Healthcare Compliance Inc: 2017

Thursday, 14 December 2017

Affordable Care Act ALE Compliance | Health Plan Rules – Treating Employees Differently

Some employers may want to be selective and treat employees differently for purposes of group health plan benefits. For example, employers may consider implementing the following plan designs:

– A health plan “carve-out” that insures only select groups of employees (for example, a management carve-out);
– Different levels of benefits for groups of employees; or
– Employer contribution rates vary based on employee group.

In general, employers may treat employees differently, as long as they are not violating federal rules that prohibit discrimination in favor of highly compensated employees. These rules currently apply to self-insured health plans and arrangements that allow employees to pay their premiums on a pre-tax basis. The nondiscrimination requirements for fully insured health plans have been delayed indefinitely.

Employers should also confirm that any health plan rules do not violate other federal laws that prohibit discrimination. In addition, employers with insured plans should confirm that carve-out designs comply with any minimum participation rules imposed by the carrier.

Click Here to download the full article.

ACA Reporting Service | California Supports Obamacare by Outspending U.S. 4-to-1 on Ads

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Tuesday, 21 November 2017

ACA Reporting Service | California Supports Obamacare by Outspending U.S. 4-to-1 on Ads

The Affordable Care Act is still law.

Californians are getting barraged with online pop-up ads, radio spots and television commercials, all aimed at persuading them to sign up for Affordable Care Act health plans during this year’s open-enrollment season.

Covered California, the state’s Obamacare exchange, is wielding a monster marketing budget that devotes $45 million to ads, including $18 million for TV and $8 million for radio. The agency is so flush with marketing dollars that it also spent $100,000 for a dozen freshly painted murals across the state, most of which have nothing directly to do with health insurance enrollment.

Covered California’s marketing riches contrast starkly with the advertising budget for the federal health insurance exchange, healthcare.gov. The feds have slashed ad dollars to $10 million, down from $100 million last year.

The huge discrepancy reflects conflicting attitudes toward the ACA, commonly known as Obamacare, said Gerald Kominski, director at the UCLA Center for Health Policy Research.

Also, before changes to the provisions of the Affordable Care Act can be made, alternatives need to be worked out.

Friday, 20 October 2017

ACA Large Group Compliance | HCI Introduces New ACA Compliance Software

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source https://healthcare-compliance-inc.com/aca-large-group-compliance-hci-introduces-new-aca-compliance-software/

Tuesday, 19 September 2017

IRS Continues to Enforce the Affordable Care Act

In the wake of Congress being unable to pass ACA repeal and replace legislation, a bipartisan effort seems to be growing around improving the ACA. Indeed, a majority of Americans want to see Congress take a bipartisan approach to addressing healthcare issues.

Among those Americans is a bipartisan group of liberal and conservative leaders in health policy are supporting the continued payment of all the federal subsidies provided under the ACA and to help Americans enroll in coverage. President Trump recently authorized the U.S. Department of Health and Human Services to make the next round of subsidy payments to the insurance companies providing health insurance through government exchanges.

Hearings are expected to be held by the U.S. Senate’s Health, Education, Labor and Pensions Committee in September to discuss bipartisan legislation for a one-year extension of the federal payments to insurers.

Tuesday, 29 August 2017

GOP leaders Make Another Attempt to Fix Obamacare

Discussion of the Affordable Care Act often incites fear, confusion, and anger in people both for and against its passage.

When Congress returns next month, some Senate Republicans plan to turn from yet another effort to repeal and replace the Affordable Care Act, nicknamed Obamacare, and make a bipartisan effort to fix some of the current system’s most pressing problems.

But the recent antagonistic exchanges between Majority Leader Mitch McConnell and President Donald Trump raise questions whether any such effort can succeed. Even if it gets the 60 votes needed to pass the Senate, it would need support from the more repeal-friendly House and the president’s signature.

Unfortunately, despite some bipartisan stirrings in the House, Speaker Paul Ryan so far opposes action and the crowded congressional calendar complicates matters further. But some action is necessary.

Employer reactions to the Affordable Care Act often result in less than favorable outcomes for employees.

Wednesday, 23 August 2017

IRS CONFIRMS ACA MANDATE PENALTIES STILL EFFECTIVE

The Internal Revenue Service (IRS) Office of Chief Counsel has recently issued several information letters regarding the Affordable Care Act’s (ACA) individual and employer mandate penalties.

These letters clarify that:
– Employer shared responsibility penalties continue to apply for applicable large employers (ALEs) that fail to offer acceptable health coverage to their full-time employees (and dependents); and

– Individual mandate penalties continue to apply for individuals that do not obtain acceptable health coverage (if they do not qualify for an exemption).

These letters were issued in response to confusion over President Donald Trump’s executive order directing federal agencies to provide relief from the burdens of the ACA.

Download the full report

Obamacare Becoming Popular with Voters During Trump’s Presidency

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source https://healthcare-compliance-inc.com/irs-confirms-aca-mandate-penalties-still-effective/

Wednesday, 22 February 2017

Obamacare Becoming Popular with Voters During Trump’s Presidency

Understanding every aspect of ObamaCare can be daunting, but getting the gist isnt hard.

Obamacare is getting more popular with voters even as President Donald Trump moves to get rid of the landmark health-care law.

A total of 45 percent of registered voters say they approve of Obamacare, compared to 45 percent who oppose the law, a new Politico/Morning Consult poll finds.

Since early January — weeks before Trump moved into the White House — there has been a drop of seven percentage points among voters opposed to Obamacare.

Trump and fellow Republicans who hold control of Congress have said they want to repeal the ACA and replace it with new health-care legislation. The GOP says that Obamacare is a failed program that has led to increasing premiums and onerous out-of-pocket charges to many Americans.

ObamaCare can help decrease your deductible if you qualify for Cost Sharing Reduction subsidies on the Marketplace.

Tuesday, 21 February 2017

A Solution for the Affordable Care Act

Discussion of the Affordable Care Act often incites fear, confusion, and anger in people both for and against its passage.

Despite the political challenges, it’s very clear that the new administration and Congress are moving forward on their promise to repeal and replace the Affordable Care Act (ACA). This gives them a chance to fix the ACA’s weaknesses, while preserving and building on what it got right.

Guiding their reform should be the principles that healthcare should be accessible to every American, be high quality, and be affordable. Upholding all three principles means, first and foremost, enacting policies that better harness market competition. In countless industries from manufacturing to services to retail, market competition works, delivering more value to more people. But in healthcare, structural shortfalls of the market stifle choice and competition and drive up cost.

Policymakers should retain and improve the ACA’s existing health care exchanges as one option for access to health care plans. To foster competition and choice, they should open the exchanges to all individuals served in the “natural” healthcare market which could reach beyond state lines — not just the ACA’s strict state boundaries. As a result, many healthcare consumers would benefit from pricing unique to their respective area (consider the cost of doing business in New York City versus the state’s rural areas). This reform would change the status quo “cookie cutter” policy, in which only one exchange must serve an entire state but not exceed its boundaries, even into contiguous metropolitan areas.

Have questions regarding the Affordable Care Act often called ObamaCare?

Monday, 20 February 2017

Could California fund the Medi-Cal Expansion on its Own ?

Covered California is the only place where you can use new tax credits to help pay insurance premiums.

A repeal of the Affordable Care Act could jeopardize up to $140 million per year in federal funding that pays for the Medi-Cal expansion in Santa Barbara and San Luis Obispo counties, said Bob Freeman, who administers the program as the CEO of CenCal Health. Nearly one in three Santa Barbara County residents – and more than one in three statewide – are now enrolled in Medi-Cal, getting free or low-cost care.

Santa Barbara County has seen a 68 percent increase in all Medi-Cal enrollment over pre-reform levels, wildly exceeding expectations, said Maria Gardner, a deputy director of the county Department of Social Services.

Covered California, the marketplace for private insurance under the law, has some very high deductibles, and that is hard for patients, Ransohoff said. But, he said, it would be devastating to return to the days when people went bankrupt to pay their medical bills and faced ruined lives.

Covered California often requests document proofs from you to verify evidences like your income or citizenship.

Thursday, 16 February 2017

Trump Undermines Obamacare Exchanges While Trying to Save Them

ObamaCare can only do so much to protect your rights.

With the drive to “repeal and replace” Obamacare losing steam, the Trump administration quietly moved to shore up a key feature of the healthcare law this week: the state exchanges where people shop for non-group coverage. And to its credit, Trump’s Department of Health and Human Services zeroed in on some of the factors that have led a handful of major insurers to leave the exchanges.

But before you praise (or condemn) Trump for coming to Obamacare’s rescue, consider this: Another arm of the new administration has taken a step that could undo much of the work the department is trying to do, and leave the exchanges no better off — and possibly in worse shape — than they are today.

The real threat to the exchanges’ health remains the specter of Congress enacting a law that repeals all or part of Obamacare in two or three years. Planting such a legislative time bomb would have an immediate impact, sending the market for non-group insurance policies quickly into chaos, according to analysts from both sides of the political spectrum. As John Rother of the pro-Obamacare National Coalition on Health Care put it, “[N]o market stabilization effort can succeed if policymakers disrupt existing coverage arrangements rather than improving on them.”

Proponents of ObamaCare often point to expanded coverage as proof that ObamaCare is working.

Tuesday, 14 February 2017

Rest Of The U.S. Could Learn From Covered California

In its advertising, Covered California often played up the benefits of Obamacare, such as guaranteed coverage regardless of pre-existing conditions and access to checkups and mammograms.

A five-state study of Obamacare health insurance exchanges finds California’s to be the “most successful” of the group. Researchers say the state’s experience may provide valuable lessons to lawmakers in Congress seeking to “repeal and replace” the federal health reform law.

California’s exchange, Covered California, has succeeded in large part because of its ability to retain a “relatively large” number of insurers compared with other states, according to the study, sponsored by The Brookings Institution.

Officials also boosted the fortunes of the exchange by aggressively negotiating premiums with insurers and imposing conditions on their participation. And Covered California helped facilitate the enrollment of low-income consumers, the study notes.

Research teams conducting The Brookings study took a deep-dive look at California, Florida, Michigan, North Carolina and Texas to determine what has worked, what hasn’t and why.

Covered California is the only place where you can use new tax credits to help pay insurance premiums.

Thursday, 19 January 2017

Fight Is On To Protect Health Care In California

Covered California is the place where Californians can get brand-name health insurance under the Patient Protection and Affordable Care Act.

As Republicans seek to repeal and replace the Affordable Care Act, advocacy organizations around the nation are strategizing on how best to respond. Do they defend the law at all costs? Do they take part in the repeal conversation so they can help design an alternative?

Already, numerous groups are mobilizing patients and health care advocates to raise awareness of the impact of a repeal. Families USA, for example, launched an initiative called “Protect Our Care” and is encouraging consumers to share their stories through social media. Opponents of repeal staged protests around the country last Sunday.

The California Endowment, a private health foundation in Los Angeles, was among the state’s biggest backers of the Affordable Care Act, spending tens of millions of dollars on outreach and awareness. Robert K. Ross, the foundation’s president and CEO, was one of the founding board members of the state’s health insurance exchange, Covered California.
During open enrollment, Covered California often needed to resolve inconsistencies on customer applications and get further documentation.

Monday, 16 January 2017

The Future of Covered California under President Trump

Covered California is the only place where an individual can learn about and use federal financial assistance that can help reduce health care costs.

California stands to lose $20.5 billion a year in Obamacare funding — $15.5 billion for Medi-Cal and $5 billion in Covered California subsidies.

California’s programs won’t be gone overnight. Despite campaign promises to the contrary, it is virtually impossible to repeal Obamacare on day one of the Trump administration. The Senate filibuster rule, which requires 60 votes to move legislation forward, provides Democrats with a mechanism to block a complete repeal effort. And there would be an enormous backlash against an immediate, abrupt repeal. More than 20 million Americans are newly insured under Obamacare, and many congressional leaders, including House Speaker Paul D. Ryan, understand the very real political costs of throwing them under the bus. So Obamacare is likely to continue through the end of 2017, and perhaps 2018.

Since the election, Trump has emphasized maintaining at least two popular features of Obamacare — allowing children to stay on their parents’ policies up to age 26, and requiring insurers to offer insurance to those with pre-existing conditions without higher premiums. (There’s a caveat — premiums will go up if you aren’t continuously covered.)

Covered California is the place where Californians can get brand-name health insurance under the Patient Protection and Affordable Care Act.

Thursday, 12 January 2017

How Will The Planned Repeal Of Obamacare Affect Californians?

Covered California is a state-designed program to make it simple and affordable for you to purchase high-quality health insurance and access financial assistance to pay for coverage.

As federal lawmakers debate the fate of Obamacare this month, health coverage for millions of Californians hangs in the balance.

Covered California, the state health insurance exchange, and the expansion of Medi-Cal, the state’s Medicaid program for low-income residents, are products of the Affordable Care Act. Both could be at risk if the GOP-led Congress and President-elect Donald Trump gut key pieces of the health law.

For instance, if federal lawmakers kill the tax credits that have subsidized health insurance premiums for those who qualify, “what happens … to the people who purchase the plans on Covered California? Will they just have to pay out of pocket?” she said. “So many people just won’t be able to afford that.”

If you have a small business, Covered California can help you shop for health plans for your employees.

Covered California Official Says Obamacare Repeal Won’t Happen Anytime Soon

Covered California is where you can compare quality health plans from brand-name health insurance companies.

So if Obamacare is being repealed and replaced simultaneously with something else, does that mean there’s no point in signing up for medical insurance through Covered California? And if you have an existing plan, is it going away soon?

Not so.

Peter Lee, the executive director of Covered California, says those who already have health insurance through Covered California can count on that coverage. And those who don’t, should sign up now.

“Things in Washington do not happen overnight. Health care can change overnight,” Lee said. “Our number one message is, we’re in open enrollment, now is the time. If you don’t have insurance, sign up and get the insurance, change is going to take time.”

Right now, you can get a new plan or make changes to an existing one. And the open enrollment period ends on January 31.

Covered California is a state-designed program to make it simple and affordable for you to purchase high-quality health insurance and access financial assistance to pay for coverage.

Wednesday, 4 January 2017

Trump’s Obamacare | Congress Prepares for Obamacare War

The conservative case against Obamacare can take a lot of different forms but it often focuses on the expansion of government regulation and spending.

As Republicans near their long-sought repeal of Obamacare, their battle with congressional Democrats entered a new phase Wednesday, with both parties vowing to convince Americans the other side is to blame if millions of people see their health care disrupted.

President Barack Obama huddled with Democrats to formulate a strategy that will inflict maximum political pain on Republicans as they move closer to a repeal vote — and encourage Americans whose health care may be disrupted to pin their problems on the GOP. Meanwhile, Vice President-elect Mike Pence held court with Republican lawmakers and pleaded with them to tell their constituents “the truth” — that Democrats are responsible for passing a broken law in the first place.

To begin with, ObamaCare often speaks of consumers, rather than citizens.