To help member businesses reduce their costs, the Associations are providing complimentary services such as Section 125 Plans and Summary Plan Descriptions (SPD) documents to all dues paying members in good standing. The adoption agreements are now compliant documents reflecting ALL the Health Care Reform Law changes as of January 2013. These documents are […]
The MBPA and MFBA are partnering with Management Impact and EctoHR, Inc., two established, Michigan-based companies, providing free expert consultation services and tailoring the best human resources practices and solutions at discounted prices for your groups. MBPA/MFBA Members receive a free consultation and discounted services Provide a primary point […]
Under Sections 1311 and 1413 of the Affordable Care Act (ACA), the Centers for Medicare and Medicaid Services (CMS) must develop and provide each state with a single, streamlined enrollment application form. States also may elect to develop and use their own application, with approval by CMS. On January 29, 2013, CMS published the […]
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.
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
By 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.
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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By 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.
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 […]
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 – […]
