Summaries of Benefits & Coverage, Patient Protection Disclosures, Medicare Part D Creditable Coverage, Grandfathered Plan Notices, Model Exchange Notice, Health FSAs and COBRA Qualified Beneficiary Communications!
The document provides a timeline for key provisions of the Affordable Care Act (ACA) being implemented between 2010-2014. Some 2010 provisions included requiring plans to cover adult children up to age 26, prohibiting pre-existing condition exclusions for children, covering preventive care with no cost sharing, and establishing a high-risk pool. An improved claims/appeals process and rebates for the Medicare Part D "donut hole" also took effect in 2010. Future provisions will expand insurance coverage and reforms through 2014.
The document outlines several provisions of the Affordable Care Act that go into effect between 2013 and 2014, including expanding preventive care coverage, increasing Medicaid payments to primary care doctors, establishing health insurance marketplaces, and prohibiting discrimination due to pre-existing conditions or gender in health insurance plans. Many of the provisions aim to expand access to affordable health insurance and healthcare.
Frequently asked questions about Obamacareexchangeenvoy
The document summarizes key provisions of the Affordable Care Act (ACA) related to health insurance exchanges, the individual mandate, employer penalties, and dependent coverage requirements. It explains that the ACA requires states to establish health insurance exchanges by 2014 to offer qualified health plans. It also outlines the individual mandate requiring most individuals to have minimum essential health coverage beginning in 2014, and penalties for employers not offering coverage. The ACA extends dependent coverage to age 26.
Join us as we learn about the benefits of the Affordable Care Act, the ways you can get help paying for insurance, and where you can get help enrolling. (Hint: We can help!)
News Flash: September 16, 2013 – Federal Regulators Have Been Busy; Two New D...Annette Wright, GBA, GBDS
Federal regulators issued two new developments related to health care reform: 1) A model notice of HIPAA privacy practices with versions for health plans and providers to use; and 2) New guidance on applying health care reform to HRAs, health FSAs, and other arrangements. The new guidance indicates stand-alone HRAs are no longer viable unless integrated with group health coverage by meeting restrictive conditions. It also addresses health FSAs, EAPs, and employer-paid premium arrangements. The guidance is intended to coordinate previous rules and fill gaps, clarifying that tax-favored employer health coverage must comply with reform laws.
Most Medicare Advantage Plans offer Part D prescription drug benefits. Some do not, but you can purchase a standalone prescription drug plan. However, if the plan lacks drug coverage, you cannot join a Medicare Part D prescription drug plan.
The document provides a timeline for key provisions of the Affordable Care Act (ACA) being implemented between 2010-2014. Some 2010 provisions included requiring plans to cover adult children up to age 26, prohibiting pre-existing condition exclusions for children, covering preventive care with no cost sharing, and establishing a high-risk pool. An improved claims/appeals process and rebates for the Medicare Part D "donut hole" also took effect in 2010. Future provisions will expand insurance coverage and reforms through 2014.
The document outlines several provisions of the Affordable Care Act that go into effect between 2013 and 2014, including expanding preventive care coverage, increasing Medicaid payments to primary care doctors, establishing health insurance marketplaces, and prohibiting discrimination due to pre-existing conditions or gender in health insurance plans. Many of the provisions aim to expand access to affordable health insurance and healthcare.
Frequently asked questions about Obamacareexchangeenvoy
The document summarizes key provisions of the Affordable Care Act (ACA) related to health insurance exchanges, the individual mandate, employer penalties, and dependent coverage requirements. It explains that the ACA requires states to establish health insurance exchanges by 2014 to offer qualified health plans. It also outlines the individual mandate requiring most individuals to have minimum essential health coverage beginning in 2014, and penalties for employers not offering coverage. The ACA extends dependent coverage to age 26.
Join us as we learn about the benefits of the Affordable Care Act, the ways you can get help paying for insurance, and where you can get help enrolling. (Hint: We can help!)
News Flash: September 16, 2013 – Federal Regulators Have Been Busy; Two New D...Annette Wright, GBA, GBDS
Federal regulators issued two new developments related to health care reform: 1) A model notice of HIPAA privacy practices with versions for health plans and providers to use; and 2) New guidance on applying health care reform to HRAs, health FSAs, and other arrangements. The new guidance indicates stand-alone HRAs are no longer viable unless integrated with group health coverage by meeting restrictive conditions. It also addresses health FSAs, EAPs, and employer-paid premium arrangements. The guidance is intended to coordinate previous rules and fill gaps, clarifying that tax-favored employer health coverage must comply with reform laws.
Most Medicare Advantage Plans offer Part D prescription drug benefits. Some do not, but you can purchase a standalone prescription drug plan. However, if the plan lacks drug coverage, you cannot join a Medicare Part D prescription drug plan.
MA Appeals Overturn 75% Of Claims Denialsbrennaljan
The name of the company that made the redetermination (the company that handled the Medicare claim in Level 1). You can find this information on the Medicare Summary Notice or the redetermination notice.
1094-B & 1095-B: Reporting Requirements: A Step-by-Step Guide Mario K. Castillo
This document provides a step-by-step guide to completing Forms 1095-B and 1094-B for reporting health insurance coverage information to the IRS under the Affordable Care Act. It explains the purpose of the forms is to verify which individuals had health insurance coverage to avoid penalties. It outlines how to fill out each section of the forms including covered individuals' identifying information and months of coverage. Employers that are self-insured will report using Form 1095-B that gets sent to covered individuals and to the IRS, along with a transmittal Form 1094-B coversheet stating the number of 1095-B forms.
Associate benefits at Agnesian HealthCare include medical, dental, vision, and life insurance beginning after one month of employment. Short and long-term disability insurance begin after one year of employment. Additional benefits include a 401k retirement plan with employer matching, tuition assistance after 90 days, paid time off accruals based on years of service, and discounts at Agnesian facilities. Wellness initiatives promote preventative health screenings and activities to support associates' health and well-being.
Health Reform Bulletin – Implementation Update: Women’s Preventive Health Se...CBIZ, Inc.
The women’s health services component of the Affordable Care Act’s (ACA) preventive services mandate continues to evolve. As background, the ACA requires non-grandfathered plans to provide specified preventive services at no cost to plan participants. These preventive services require coverage of certain women’s health services including contraceptive coverage. Recent challenges to this requirement have reached the Supreme Court.
Understanding Wisconsins Health Plan Optionsnekiminurse
Wisconsin has been a leader in trying to provide low cost health insurance for those individuals who are unable to access or qualify for employer sponsored plans. This presentation was part of a kaizen event for clinic personnel on the prior authorization proccess.
This episode continues our COVID-19 COVID-19 Insights Webinar discussing CMS changes, available grants and loans, existing opportunities in telehealth, and more state openings for elective surgeries.
If you are retiring before the age of 65 and do not have retiree insurance benefits, you may need to bridge the gap to Medicare. Here are some of the options you may have to help you bridge the gap.
Your personal guide to health insuranceAnisha Sachit
Health Insurances, in technical terms, are a contract between the insurer and the insured, wherein the insurer will bear the costs of treatments of the insured, either by reimbursement or direct payment to the service provider, as long as the insured satisfies all the terms and conditions of the policy.
Blog: https://financebuddha.com/blog/your-personal-guide-to-health-insurance
The document discusses the Early Retiree Subsidy Program established under the Patient Protection and Affordable Care Act. It provides reimbursements to sponsors of health plans that cover early retirees aged 55-65. Early retirees and their dependents whose healthcare costs exceed $15,000 are eligible for reimbursement of up to 80% of costs between $15,000-$90,000. Applicants must submit an application including information about their plan and how reimbursements will be used. Questions can be directed to contacts provided.
The document provides information about the Affordable Care Act and what it means for individuals and businesses in 2014. Some of the key provisions taking effect in 2014 include:
- Individuals are required to have health insurance or pay a penalty. Subsidies will be available to help purchase insurance through state exchanges.
- Businesses with 50+ employees must offer affordable health insurance or pay penalties. Small businesses can receive tax credits for offering employee coverage.
- State-run insurance exchanges will offer individual and small group policies, and tax credits will help make premiums affordable for many. Essential health benefits must be covered.
Although many key reforms of the Affordable Care Act (ACA) are effective for 2014, additional reforms will become effective in 2015 for employers sponsoring group health plans. For 2015, the most significant ACA change is the shared responsibility penalty for applicable large employers. To prepare for 2015, employers should review upcoming requirements and develop a compliance strategy. This Legislative Brief provides a health care reform checklist for 2015.
This document summarizes information about Medicare coverage options. It discusses who is eligible for Medicare and what Parts A and B cover. It also describes supplemental plans like Medigap and Medicare Advantage plans, noting their benefits and costs. Examples are provided to illustrate out-of-pocket expenses under different coverage options. The summary concludes that having original Medicare with a Medigap plan and Part D prescription drug coverage provides the most comprehensive coverage at the lowest cost, but a Medicare Advantage plan may also be suitable depending on individual needs and circumstances.
Revised 2015 CCS-GHPP for Xerox Training v5Harry Chang
This document provides an overview of the California Children's Services (CCS) Program and the Genetically Handicapped Persons Program (GHPP). It discusses eligibility requirements, covered services, referral processes, billing statuses, and the roles of providers. Key points include that CCS serves children with certain medical conditions who meet residential, financial, and medical eligibility, while GHPP serves adults with specified genetic diseases. Referrals are made to local CCS county offices or the state GHPP office by submitting a Service Authorization Request form. Providers must be paneled and authorized to provide services to CCS and GHPP clients.
The New York State Department of Health is seeking a vendor to provide an online continuing medical education course for physicians and pharmacists on the approved medical use of marijuana in New York State. The course must be accredited and available online from September 1, 2015 through August 31, 2016. Vendors must have at least five years of experience providing online medical education and one year of experience with medical marijuana education. Proposals are due by July 14, 2015 and should include details on the vendor's experience and qualifications, course content, fees, and methods of payment.
Understanding the ObamaCare North Carolina Health Insurance Plans
As a result of the Affordable Care Act (a.k.a. ObamaCare) the following provisions are now in place for health insurance policies with an effective date January 1, 2014 or after:Individuals cannot be declined for health insurance or charged more due to their health status or gender.
Insurance premiums are based on age, your zip code and tobacco usage.
Coverage limitations or exclusions based on pre-existing conditions are not allowed.
Elimination of annual and lifetime coverage limits.
Prohibition of declining an individual for coverage based on their participation in an approved clinical trial.
Maternity and mental health are included on all policies.
Preventative dental is covered with a $25 copay for members up to age 19. There is also some vision coverage for this age group.
Whether or not your children are students they can stay on your policy until age 26.
Introduction of the Medical Loss Ratio (MLR) which ensures that 80% of the premium dollars paid to the health insurance issuer are spend on providing health care. An insurance company that does not do this must provide rebates to their policyholders
http://www.hisonc.com/obamacare-north-carolina
This document discusses several notices and disclosures that employers must provide to employees under the Affordable Care Act (ACA) and other regulations. It covers the requirement to provide a Summary of Benefits and Coverage to all applicants and enrollees. It also discusses requirements for grandfathered plans, notices of patient protection rights, Medicare Part D creditable coverage notices, COBRA qualified beneficiary communications including open enrollment notifications, and challenges with health flexible spending accounts during open enrollment.
The document provides a timeline of key provisions from the Affordable Care Act (ACA) being implemented between 2010-2013. Some key reforms include expanding dependent coverage up to age 26 (2010), prohibiting pre-existing condition exclusions for children (2010), requiring coverage of preventive care with no cost sharing (2010), eliminating lifetime and annual limits on coverage (2010), and establishing health insurance exchanges and individual mandates (2014).
Health Care Reform Legislative Brief
2013 Compliance Checklist
In light of the Supreme Court's June 28, 2012, decision to uphold the health care reform law, or Affordable Care Act (ACA), employers must continue to comply with ACA mandates that are currently in effect.
MA Appeals Overturn 75% Of Claims Denialsbrennaljan
The name of the company that made the redetermination (the company that handled the Medicare claim in Level 1). You can find this information on the Medicare Summary Notice or the redetermination notice.
1094-B & 1095-B: Reporting Requirements: A Step-by-Step Guide Mario K. Castillo
This document provides a step-by-step guide to completing Forms 1095-B and 1094-B for reporting health insurance coverage information to the IRS under the Affordable Care Act. It explains the purpose of the forms is to verify which individuals had health insurance coverage to avoid penalties. It outlines how to fill out each section of the forms including covered individuals' identifying information and months of coverage. Employers that are self-insured will report using Form 1095-B that gets sent to covered individuals and to the IRS, along with a transmittal Form 1094-B coversheet stating the number of 1095-B forms.
Associate benefits at Agnesian HealthCare include medical, dental, vision, and life insurance beginning after one month of employment. Short and long-term disability insurance begin after one year of employment. Additional benefits include a 401k retirement plan with employer matching, tuition assistance after 90 days, paid time off accruals based on years of service, and discounts at Agnesian facilities. Wellness initiatives promote preventative health screenings and activities to support associates' health and well-being.
Health Reform Bulletin – Implementation Update: Women’s Preventive Health Se...CBIZ, Inc.
The women’s health services component of the Affordable Care Act’s (ACA) preventive services mandate continues to evolve. As background, the ACA requires non-grandfathered plans to provide specified preventive services at no cost to plan participants. These preventive services require coverage of certain women’s health services including contraceptive coverage. Recent challenges to this requirement have reached the Supreme Court.
Understanding Wisconsins Health Plan Optionsnekiminurse
Wisconsin has been a leader in trying to provide low cost health insurance for those individuals who are unable to access or qualify for employer sponsored plans. This presentation was part of a kaizen event for clinic personnel on the prior authorization proccess.
This episode continues our COVID-19 COVID-19 Insights Webinar discussing CMS changes, available grants and loans, existing opportunities in telehealth, and more state openings for elective surgeries.
If you are retiring before the age of 65 and do not have retiree insurance benefits, you may need to bridge the gap to Medicare. Here are some of the options you may have to help you bridge the gap.
Your personal guide to health insuranceAnisha Sachit
Health Insurances, in technical terms, are a contract between the insurer and the insured, wherein the insurer will bear the costs of treatments of the insured, either by reimbursement or direct payment to the service provider, as long as the insured satisfies all the terms and conditions of the policy.
Blog: https://financebuddha.com/blog/your-personal-guide-to-health-insurance
The document discusses the Early Retiree Subsidy Program established under the Patient Protection and Affordable Care Act. It provides reimbursements to sponsors of health plans that cover early retirees aged 55-65. Early retirees and their dependents whose healthcare costs exceed $15,000 are eligible for reimbursement of up to 80% of costs between $15,000-$90,000. Applicants must submit an application including information about their plan and how reimbursements will be used. Questions can be directed to contacts provided.
The document provides information about the Affordable Care Act and what it means for individuals and businesses in 2014. Some of the key provisions taking effect in 2014 include:
- Individuals are required to have health insurance or pay a penalty. Subsidies will be available to help purchase insurance through state exchanges.
- Businesses with 50+ employees must offer affordable health insurance or pay penalties. Small businesses can receive tax credits for offering employee coverage.
- State-run insurance exchanges will offer individual and small group policies, and tax credits will help make premiums affordable for many. Essential health benefits must be covered.
Although many key reforms of the Affordable Care Act (ACA) are effective for 2014, additional reforms will become effective in 2015 for employers sponsoring group health plans. For 2015, the most significant ACA change is the shared responsibility penalty for applicable large employers. To prepare for 2015, employers should review upcoming requirements and develop a compliance strategy. This Legislative Brief provides a health care reform checklist for 2015.
This document summarizes information about Medicare coverage options. It discusses who is eligible for Medicare and what Parts A and B cover. It also describes supplemental plans like Medigap and Medicare Advantage plans, noting their benefits and costs. Examples are provided to illustrate out-of-pocket expenses under different coverage options. The summary concludes that having original Medicare with a Medigap plan and Part D prescription drug coverage provides the most comprehensive coverage at the lowest cost, but a Medicare Advantage plan may also be suitable depending on individual needs and circumstances.
Revised 2015 CCS-GHPP for Xerox Training v5Harry Chang
This document provides an overview of the California Children's Services (CCS) Program and the Genetically Handicapped Persons Program (GHPP). It discusses eligibility requirements, covered services, referral processes, billing statuses, and the roles of providers. Key points include that CCS serves children with certain medical conditions who meet residential, financial, and medical eligibility, while GHPP serves adults with specified genetic diseases. Referrals are made to local CCS county offices or the state GHPP office by submitting a Service Authorization Request form. Providers must be paneled and authorized to provide services to CCS and GHPP clients.
The New York State Department of Health is seeking a vendor to provide an online continuing medical education course for physicians and pharmacists on the approved medical use of marijuana in New York State. The course must be accredited and available online from September 1, 2015 through August 31, 2016. Vendors must have at least five years of experience providing online medical education and one year of experience with medical marijuana education. Proposals are due by July 14, 2015 and should include details on the vendor's experience and qualifications, course content, fees, and methods of payment.
Understanding the ObamaCare North Carolina Health Insurance Plans
As a result of the Affordable Care Act (a.k.a. ObamaCare) the following provisions are now in place for health insurance policies with an effective date January 1, 2014 or after:Individuals cannot be declined for health insurance or charged more due to their health status or gender.
Insurance premiums are based on age, your zip code and tobacco usage.
Coverage limitations or exclusions based on pre-existing conditions are not allowed.
Elimination of annual and lifetime coverage limits.
Prohibition of declining an individual for coverage based on their participation in an approved clinical trial.
Maternity and mental health are included on all policies.
Preventative dental is covered with a $25 copay for members up to age 19. There is also some vision coverage for this age group.
Whether or not your children are students they can stay on your policy until age 26.
Introduction of the Medical Loss Ratio (MLR) which ensures that 80% of the premium dollars paid to the health insurance issuer are spend on providing health care. An insurance company that does not do this must provide rebates to their policyholders
http://www.hisonc.com/obamacare-north-carolina
This document discusses several notices and disclosures that employers must provide to employees under the Affordable Care Act (ACA) and other regulations. It covers the requirement to provide a Summary of Benefits and Coverage to all applicants and enrollees. It also discusses requirements for grandfathered plans, notices of patient protection rights, Medicare Part D creditable coverage notices, COBRA qualified beneficiary communications including open enrollment notifications, and challenges with health flexible spending accounts during open enrollment.
The document provides a timeline of key provisions from the Affordable Care Act (ACA) being implemented between 2010-2013. Some key reforms include expanding dependent coverage up to age 26 (2010), prohibiting pre-existing condition exclusions for children (2010), requiring coverage of preventive care with no cost sharing (2010), eliminating lifetime and annual limits on coverage (2010), and establishing health insurance exchanges and individual mandates (2014).
Health Care Reform Legislative Brief
2013 Compliance Checklist
In light of the Supreme Court's June 28, 2012, decision to uphold the health care reform law, or Affordable Care Act (ACA), employers must continue to comply with ACA mandates that are currently in effect.
Intertwined Guidelines: Untangling Your Enrollment Notice Requirementbenefitexpress
This document discusses various notices that must be provided to participants in group health plans. It separates the notices into those that are required for all plans, those required for all plans but not annually, and notices required for plans meeting specific criteria. For each notice, it provides details on who must provide the notice, who it must be provided to, and the timeline for delivering the notice. Notices discussed include the SBC, HIPAA special enrollment rights, Medicare Part D creditable coverage, CHIP, and various COBRA required notices.
Health Reform Bulletin: Implementation Guidance & ACA UpdatesCBIZ MHM, LLC
1) Distribution of Marketplace Notice to Employees; 2) 90-day Waiting Period; 3) Individual Shared Responsibility- Final Regulations; 4) Employer Appeals in Marketplace Eligibility Determinations; 5) Small Business Tax Credit; 6) Preventive Care - Health Saving Accounts; and 7) Internal Claims, Appeals and External Review: Providing Culturally and Linguistically Appropriate Notices
The document provides an overview of the Affordable Care Act (ACA) and its implementation in South Carolina. Some key points:
- The ACA requires most Americans to have health insurance or pay a penalty. It also prohibits denying coverage due to preexisting conditions and prohibits charging sick individuals higher premiums.
- South Carolina has a federally-facilitated health insurance marketplace for individuals and small businesses. Health plans must cover essential health benefits.
- Beginning in 2014, there is no annual or lifetime limits on coverage, no preexisting condition exclusions, guaranteed issue of policies, and limits on out-of-pocket costs. However, grandfathered plans are exempt from some provisions.
-
The document provides answers to frequently asked questions about the new US health care reform laws. Some key points:
- Major provisions of the laws will be phased in between 2010-2020, with many taking effect in 2014.
- Beginning in 2014, all citizens must have qualifying health insurance or pay a tax penalty.
- Starting in 2014, individuals and small businesses can purchase qualified coverage through state-based insurance exchanges.
- Employers with over 50 employees that do not offer coverage will face penalties starting in 2014.
- High-risk individuals unable to get coverage due to preexisting conditions will have access to a federal program until 2014.
- Preventive care must be covered without co
Health Reform Bulletin: Small Business Health Options Program (SHOP) UpdatesCBIZ MHM, LLC
The document summarizes updates to the Small Business Health Options Program (SHOP) from the Centers for Medicare and Medicaid Services (CMS). It discusses which states are utilizing federally-run SHOP exchanges versus state-run exchanges. It also summarizes CMS guidance on eligible employers and employees, coverage options, enrollment periods, premium calculations, and the interaction between SHOP and the small business tax credit.
Health Care Reform - Small Business Health Options Program (SHOP) UpdatesCBIZ, Inc.
One of the components of the Affordable Care Act is the Small Business Health Options Program (SHOP). The SHOP is the marketplace, sometimes referred to as “exchange”, specific to small employers.
Compliance Overview - Employee Benefits Compliance Checklist for Large Employersntoscano50
Federal law imposes numerous requirements on the group health coverage that employers provide to their employees. Many federal compliance laws apply to all group health plans, regardless of the size of the sponsoring employer. However, there are some additional requirements for large employers. For this purpose, a large employer is one with 50 or more employees.
Unlike smaller employers, large employers must comply with the Affordable Care Act’s (ACA) employer shared responsibility rules, the ACA’s Form W-2 reporting rules and the Family and Medical Leave Act’s (FMLA) requirements.
This Compliance Overview provides a checklist for employee benefit laws applicable to large employers.
Kegler Brown Hill & Ritter's 2011 Ohio Healthcare Summit offered an in-depth look at National and Ohio Healthcare Reform, Legal Challenges, Regulation and Implications for Healthcare Providers, Medical Malpractice, and the Health Information Exchange.
The Consolidated Omnibus Budget Reconciliation Act (COBRA) allows individuals to continue their group health plan coverage in certain situations. Specifically, COBRA requires group health plans to offer continuation coverage to covered employees and dependents when coverage would otherwise be lost due to certain specific events...
59828 employee benefits compliance checklist for small employers 021312Jerry Whitaker CIC,CRIS
This document provides a compliance checklist for various federal employee benefit laws applicable to small employers with 50 or fewer employees. It lists the key laws, including whether they apply to small employers or have exceptions. For those that apply, it summarizes the main requirements and any associated notices that must be provided to employees. Some major laws discussed include the Affordable Care Act, COBRA, HIPAA, FMLA, ERISA and COBRA. The document is intended to help small employers understand and comply with federal benefit plan regulations.
To prepare for open enrollment, health plan sponsors should become familiar with the legal changes affecting plans for the 2014 plan year. In addition, health plan sponsors should make sure that open enrollment packages include certain participant notices.
In early July, the Department of Treasury announced it is delaying a key mandate of the Affordable Care Act: what's known as the 'Pay or Play' mandate. While pushing pause on this mandate gives large employers another year to prepare, we strongly advise businesses not to wait to start making strategic decisions. For more information, contact Fraser Trebilcock Senior Health Care and Business Attorney Mike James at mjames@fraserlawfirm.com or 517.377.0823. You can also find more information at www.milhealthlaws.com.
HHS Extends Transition Policy for Non-ACA Compliant Health PlansKelley M. Bendele
The Department of Health and Human Services extended an existing transition policy allowing health insurance issuers to renew current policies that do not comply with the Affordable Care Act for an additional year, through 2018. This will allow individuals and small businesses to keep their non-compliant coverage through 2018, depending on plan year. The extension may mean ACA compliance is never required for these transitional plans, depending on future changes made to the ACA. States can choose whether to adopt the extended transitional policy for individual, small group, or both markets.
The document summarizes key provisions of the 2010 health care reform legislation that affect employers, including requirements regarding lifetime and annual limits on coverage, dependent coverage for children up to age 26, uniform explanations of coverage, reporting on quality of care, and appeals processes. The reforms impose new regulations on employer-provided health plans with respect to benefits and administration.
Mrs. Richards will present on various topics related to the Affordable Care Act including the status of health insurance exchanges, grace periods for premium payments, and the future of premium tax credits. Data shows over 7 million have selected plans for 2015 on Healthcare.gov with most qualifying for subsidies. Region 5 states like Alabama, Florida, Georgia, South Carolina and Tennessee saw hundreds of thousands of new enrollees. The Supreme Court will hear a case on whether subsidies can be used on federal exchanges. Mrs. Richards is an attorney who specializes in third party healthcare reimbursement and is a fellow of HFMA.
Since 1986, many employers have had to comply with COBRA rules. COBRA law not only requires employers and plan administrators to allow continuation coverage, it requires that all beneficiaries are notified of their COBRA rights.
GINA prohibits employers from discriminating against employees or job applicants based on their genetic information, including family medical history. While GINA clearly bans the use of genetic data in hiring decisions, the law is less clear around how it applies to employer wellness programs and health risk assessments. Under GINA, employers can only require employees to undergo medical exams or health assessments if participation is truly voluntary.
Glitches in an automated data feed between an employer and its COBRA administrators affected more than 700 employees. Review this infographic to see how to avoid mistakes like this one!
It's that time of year. The time where you make a list, you check it twice. This list may not be as fun as a holiday to-do list of shopping and wrapping, but it's still as important. It's the time for all HR, payroll and benefit professionals to finish up on year-end requirements.
Working together, the Bay Area Air Quality Management District and the Metropolitan Transportation Commission (MTC) approved a regional commuter benefits ordinance which became effective on March 25, 2014.
This document outlines key tax and benefit limits that are changing for 2016, including:
- The Social Security taxable wage base remaining at $118,500 and Medicare tax rates remaining at 1.45% for employee and employer and an additional 0.9% for employees earning over $200,000.
- The health FSA contribution limit increasing to $2,550 and HSA contribution limit rising to $3,350 for individuals or $6,750 for families.
- Minimum deductibles for HDHPs increasing to $2,600/$1,300 and out-of-pocket maximums rising to $13,100/$6,550 for individuals/families.
The U.S. Department of Health & Human Services (HHS) has issued guidance regarding the HIPAA Privacy Rule that includes frequently asked questions regarding what is appropriate to share for a patient that is being treated for a mental health condition.
The document contains questions and answers about various health benefits topics:
1. Reporting under Section 6055 is required for retiree-only HRAs but not for HRAs integrated with an employer's medical plan or Medicare supplemental coverage. Whether standalone retiree HRAs require reporting is unclear.
2. Special enrollment rights notices are still required under HIPAA portability even though certificates of creditable coverage and general/individual notices of pre-existing conditions were eliminated in 2014.
3. For determining affordability of coverage, employers can use the rate of pay safe harbor based on 130 hours per month rather than 30 hours per week, or the federal poverty level safe harbor. Using the W-2 method, employers
The document discusses the relationship between COBRA and the Affordable Care Act (ACA). It notes that several key ACA provisions have been delayed, and examines how COBRA will interact with the ACA once it is fully implemented. It finds that the ACA, Department of Labor, and health insurance marketplaces all recognize the importance of COBRA. COBRA will continue to exist alongside the ACA and fill some gaps, such as providing continued coverage for standalone dental, vision, and prescription drug plans not offered on the marketplaces. The ACA did not eliminate or change COBRA rules, according to the Department of Labor.
The 10 Most Influential Leaders Guiding Corporate Evolution, 2024.pdfthesiliconleaders
In the recent edition, The 10 Most Influential Leaders Guiding Corporate Evolution, 2024, The Silicon Leaders magazine gladly features Dejan Štancer, President of the Global Chamber of Business Leaders (GCBL), along with other leaders.
Taurus Zodiac Sign: Unveiling the Traits, Dates, and Horoscope Insights of th...my Pandit
Dive into the steadfast world of the Taurus Zodiac Sign. Discover the grounded, stable, and logical nature of Taurus individuals, and explore their key personality traits, important dates, and horoscope insights. Learn how the determination and patience of the Taurus sign make them the rock-steady achievers and anchors of the zodiac.
Unveiling the Dynamic Personalities, Key Dates, and Horoscope Insights: Gemin...my Pandit
Explore the fascinating world of the Gemini Zodiac Sign. Discover the unique personality traits, key dates, and horoscope insights of Gemini individuals. Learn how their sociable, communicative nature and boundless curiosity make them the dynamic explorers of the zodiac. Dive into the duality of the Gemini sign and understand their intellectual and adventurous spirit.
[To download this presentation, visit:
https://www.oeconsulting.com.sg/training-presentations]
This presentation is a curated compilation of PowerPoint diagrams and templates designed to illustrate 20 different digital transformation frameworks and models. These frameworks are based on recent industry trends and best practices, ensuring that the content remains relevant and up-to-date.
Key highlights include Microsoft's Digital Transformation Framework, which focuses on driving innovation and efficiency, and McKinsey's Ten Guiding Principles, which provide strategic insights for successful digital transformation. Additionally, Forrester's framework emphasizes enhancing customer experiences and modernizing IT infrastructure, while IDC's MaturityScape helps assess and develop organizational digital maturity. MIT's framework explores cutting-edge strategies for achieving digital success.
These materials are perfect for enhancing your business or classroom presentations, offering visual aids to supplement your insights. Please note that while comprehensive, these slides are intended as supplementary resources and may not be complete for standalone instructional purposes.
Frameworks/Models included:
Microsoft’s Digital Transformation Framework
McKinsey’s Ten Guiding Principles of Digital Transformation
Forrester’s Digital Transformation Framework
IDC’s Digital Transformation MaturityScape
MIT’s Digital Transformation Framework
Gartner’s Digital Transformation Framework
Accenture’s Digital Strategy & Enterprise Frameworks
Deloitte’s Digital Industrial Transformation Framework
Capgemini’s Digital Transformation Framework
PwC’s Digital Transformation Framework
Cisco’s Digital Transformation Framework
Cognizant’s Digital Transformation Framework
DXC Technology’s Digital Transformation Framework
The BCG Strategy Palette
McKinsey’s Digital Transformation Framework
Digital Transformation Compass
Four Levels of Digital Maturity
Design Thinking Framework
Business Model Canvas
Customer Journey Map
Best Competitive Marble Pricing in Dubai - ☎ 9928909666Stone Art Hub
Stone Art Hub offers the best competitive Marble Pricing in Dubai, ensuring affordability without compromising quality. With a wide range of exquisite marble options to choose from, you can enhance your spaces with elegance and sophistication. For inquiries or orders, contact us at ☎ 9928909666. Experience luxury at unbeatable prices.
Best practices for project execution and deliveryCLIVE MINCHIN
A select set of project management best practices to keep your project on-track, on-cost and aligned to scope. Many firms have don't have the necessary skills, diligence, methods and oversight of their projects; this leads to slippage, higher costs and longer timeframes. Often firms have a history of projects that simply failed to move the needle. These best practices will help your firm avoid these pitfalls but they require fortitude to apply.
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Zodiac Signs and Food Preferences_ What Your Sign Says About Your Tastemy Pandit
Know what your zodiac sign says about your taste in food! Explore how the 12 zodiac signs influence your culinary preferences with insights from MyPandit. Dive into astrology and flavors!
Top mailing list providers in the USA.pptxJeremyPeirce1
Discover the top mailing list providers in the USA, offering targeted lists, segmentation, and analytics to optimize your marketing campaigns and drive engagement.
Industrial Tech SW: Category Renewal and CreationChristian Dahlen
Every industrial revolution has created a new set of categories and a new set of players.
Multiple new technologies have emerged, but Samsara and C3.ai are only two companies which have gone public so far.
Manufacturing startups constitute the largest pipeline share of unicorns and IPO candidates in the SF Bay Area, and software startups dominate in Germany.
Understanding User Needs and Satisfying ThemAggregage
https://www.productmanagementtoday.com/frs/26903918/understanding-user-needs-and-satisfying-them
We know we want to create products which our customers find to be valuable. Whether we label it as customer-centric or product-led depends on how long we've been doing product management. There are three challenges we face when doing this. The obvious challenge is figuring out what our users need; the non-obvious challenges are in creating a shared understanding of those needs and in sensing if what we're doing is meeting those needs.
In this webinar, we won't focus on the research methods for discovering user-needs. We will focus on synthesis of the needs we discover, communication and alignment tools, and how we operationalize addressing those needs.
Industry expert Scott Sehlhorst will:
• Introduce a taxonomy for user goals with real world examples
• Present the Onion Diagram, a tool for contextualizing task-level goals
• Illustrate how customer journey maps capture activity-level and task-level goals
• Demonstrate the best approach to selection and prioritization of user-goals to address
• Highlight the crucial benchmarks, observable changes, in ensuring fulfillment of customer needs
How to Implement a Real Estate CRM SoftwareSalesTown
To implement a CRM for real estate, set clear goals, choose a CRM with key real estate features, and customize it to your needs. Migrate your data, train your team, and use automation to save time. Monitor performance, ensure data security, and use the CRM to enhance marketing. Regularly check its effectiveness to improve your business.
𝐔𝐧𝐯𝐞𝐢𝐥 𝐭𝐡𝐞 𝐅𝐮𝐭𝐮𝐫𝐞 𝐨𝐟 𝐄𝐧𝐞𝐫𝐠𝐲 𝐄𝐟𝐟𝐢𝐜𝐢𝐞𝐧𝐜𝐲 𝐰𝐢𝐭𝐡 𝐍𝐄𝐖𝐍𝐓𝐈𝐃𝐄’𝐬 𝐋𝐚𝐭𝐞𝐬𝐭 𝐎𝐟𝐟𝐞𝐫𝐢𝐧𝐠𝐬
Explore the details in our newly released product manual, which showcases NEWNTIDE's advanced heat pump technologies. Delve into our energy-efficient and eco-friendly solutions tailored for diverse global markets.
1. MODEL EXCHANGE NOTICE
MEDICARE PART D CREDITABLE COVERAGE
PATIENT PROTECTION DISCLOSURES
GRANDFATHERED PLAN NOTICES
HEALTH FSAs
All applicants and enrollees for all group health plans, excepted
for those that are excepted benefits under HIPAA.
WHO
This requirement began with open enrollment periods after
September 23, 2012. This is required to be sent annually.
WHEN
The purpose is to allow health care consumers compare coverage
options and choose what is best for them.
WHAT
This requirement applies to all employers that are subject to the Fair
Labor Standards Act. The notice must be sent to all current employees.
WHO
The notice must be sent no later than October 1, 2013. After that,
the notice must be provided to all new hires at the time of hire.
WHEN
Information on: Existence of the Marketplace, services provided by
the Marketplace, how employees may contact the Marketplace, etc.
WHAT
SUMMARIES OF BENEFITS & COVERAGE
All employer-sponsored plans that offer a prescription drug
benefit must annually notify participants as to whether their
coverage is creditable or non-creditable.
WHO
The deadline to mail these notices is October 15 each year.
WHEN
This will require notices to go out prior to most plans being
finalized. Any changes in creditable status once a plan is finalized
will require another round of notices to be sent.
WHAT
With ACA, employers must notify participants of their right to
designate any primary care provider who participates in the network.
WHO
Must be provided whenever the plan provides an SBC. Must be
provided no later than the first day of the first plan year beginning
on or after September 23, 2010, and annually thereafter.
WHEN
This notice provides information regarding rights to choose a
primary care provider or obtain obstetrical or gyneological care
without prior authorization.
WHAT
Open enrollment packet must be sent to: Possible Electees,
Electees or Continuees.
WHO
This is a requirement that states employers provide the same rights
to COBRA Continuees during an open enrollment period that are
offered to active employees.
WHEN
The Open Enrollment Notification is required even if the only
change is the COBRA rates.
WHAT
ACA requires that this notice be provided to all participants if the
plan is to maintain its grandfathered status.
WHO
This requirement began with open enrollment periods after
September 23, 2012. This is required to be sent annually as long as
the group health plan maintains its grandfathered status.
WHEN
A notice explaining that the plan or coverage is a grandfathered
health plan with the ACA definition.
WHAT
If the Health FSA is HIPAA-excepted and the employer need only
offer COBRA when the FSA account is underspent, then the COBRA
obligation ends at the end of the first plan year.
WHO
During open enrollment period.
WHEN
Included with open enrollment notification of available coverages.
WHAT
ANNUAL NOTICE
COBRA QUALIFIED BENEFICIARY COMMUNICATIONS
copyright 2013