Large employers can choose whether to send their workers Form 1095-C coverage information notices for the 2014 plan year. Health insurers and sponsors of self-insured plans can choose whether to send enrollees Form 1095-B coverage information notices for the 2014 plan year. Patient Protection and Affordable Care Act (PPACA) public exchanges have to send out […]
The Michigan Business and Professional Association (MBPA) strives to keep you updated on all things related to healthcare reform, namely the Affordable Care Act (ACA). This March 4th, 2015 the U.S. Supreme Court intends to hear oral arguments on a case that could affect the sustainability of the ACA public exchange system and its insurance underwriting rules.
Background:
Michigan is a federally facilitated exchange, (FFE), which means the federal government runs our public health care exchange. As written, the ACA requires those states’ utilizing the federal health care subsidies to have a state-based exchange. Michigan made several good attempts to secure such a status, but politically that goal was not achievable. In the meantime, before the individual mandate took effect, the Administration overrode that stipulation and allowed all state’s to participate and gain the subsidies for those individuals who qualified.
If the U.S. Supreme Court rules against the Administration, that would prohibit Michigan from participating and accepting the health care subsidies under the federal health care law. This action could destabilize the individual health care market, making insurance unaffordable for those that need it most. Michigan would then be charged with the decision and responsibility on how to move forward. An answer not easily made when politics is involved.
If the U.S. Supreme Court rules in favor of the Administration, Michigan’s health care subsidies remain status quo. The decision on the subsidy ruling does not impact our state’s decision of adopting the Healthy Michigan Plan, which was an expansion of our Medicaid recipients. Michigan has enrolled over 500,000 individuals in the Healthy Michigan Plan, which is quite an achievement.
We will continue to keep you up to date on the subsidy ruling. There is much speculation out there, but we truly will not know the outcome until the U. S. Supreme Court rules in late June of 2015. Please contact our government relations team if you have any questions or comments. All feedback is appreciated!
Contact information:
Email: bbochniak@michbusiness.org
Phone: (888) 277-6464
Summary Plan Descriptions (SPDs)
The Employee Retirement Income Security Act (ERISA) guidelines make it mandatory for all businesses with two or more employees to provide their employees with a compliant Summary Plan Description. The MBPA continues to take a leading role in informing and helping our members meet their obligations under ERISA.
The types of benefits covered by Summary Plan Descriptions include: Medical, Long Term Disability (LTD), Short Term Disability (STD), Life and AD&D and freestanding Dental/Vision.
These documents have been reviewed and are certified as being compliant with all applicable laws, including health care reform to date.
How to Complete an SPD for a Client:
• Log into MBPA’s secured Agent Pavilion via our website www.michbusiness.org. Complete the adoption agreement online for an existing member and immediately receive a customized SPD.
• Contact our office and our Client Services Department will work directly with you or your client(s) to help you through the process and assist with your questions. (See back of flyer for our Quick SPD checklist).
* The completed form should be e-mailed in WORD format to info@michbusiness.org for processing.
• Our Client Services Department will send the processed document to you or your client within two business days.
• If your client is NOT a member of MBPA, a $200.00 fee to attain an SPD applies. Contact our Office for more details P: 888.277.6464
Creating an ERISA Compliant SPD is Quick & Easy
To help you reduce costs and time, the Associations are providing complimentary Summary Plan Descriptions to all dues-paying members. Below are the key facts needed to process an SPD.
1. Client name, address, phone & contact.
2. Federal ID number.
3. Legal contact, if different than question 1.
4. Effective date.
5. Plan number.
6. Plan year.
7. Subject to FMLA
8. Benefits offered, with carrier name & phone number. Please indicate if self-insured
or grandfathered.
9. Employee contribution to benefit(s), pre-tax, after tax.
10. Employee contribution to benefit(s) for spouse & dependents, pre-tax, after tax.
11. Who is eligible (number of hours worked).
12. Are spouses covered? Are domestic partners covered? Are children covered?
13. Any exclusions to spouses/domestic partners or children?
14. New hire rule, rehire rule.
15. Is there a leave of absence? Payment requirements, if yes.
16. Termination of coverage date?
17. States where client has offices.
18. Does the client have Privacy & Security officer? If yes, need name or title.
We look forward to continuing to provide you and your clients with the most up-to-date and easily accessible services in this important compliance area for businesses. If you have any questions or are in need of assistance, please contact our Client Services Department at 888.277.6464 or 586.393.8800 ext. 606.
The MBPA has updated our one-page reference sheet on penalties for employers NOT offering health coverage. Click here to download this resource
We wanted to share some important information that may help certain individuals avoid the Insurance Marketplace Fee. We don’t want you to miss this!! The U.S. Department of Health and Human Services has compiled a list of “exemptions” that are worth taking a look at. Exemptions from the Health Insurance Marketplace Fee If you don’t […]
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October 30, 2014 Today, the Internal Revenue Service announced in Revenue Procedure 2014-61 the annual inflation adjustments for more than 40 tax provisions for 2015, including the tax rate schedules, and other tax changes. This Revenue Procedure provides details about these annual adjustments. There are several benefit limitations for 2015 included: * […]
The maximum annual employee contribution to a health flexible spending account plan is increasing to $2,550 for 2015 (up $50 from the $2,500 limit that has applied since 2013). Employers that sponsor health flexible spending accounts should consider whether they wish to adopt this higher limit for 2015. If so, the increased amount should […]
October 31, 2014 Statement of Enforcement Discretion regarding 45 CFR 162 Subpart E – Standard Unique Health Identifier for Health Plans Effective October 31, 2014, the Centers for Medicare & Medicaid Services (CMS) Office of e-Health Standards and Services (OESS), the division of the Department of Health & Human Services (HHS) that is responsible […]
The IRS issued a notice on November 4, 2014 concluding that a health plan that does not provide substantial coverage for inpatient hospitalization and/or physician services will not qualify as a “minimum value” plan under the Affordable Care Act. Therefore, large employers that adopt such plans are subject to penalties under the Affordable Care Act […]
