal season is quickly approaching and the Michigan Liquor Control Commission (MLCC) is stressing the importance of renewing on time. Renewal packages will be mailed March 1, 2013 and all licenses are to be renewed by May 1, 2013. All licenses expire on April 30 of each year and new […]
Just Fix The Roads – Save Money. Save Lives.
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Please Welcome Michigan’s House of Representatives for the Legislative Term of 2013 & 2014
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IRS Issues Guidance on Health Insurance Premium Tax Credit – Clarification
/in Business Knowledge, Legislative InfluenceBy Larry Grudzien
Attorney-At-Law
February 2013 – The IRS issued a final regulations on when an employer-sponsored plan is considered “affordable” for an individual related to the employee for purposes of eligibility for a premium tax credit. Under Health Care Reform, employees may be eligible for a premium tax credit to purchase health insurance through the future health insurance exchanges if, among other reasons, the employer plan is deemed unaffordable.
The final regulations clarify that for taxable years beginning before January 1, 2015, an eligible employer-sponsored plan is affordable for related individuals if the portion of the annual premium the employee must pay for self-only coverage does not exceed 9.5% of the taxpayer’s household income.
An employer plan will be affordable for 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 whether family members are eligible for tax credits, the affordability of family coverage is not taken into account; all that matters is that the cost of self-only coverage is affordable to the employee.
For purposes of applying the affordability exemption from the individual mandate in the case of related individuals, the required contribution is based on the premium the employee would pay for employer-sponsored family coverage.
For an employee eligible under an employer plan, affordability (for individual mandate exemption purposes) will be based on whether the cost of self-only coverage exceeds 8% of the employee’s household income. For a related individual (such as a spouse or child), however, affordability for this purpose will be based on whether the cost of family coverage exceeds 8% of household income. Under these rules, members of an employee’s family may qualify for an individual mandate exemption, even though the offer of affordable employer coverage to the employee would require the employee to enroll or risk paying a penalty.
These final regulations apply to taxable years ending after December 31, 2013.
For a copy of the final regulations, please click here.
For More Information:
If you have any comments or questions regarding any of above information, please do not hesitate to call me at (708) 717-9638 or e-mail at larry@larrygrudzien.com.
Your Voice: The Most Powerful Personal Tool In Making Presentations
/in Business KnowledgeBy Marlena Reigh International Voice Image Specialist You have impressive visuals, the latest technology — you look great and your topic is hot, but have you invested time and energy in the most important of all personal tools — your voice? I know you have seen it. A presenter has all the “bells […]
Be A Networking Star And Increase Your Sales
/in Business KnowledgeBy Marlena Reigh
Over the last five years or so networking – that is, meeting other professionals with which to do business – has evolved into making connections in order to build relationships. With the old model, you arrived at an event, passed out your cards to as many people as possible while giving them your best impression of how great your product is, and hoped that some of the tactics would get results. Some people would even rate their success by how many cards they gave away.
But now, because more and more people sell the same products or service at comparably the same prices, competition is hot and building relationships is essential. The truth is that what we are selling is ourselves. Our appearance counts for 55% of first impressions and the quality of our voice counts for 37%. Words only count for 18%. Yes, we can be remembered by how we look, but what is even more powerful in being remembered by how we use our voice and how we’ve treated others.
One evening I went to a networking event in a different city. In the elevator I had a conversation with a woman. As we chatted, she asked me if I was going the networking event. I answered, “Yes, it’s my first time” in which she then asked me about my business and the kind of clients I was looking for. Tamera (her real name with her permission) was a regular and when we arrived she said, “Let me introduce you to the people I know.”
As Tamera took me around the room, she not only introduced me to others but also mentioned my expertise to each person. She used her voice in an enthusiastic and engaging way that opened up conversations. Her posture and eye contact were strong and confident as though I was someone special and they were special too, yet she was genuine. I felt Tamera was part of my team. It turns out she knew just about everyone there. In my eyes Tamera was a star, a people connector. She gained my admiration, respect, and I wanted to get to know her better so I could be on her team too.
That day I left the event truly inspired to take networking to a higher level. Building connections through helping others build connections, not by only introducing them, but by sharing what I know about them. Someone who others could count on as a connector and resource; Someone to be remembered and with which to stay connected.
7 Tips On How You Too Can Be A Networking Star:
In networking the goal is to increase your sphere of influence, helping others, increasing the opportunity to improve lives with your products, and assisting in more prosperity and success for all.
By the way, because of this encounter I got a radio interview, contracted a new client and secured a presentation, which Tamera attended and I then could acknowledge her to the audience thus giving her the kudos she deserved.
Marlena Reigh, international voice image specialist since 1992, teaches unique, effective and powerful voice communication techniques which are critical in getting results in any speaking situation. www.MarlenaReigh.com 2359 Prairie Street, Ann Arbor, MI 48105 Marlena@marlenareigh.com (734)395.3553
©2013 M. Reigh Radiant Communications (734)395.3553
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