INDIVIDUAL MANDATE DEADLINE DELAYED

With the roll-out of the Health Exchanges on October 1, 2013 came a host of problems and computer glitches that kept would-be participants from enrolling in Exchange Plans through the Maryland State and/or Federal Websites.  Due to these hurdles, the Administration is pushing the Individual Mandate Date (date which most citizens must have coverage or face a penalty) back from January 1, 2014 to March 31, 2014.  Many senate democrats are also calling for a push-back on the "Open Enrollment" time-frame as well.  

AN EASIER WAY TO FIND RATES AND POTENTIAL SUBISIDES FOR REFORM PLANS

Anyone tried to get on the Maryland Health Connection website to see how affordable the health plans are?  From time to time I was successful and generated a couple scenario plans for clients.  What I found was that you needed to input a lot of information to find out if there were any Advanced Premium Tax Credits (APTC/Subsidies) available as well as the cost of the various "Medal" plans (Bronze, Silver, Gold, Platinum).  In addition, I also found that Carefirst, in many age bands, appeared to have the most competitive rates. Below is a link through our Portal (Brooks Benefit Services), that allows you to search, review, and see if you are eligible for APTC/Subsidies and apply for coverage if you don't. If you do qualify, you can only get those APTC's/Subsidies through the Maryland Health Connection Website. The Carefirst website is much easier, less time consuming, and will not log you off in the middle of doing a search.  Here is the Carefirst Medical Plan link. Please note that when you input the plan start date you should choose January 1, 2014.  If you do qualify for the "Subsidies" please feel free to contact me, Ben Brooks,  for assistance at 410-239-5009 or ben@brooksbenefit.com.  

MARYLAND HEALTH CONNECTION, SORT OF UP AND RUNNING

What a day.  We have had a partial government shutdown and the Maryland Health Exchanges are up and running, well sort of.  Trying all day to get into the exchange to compare rates, plans and features was met with absolutely no success. What I do know from some of my clients who were able to get rates, they were not very happy.  In fact very disappointed to find out that they were going to be paying the same or higher rates for inferior plans than they currently have.  It is important to remember that the Affordable Care Act is suppose to make plans both more affordable, accessible and provide decent coverage to those who otherwise wouldn't be able to obtain medical insurance in the individual market. 

Most brokers/consultants have taken the appropriate training to become certified to sell these plans both inside and outside of the Maryland Health Connection.  We are trying hard to educate not only the employers but the employees as well. Below please note the Maryland Health Connection logo and our reference ID which we would appreciate the employees using when completing applications as this not only credits our firm but also keeps the employees connected to our clients through Brooks Benefit Services.  In the upcoming weeks/months we will be reaching out to offer a time to set-up educational meeting for your employees.   If you would like to schedule a meeting in the meantime or request a copy of the PowerPoint Presentation, please do not hesitate to contact us at 410-239-5009 or ben@brooksbenefit.com.

Brooks Benefit Services, LLC

Benjamin Brooks

Consumer Assistance Reference ID: 9000054278

NEVERMIND, WE AREN'T GOING TO FORCE YOU TO NOTIFY YOUR EMPLOYEES OF THE EXCHANGES

The U.S. Department of Labor, after stating fines of about $100 per day for noncompliance, is now telling employers that they will not be fined if they fail to notify their workers of their health insurance exchanges by October 1, 2013.  What’s interesting is that they wait nearly two weeks prior to the “drop dead” date to do this.  Most employers have probably complied with the requirement already.

The Department of Labor announced on September 11, 2013 through a question and answer format specifically addressing the fine:

Q: Can an employer be fined for failing to provide employees with notice about the Affordable Care Act's new Health Insurance Marketplace?

A: No. If your company is covered by the Fair Labor Standards Act, it should provide a written notice to its employees about the Health Insurance Marketplace by October 1, 2013, but there is no fine or penalty under the law for failing to provide the notice.

Employers are told that they should still provide the information to their employees, seemingly as a recommendation rather than as a requirement.

NOTIFICATION OF THE EXISTENCE OF HEALTH EXCHANGE-URGENT

Essentially all employers must notify all of their employees, regardless of those on a medical plan or not, of the existence of the Health Exchanges.  The Model Notice of Health Exchange is the Notification issued by the Department of Labor (or one that contains essentially the same information) that MUST be sent to ALL employees by 10-1-2013. There are three pages to the notification.  Page 2 needs to be completed by you prior to sending to your employees. The third page is optional.  All newly hired employees must be given the notification within 14 days of Hire.

Below please find the distribution and delivery requirements. 

Distribution Requirements

Employers

Any employer who is subject to the Fair Labor Standards ACT of 1938 is required to distribute the Exchange Notice to its employees. Employers who do not currently offer health care coverage to their employees and/or are not subject to the Employer Mandate under the ACA are not exempt from this notification requirement.

Employees

ALL employees must be provided with an Exchange Notice, including employees who are not eligible to enroll in employer-sponsored benefits. A few exceptions do apply. A notice does not need to be issued to:

• Spouses and dependent children covered under an employer’s plan,
• COBRA participants, and
• Retirees (even if they are enrolled in an employer-sponsored health plan).

Delivery

When it comes to getting the Exchange Notice into the hands of employees, the updated guidance provides employers with two options: 1) First Class Mail and 2) Electronic Distribution. You may choose one option for all employees or a combination of both (depending on your employee population). Please note that electronic distribution is only permissible if the following DOL regulations are satisfied:

• Access to the electronic delivery system is an integral part of the employees’ work duties.
• A statement regarding the importance of the Exchange Notice is provided.
• A free paper copy is made available upon request.

     

AETNA/COVENTRY PULLING OUT OF THE INDIVIDUAL MARYLAND EXCHANGES

Earlier this week Aetna, who recently purchased Coventry Health Plans, told the Maryland Health Administration Commissioner, Therese Goldsmith that both Aetna and Coventry will be pulled out of the mix for plans offered on the individual exchange.  Aetna requested rates for one of their plans that was 29% higher than what the exchange would allow and decided that to lower their premiums by that amount would be unprofitable. Aetna and Coventry, however, have shown no signs that they are pulling out of the Small Group Exchange Plans.  

POSSIBLE DELAYS TO THE INDIVIDUAL MANDATE UNDER TRANSITION RELIEF

According to IRS Notice 2013-42, for non-calendar year Medical Plans, transition relief is available for those plans that begin in 2013 and end in 2014.  If your coverage is available through an employer, depending upon when that coverage is made available to you (or your spouse) would depend upon when you would need to obtain coverage.

Example 1. You are eligible for enrollment in a non-calendar year employer sponsored medical plan beginning August 1, 2013 and ending July 31, 2014.  You have parent/child coverage for you and your 10-year old son.  You do not elect coverage for yourself/son on August 1, 2013.  Under this rule you would have transition relief through July 31, 2014.  If you do not elect coverage at this time, penalties would be assessed.

Example 2. You are Married and both you and your spouse are eligible for enrollment in a Non-Calendar Year Plan of an Employer for the 2013-2014 Plan Year and in a Calendar Year Plan with your Spouse’s Employer for 2014.  Your plan begins August 1, 2013 and ends July 31, 2014.  Your spouses plan begins January 1, 2014.  You do not elect coverage for you and your spouse under your plan August 1, 2013 and your spouse does not elect coverage for the both of you on January 1, 2014. In this example both you and your spouse would have transition relief until your plan renewal in August of 2014.  If at this time, no coverage was elected, penalties would be assessed.

(From IRS Notice 2013-42)