By Michelle Andrews
Jun 20, 2014

Here is a Question & Answer “Provided by Kaiser Health News.”

A Reader Asks: Can Our Plan Kick Off Our Daughter Because Her Job Offers Coverage?

Q. My 24-year-old daughter was covered under her father’s health insurance, which is a grandfathered plan. She started working and was offered coverage through her employer. My husband’s employer said she had to sign up for her employer’s insurance and could not stay on his policy. Is that true?

A. Not anymore. Under the health law, health plans that offer dependent coverage have to allow adult children to stay on their parents’ plan until they turn 26 under most circumstances, even if the young adults are married or financially independent. The law initially allowed one major exception for grandfathered plans—those that were in existence before the health law passed in March 2010 and hadn’t changed substantially since then. Those plans could refuse to cover adult children if they had an offer of employer-based coverage elsewhere, such as through their own jobs. However, starting last January, that exception no longer applies. A 24-year-old such as your daughter should be able to remain on her father’s plan until she turns 26, even if her own job also offers health insurance.

The original provision, which went into effect six months after the law passed, was likely intended to ease the transition to new coverage rules for employer group plans, says Sara Collins, vice president at the Commonwealth Fund.

Attention FFM Agents: What You Need to Know for Plan Year 2015
Earlier this week, the Centers for Medicare and Medicaid Services (CMS) released some important information for agents and brokers planning to sell on the federal exchange in 2015. As a reminder, in order to participate in the federally facilitated marketplace, agents and brokers must go through CMS training annually. The 2015 training will be released by CMS in July. CMS put together this helpful chart, click here, which highlights the upcoming important training dates and training requirements for each marketplace.

Onsite Employee Overview, Enrollment Assistance and Marketplace Coaching
An informative overview of the ACA law is given from an individual perspective. Subsidies, Tax Credits and eligibility will all be explained for Marketplace enrollment. Coaching on how to enroll into the government Marketplace will be given. Any individual that would like to enroll into individual coverage for products not on the Marketplace will be assisted in the purchasing of individual coverage as required by law.

Resources will be provided and customer service numbers will be available for those that need further assistance. These services include a one year membership for new members.

The NEW Health Care Reform App: Everything You Need for Health Reform Compliance
Download the Exclusive NEW Health Care Reform App for the iPhone and iPad in the Apple App Store, search “MBPA.” The app is also available for download for Android smartphones in the Play Store. This app has all the information you need, on the run, to stay ahead of Health Care Reform. Plus, you can receive push notifications to keep on top of the newest information and latest changes in this law.

The Enhanced Member Website 2.0
All new! We’ve redesigned our Health Care Reform Connect™ website to make it easier for you to find and use valuable information.

Topics have been divided into the following sections:

• ACA Overview
• Mandates
• Compliance
• Insurance
• Articles
• Resources
• Events

Conferences and Webinars
We have hosted health care reform conferences across the state with several hundred attendees who have learned about the impact of healthcare reform on their business, additionally we have hosted monthly webinars presenting timely information on health care reform to our members.

Health Care Reform Articles
We have numerous health care reform articles from various subject matter experts from around the country – these articles are available via our secured website as downloadable PDFs.

Small Business Health Care Reform Guide
Our Small Business Health Care Reform Guide, including Tax Credit and FTE Calculators, Health Care Reform Timeline and Reform Roadmap, to help Michigan businesses and their agents through health care reform.

Health Care Reform Hotlink
We have developed a health care reform “hotlink” giving businesses the opportunity to ask their specific health care reform questions, with a typical answer back in 24-48 hours. This free service for our members has saved them countless hours and helped to clear the fog on reform.

The MBPA is working in conjunction with your independent insurance agent to help demystify the requirements of health care reform. This year, individuals are required to have health care coverage in order to comply with the Affordable Care Act (ACA). Many companies are assisting employees by providing educational seminars and coaching to help employees understand how the ACA impacts them. The MBPA can provide this service. Employers will need to make critical decisions about company-sponsored health care coverage and, effective January 1, 2016, will be required to offer minimum essential coverage or pay penalties, among various other employer mandates. The MBPA Team can help you understand the law, how it impacts you, and how the ACA impacts your employees.

This program is ideal for member businesses that may need one or more of the following:

• An ACA (Health Care Reform) overview specific to their company for owners and executives to make the best possible decisions for their employees regarding group health care coverage.

• An employee overview of individual requirements under reform to better understand how the law impacts them.

• Employers thinking about dropping their health insurance coverage and would like a smooth transition for employees to enroll in individual health care coverage.

• Employers with a large part-time workforce that need to understand their options under reform. All individuals are required to have coverage under the ACA law. This service will help them make decisions.

• All employers that would like to ensure that employees receive one-on-one counseling regarding their health coverage options under health care reform.

While the MBPA did not support this piece of legislation politically, we are here to help you get through it. If you are interested in learning more about what we can do to assist you, contact Tina Brodak or Jennifer Werner at 888-277-6464.

The Obama administration is issuing a fourth round of health plan rate review grant monies to state insurance departments.  All 50 states including the District of Columbia and six territories can apply for the grants.  

These grants may be used to acquire the legal authority to review rate changes, to expand the scope of existing rate review operations, to make rate information available to the public through the internet, and to examine medical claims reimbursement data, according to the Center for Consumer Information & Insurance Oversight (CCIIO) officials.
 
Grants awarded will range from $719,643 dollars to a maximum of $5 million dollars, and applications are due July 21st, 2014.

The ACA required CCIIO’s parent, the U.S. Department of Health and Human Services (HHS), to help improve state health insurance rate review programs.  HHS established regulations that require state insurance departments or another entity to review any requests for increases of 10 percent or higher.  And HHS does not require reviews of requests for large rate decreases.

Since the inception of the ACA, in 2010, HHS awarded a total of $46 million in ACA rate review program grants to 45 states and the District of Columbia.  HHS handed out rate review grants in three phases in 2011. That year, 29 states shared $109 million in Phase I grants; one state and three territories shared $8 million in Phase II grants; and one state received $2 million in Phase III grants.
 
In 2013, HHS gave about $68 million in rate review grants to 20 states and one territory.  This year, 15 states are using rate review grants to establish or improve health rate data centers.  We are hopeful more states will continue to take advantage of this federal funding in order to improve the rate review process.

As always, please contact our government relations team with any questions, by phone: (586) 393-8800 ext. 401 or by email: bbochniak@michbusiness.org.

The NEW Health Care Reform App: Everything You Need for Health Reform Compliance!

Download the Exclusive NEW Health Care Reform App for the iPhone and iPad in the Apple App Store, search “MBPA.” The app is also available for download for Android smartphones in the Play Store.

This app has all the information you need, on the run, to stay ahead of Health Care Reform. Plus, you can receive push notifications to keep on top of the newest information and latest changes in this law.

PLUS

The Enhanced Member Website 2.0

All new! We’ve redesigned our Health Care Reform Connect™ website to make it easier for you to find and use valuable information.

Topics have been divided into the following sections:

• ACA Overview
• Mandates
• Compliance
• Insurance
• Articles
• Resources
• Events

Visit www.michbusiness.org/hcrc and sign in today to get the full array of services!

To take advantage of all of these services, simply download the App and use your member login information at the top of the screen or online at the link above. If you have any questions, please call us at 888-277-6464 and ask for your Client Service Associate.