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[Official Guidance]
Text of CMS Updated Federal Standard Renewal and Product Discontinuation Notices (PDF)
56 pages. Unnumbered document, dated Sept. 2, 2016. "The purpose of this Bulletin is to provide updated Federal standard notices that must be used by an issuer in the individual market to provide notice of product discontinuation, coverage renewal, and non-renewal or termination based on enrollees' movement outside the product service area.... This Bulletin also provides additional guidance related to the notice requirements in the group and individual market under the guaranteed renewability provisions."
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]
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[Official Guidance]
Text of CMS FAQs on Crosswalk of Enrollees Into Plans Offered by Other Issuers (PDF)
Unnumbered document, dated Sept. 2, 2016. "CMS has flexibility to adjust the crosswalk, such as excluding issuers from this process based on their financial capacity.... States may choose to develop their own suggested alternative plan crosswalks. CMS will allow those crosswalks to be submitted to CMS by September 13, 2016."
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]
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[Official Guidance]
Text of CMS FAQs on Verification of Special Enrollment Periods (PDF)
Unnumbered document, dated Sept. 6, 2016. "Preliminary data indicate that the confirmation process has resulted in a material decrease in special enrollment period plan selections.... [W]hy enrollments are falling in response to the new confirmation process is unclear.... We have been asked what policy changes we might consider and when and what input would be most relevant.... In particular, to further inform policy development, we seek input on a pilot we intend to launch in the months after Open Enrollment in 2017.... Q1: What further actions is CMS considering to curb potential abuse of special enrollment periods ? ... Q2: When would the pilot be implemented? ... Q3: What information and data will CMS consider as it designs the pilot ?"
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]
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[Guidance Overview]
October 15 Deadline Approaching for Medicare Part D Creditable Coverage Notices
"Medicare Part D notices of creditable coverage must be provided to Medicare eligible individuals prior to October 15 of each year. Many employers satisfy this requirement by including the notice in enrollment materials or in a separate mailing. As a reminder, the [ACA] changed the Medicare Part D annual enrollment period to October 15 through December 7."
Marsh Consulting Group
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[Guidance Overview]
Will Your Part-Time and Seasonal Employee Policy Result in an ACA Penalty?
"[S]ome employers have implemented policies to restrict part-time and seasonal employees (non-FTEs) from working an average of 30 or more hours per week. However, the IRS recently specified that these policies are not enough to avoid liability. Actual hours count -- even if performed in violation of an employer's policy."
Polsinelli PC
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The Unpredictable Individual Health Insurance Market
"The future of the Marketplace and how individual health insurance options will trend is anything but predictable. This brief provides a timely look at recent market developments with state-by-state membership comparisons and competitor insights.... Insurers collectively lost almost $6 billion in the segment last year. On an aggregate basis, individual business summed to a net loss in 41 states plus the District of Columbia. The state of Texas generated the largest total deficit, with plans reporting a combined net loss of $717 million."
Mark Farrah Associates
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[Opinion]
Why Does the Democratic Party Want the Cadillac Tax Abolished?
"What neither party wants to admit is the larger implication of their opposition to the Cadillac tax: Neither party is willing to adopt serious, practical measures to confront the problem of our nation's continually rising health care costs."
Prof. Edward A. Zelinsky, OUPblog
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[Opinion]
Consumerism in Healthcare is Not Practical
"[M]aking consumer based decisions around the small stuff may become common. But as a means of controlling health care costs, no way. We all know that the majority of health care costs come from few people with chronic conditions. If I need to change have my oil changed maybe I can shop the market. But if I need a new engine I would hope to have a very educated mechanic at my side to help me make the best decisions."
Joe Markland
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Benefits in General
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Cybersecurity and the Role of ERISA Fiduciaries
"[This article provides] a discussion of ERISA fiduciary duties relating to cybersecurity and health and retirement plans, as well as best practices that ERISA fiduciaries should follow to maximize their compliance with such duties and to insulate their exposure to potential liability."
Pillsbury Winthrop Shaw Pittman LLP
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Bill to Shield Retired Miners Divides Coal-State Republicans
"Retirement and health-care funds currently support about 120,000 former miners and their families nationwide. But account balances have dwindled amid continued layoffs and bankruptcy filings as the coal industry struggles against competition from cheaper natural gas and tightening environmental regulations. The bill would ensure that retired miners receive hundreds of millions of dollars in benefits now at risk amid the industry's steep decline. Without congressional intervention, some of the funds could run out of cash by next year[.]"
The Republic
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BenefitsLink Health & Welfare Plans Newsletter, ISSN no. 1536-9595. Copyright 2016 BenefitsLink.com, Inc. All materials
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