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December 30, 2013          Get Retirement News  |  Advertise
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Employee Benefits Jobs

Regional Vice President/Retirement Plan Wholesaler
Ohio National Financial Services
in CO, IL, TX

Account Manager, Employee Benefits
Lenox Advisors
in CT, NJ, NY, PA

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official guidance, jobs, webcasts and more.
[Official Guidance]

Text of CMS FAQ on Reporting of Employee Count through SHOP
"Will employers be able to attest that they employ 50 or fewer full-time equivalent employees (FTEs) through information provided directly to the FF-SHOP? Answer: Yes, employers may attest to having 50 or fewer FTEs. Issuers will not be required to determine FTE counts for SHOP eligibility purposes." [The Q&A is labeled as FAQ ID 602 on the Registration for Technical Assistance Portal operated by CMS.] (Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services)  

[Official Guidance]

Text of CMS FAQ on SHOP Issuer Reporting of Minimum Participation
"SHOP regulations require issuers in the FF-SHOPs to use the FF-SHOP minimum participation rate methodology and default 70% rate ... However, if an issuer conducting direct enrollment in the FF-SHOP in 2014 demonstrates to CMS that it would be operationally impracticable for it to apply the FF-SHOP minimum participation rate required by CMS regulations, CMS would not take any adverse action against such an issuer for failing to impose the applicable minimum participation rate during the period that the issuer is implementing capability to comply with CMS regulations." [The Q&A is labeled as FAQ ID 601 on the Registration for Technical Assistance Portal operated by CMS.] (Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services)  

[Official Guidance]

Text of HHS Correction to Amendments to the Notice of Benefit and Payment Parameters for 2014
"On page 65095, in the Federal Register of October 30, 2013, we added subpart M 'Oversight and Program Integrity Standards for State Exchanges' to the regulations text at 45 CFR part 155. While it was clear from the preamble and regulations text that subpart M applies to all Exchanges, including small business health options program (SHOP) Exchanges, due to an oversight we inadvertently omitted cross-referencing new subpart M at section 155.705(a) of the regulations in part 155, subpart H-Exchange Functions: Small Business Health Options Program. Accordingly, we are revising section 155.705(a) so that the regulations in part 155 consistently reflect our policy that all Exchanges, including SHOP Exchanges, must carry out the required functions of an Exchange that are set forth at subpart M." (U.S. Department of Health and Human Services)  

[Guidance Overview]

Health Insurance Premiums for S Corporation Shareholder-Employees After IRS Notice 2013-54
"[W]hile it is not free from doubt, it appears that S corporation owner employees who directly or indirectly own at least 2% of the shares may now potentially be in a more favorable position than owner-employees of C corporations.... Until the IRS makes a pronouncement to the contrary, it appears that Notice 2013-54 does not affect the existing tax treatment and that the statutory language supports the following outcome: The premium subsidy is treated as taxable wages for income tax but not FICA purposes; and [t]he shareholder takes an above-the-line deduction under Code Section 162(l)." (Baker Newman Noyes)  

Text of CMS Advice to Consumers on Using Health Insurance after Enrolling through the Marketplace (PDF)
"[If] you did sign up and your insurance card has not yet arrived your coverage may already be effective. If you need to see a doctor or get a prescription filled before you get your insurance card, call your insurer to confirm that your coverage is in fact effective.... All consumers must pay their premium after enrolling in a plan in the Marketplace. However, each insurance company sets their own payment deadline. Some insurers may accept your first payment after your coverage has become effective and pay for care you receive after January 1, 2014. Contact your insurer to find out when and how you need to make your payment and what flexibility they are able to give you." (Centers for Medicare & Medicaid Services, U.S. Department of Health and Human Services)  


Health Savings Accounts - February 19 webinar

Sponsored by Lorman and BenefitsLink

Focusing on final comparability rules for employer contributions and new contribution limits and IRS guidelines, this webinar will explore new design opportunities for employers. Special BenefitsLink discount.

Insurance Turning Out to Be Unaffordable
"More than half of the counties in 34 states using the federal health insurance exchange lack even a bronze plan that's affordable -- by the government's own definition -- for 40-year-old couples who make just a little too much for financial assistance ... More than a third don't offer an affordable plan in the four tiers of coverage known as bronze, silver, gold or platinum for people buying individual plans who are 50 or older and ineligible for subsidies." (John Goodman's Health Policy Blog)  

Patients Cram In Tests Before Health Law Start
"Thousands of people are cramming in tests, elective procedures and specialist visits before year's end, seeking out top research hospitals and physician groups that will be left out of some 2014 insurance plans under the new health law, health-care providers say. Many insurers offering plans under the law are slimming down their networks of doctors and hospitals in a bid to lower the cost of policies, which begin coverage Wednesday. Health insurers are especially focused on paring academic teaching and research hospitals from their networks because they generally charge more than community hospitals for similar services." (The Wall Street Journal; subscription may be required)  

Numbers Offer Complicated Story of Health Care Law
"The government churns out tons of numbers, but here's one you won't see: 0.0002. That's the percentage of estimated online visitors to healthcare.gov who actually signed up for coverage the first day. Altogether, that's six people out of just over 3 million." (The Washington Post; subscription may be required)  

Looking Ahead After a December Enrollment Jump
"After 27,000 enrolled in qualified health plans through the federal exchange in October and 110,000 in November, 975,000 enrolled in qualified health plans in December ... It can be expected that some health plan enrollees will begin showing up at emergency rooms across the country soon after midnight on January 1, 2014, the victims of excessive New Year's celebration. Many more will need refills for their prescriptions or seek primary care early in January. These enrollees will need to establish for their health care providers the fact that they are covered." (Timothy Jost in Health Affairs Blog)  

Can Consumers Make Affordable Care Affordable? The Value of Choice Architecture
"Tens of millions of people are currently choosing health coverage on a state or federal health insurance exchange as part of the [ACA].... [The authors] conducted 6 experiments asking people to choose the most cost-effective policy using websites modeled on current exchanges.... Without interventions, respondents perform at near chance levels and show a significant bias, overweighting out-of-pocket expenses and deductibles. Financial incentives do not improve performance, and decision-makers do not realize that they are performing poorly. However, performance can be improved quite markedly by providing calculation aids, and by choosing a 'smart' default. Implementing these psychologically based principles could save purchasers of policies and taxpayers approximately 10 billion dollars every year." (E. J. Johnson, R. Hassin, T. Baker, A. T. Bajger, and G. Treuer, via PLOS [Public Library of Science])  


Healthcare.gov Enrolls 1.1 Million by Year-End: Cause for Celebration or Worry?
"If we net out the cancellations, has Obamacare signed up 5% of the uninsured, or 6%, or 7%? Whichever, it's not even 10% net of the cancellations.... The long-time underwriting rule is that it takes 70% of an eligible group in order to get a sustainable pool-- meaning we need 70% of the 20 million uninsured net of cancellations, or 14 million, for a truly sustainable risk pool." (Bob Laszewski's Health Care Policy and Marketplace Review)  

Benefits in General; Executive Compensation

Pension Legislation and Affordable Care Act Comparisons
"[ERISA and the ACA] affect private sector employers and their employees in many similar ways. Factors include those listed [in this article] in no particular order with footnotes referenced for explanations[.]" (H.C. Foster & Company, Actuaries)  

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