Monthly Archives: August 2013

Small Biz Employers With Kaiser Plans Have 5pm, August 30, 2013 Deadline

This is an important reminder that Employers with 1 to 50 employees who sponsor a California Kaiser Permanente Group Health Plan have until 5:00pm PST Friday August 30, 2013 to file the Kaiser-Early-Renewal-Intent-Form.

 What Is The Kaiser Intention To Renew Early Form?

Simply stated, this form (Kaiser Small Business Form No. 60141913 (August 2013) informs Kaiser that you want 35 more days to think about their offer to change your anniversary date.   There is no commitment on your part.  We recommend you submit the form, as it changes nothing in your current arrangement with Kaiser, but it does buy you until October 4, 2013 to think about their offer.

 Which Employers Should Consider An Early Renewal?

  • Employers with a Non-Grandfathered Kaiser small group plan
  • And contract renewal dates in the first half of the year
  • And who have not made a prior renewal date change in 2013.

 I have Submitted The Form Already, What Happens Next?

Over the next few days (until October 4th), you have the opportunity to decide if you want to go through with a contract anniversary date change.  If you wish to proceed, then you must file an additional form by October 4, 2013, titled the Kaiser-Early-Renewal-Confirmation-Form, which confirms your intent to renew early for December 1, 2013.

 What Is The Advantage To Changing My Renewal Date?

First, employers with Grandfathered plan status probably should not change their anniversary date, unless your advisor/broker has recommended it.  All other eligible employers would consider the following factors:

  • Is your existing RAF (risk adjustment factor) 1.1 or .90?
  • Is it important to delay your renewal to keep costs down?
  • Is it not worth the hassle to delay the inevitable?

Remember, there are additional important issues to consider, and Kaiser warns that a group will bear all responsibility for its decision to accept the offer for early renewal including but not limited to the group’s compliance with the ACA and ERISA (see related story)..

Talk with your broker for answers, or leave us a comment at the end of the article.

Employers Dilemma- Early Renewal or Not?

A follow-up to this story was published in October can be be read here. Many insurance brokers (and insurers) are suggesting that Employers re-date the plan anniversary (aka “Early Renewal”) to delay certain aspects of Obamacare Affordable Care Act rules and possible penalties (see our related story). Is this a good idea?  Are there pros and cons to using a “plan anniversary date change” strategy?

At Coverage California, we present alternative points of view. The following article came from Benecomplink.com, which argues that merely changing the renewal date of the insurance policy, does not necessarily change the plan anniversary date under ERISA:

“Changing the renewal date on an insurance policy with the plan’s carrier does not change the plan year. Changing a renewal date to December may be allowed by the insurance company, but if the plan sponsor/employer does not change the plan year, their plan year may continue to be a calendar year. From a legal perspective, “plan year” is the year designated in the plan document. Plan years are set by board resolutions and reinforced by plan documents and the filing of 5500 forms.. ” [Full article available at Benecomplink]

 

Employer Plan administrators should seek professional advice from their advisors.  For a limited time, we offer a limited number of free Q&A sessions.  For details, refer to the Eventbrite invitation at this link::  Reserve Q&A time.

 

Obamacare: 15,000 Working Spouses Taken Off UPS Health Plans

Marketwatch recently reported that the Obamacare law is contributing to the removal of 15,000 working spouses from the United Parcel Service (UPS) health plan.  Unfortunately, this could be true because of the structure of the new healthcare reform law.

Key to the story is that spouses are excluded from the definition of eligible dependent under Section 152(f)(1).  The implication of this omission is that so-called “pay or play” penalties would not apply to large employers who choose this road.

Here is an excerpt of the law that enables this to be true:

For any calendar month, a large employer is subject to an assessable payment if either: ” (1) the employer fails to offer to substantially all (at least 95%) of its full-time employees (and their dependents) the opportunity to enroll…”  The assessable payment is currently a $2,000 per employee penalty under Section 4980H(a)

Calculating the 2014 4980H(a) annualized penalty: The number of Full-time Employees of the applicable large employer member (reduced by the allocable share of the 30-employee reduction) multiplied by $2,000.

Read a related story on the new Obamacare law.

Public Exchange Notice- Employees Must Be Told

Employers Must Provide The Correct Public Exchange Notice to Employees

Employers must comply by providing the correct public exchange notice of coverage options to each employee, regardless of whether employees are part-time, full-time, enrolled or not enrolled at all.

Public Exchange Notice Disclosure Requirement

President Obama Signs Healthcare Legislation

[Related Story: Huge Penalties for Reimbursing employees for individual health insurance policies]

It is remarkable to note that the DOL public exchange notice disclosure forms read like a sales pitch to join the public exchange. Some industry observers have speculated about the motive behind this notice: Is it to provide neutral information on coverage options, or rather is it an attempt to raid plan participants and shift them to the public exchange?

“When key parts of the health care law take effect in 2014, there will be a new way to buy health insurance:  The Health Insurance Marketplace,” states a required regulatory notice, which all employees must receive from their employers beginning October 2013, as required by the Fair Labor Standards Act.

Regulatory notice OMB No. 1210-0149 goes on to disclose basic information about the new Health Insurance Marketplace, including how to save money on health insurance premiums in the marketplace etc.

As the individual marketplace continues to deteriorate, the small group market has gained a firmer footing, including stable PPO networks and easier participation rules with Kaiser and traditional PPO plans.  Is it time to review available small group plans?   Reserve your appointment early for Open Enrollment, which begins this November.  Find local assistance in San Jose, Santa Clara and the San Francisco bay area or via telephone, throughout Northern and Southern California..

View online pricing, free of charge

Sample Public Exchange Notice From DOL- 

To satisfy the content requirements for FLSA section 18B, employers may refer to the Department of Labor’s website www.dol.gov/ebsa/healthreform.   To save you some time from reading through the DOL website maze, I have included links below.  Note: There is one model for employers who do not offer a health plan and another model for employers who offer a health plan to some or all employees.  Employers may use one of these models, as applicable, or a modified version, provided the notice meets the content requirements described in Regulatory notice OMB No. 1210-0149.

The above public exchange notices are in PDF format. If you prefer an MS Word version for easy Edit & Print, use these versions: FLSAwithoutplans (employers who do not currently offer a plan) or FLSAwithplans (for employers who do have an existing medical plan).

There are additional requirements and upcoming ACA deadlines that affect small employer health plans: Read about them in a related article, 4 Actions Employers Must Complete By October 1st.

For additional employer requirements under the Affordable Care Act legislation click here.

 Finally, some good news…

Announcing the new VSP Individual Plan, great for the self-employed who can often write-off the premiums (but usually not the cost of self-insuring vision care).

Watch the VSP’s new vision care video for Individuals, Families, Retirees, and especially, the self-employed:VSP Video

4 Actions Employers Must Complete By October 1, 2013

Employers Must Act Soon (deadlines apply to all future new hires):

[Employers also read Huge Penalties for Reimbursing employees for their Individual Health Insurance Policies]

  1. This Department of Labor (DOL) regulation may surprise small employers who do not yet offer employee healthcare coverage:  The requirement hits them, too. Basically, the DOL requires that employers with as few as one employee hand out a disclosure form, even for 1099 employees. Further, the DOL has adopted different notices for different employer situations.  Make sure you are using the correct notice: Read more here.
  2. COBRA Notices- Amend existing COBRA notices to include new Department of Labor required language for employer COBRA disclosures.  Your COBRA administrator or vendor should be updating this notices.
  3. Move the money:  It is time to allocate monies you received in July, on behalf of your employees i.e. the Medical Loss Ratio (MLR) rebates.  Can you keep the refund?  Read our article about this very question.
  4. Download and properly distribute Summary Benefit Coverage forms by the appropriate deadline.  For a quick reference, download a free PDF Summary of SBC Requirements, which outlines employer requirements and deadlines. Kaiser employers read a related article here.

As the individual marketplace continues to deteriorate, the small group market has gained a firmer footing, including stable PPO networks and easier participation rules with Kaiser and traditional PPO plans.  Is it time to review available small group plans?   Reserve your appointment early for Open Enrollment, which begins this November.  Find local assistance in San Jose, Santa Clara and the San Francisco bay area or via telephone, throughout Northern and Southern California..

Eventbrite - Shopping For Obamacare And Better Covered California Insurance

or view online pricing, free of charge

Obamacare Healthcare Exchange Notice Is A New Requirement For Employers By October 2013

Obamacare Healthcare Surprise: Even Employers With No Health Plan Must Distribute Notices By October 1st

This article provides important information for California employers.   If you are an employee checking out Obamacare healthcare plans for yourself, read our Covered California Buyer Guide.

The Fair Labor Standards Act requires all employees to receive a disclosure notice from their employer beginning Ocrober 1, 2013.  The notice includes the following advertisement:  “When key parts of the health care law take effect in 2014, there will be a new way to buy health insurance:  The Health Insurance Marketplace.”  The Health Insurance Marketplace is another term for the new ObamaCare Healthcare Exchanges, such as the Covered California exchange (see related story), which is accepting enrollments in October 2013.

Regulatory notice OMB No. 1210-0149 goes on to disclose basic information about the new Health Insurance Marketplace, including how to save money on health insurance premiums in the marketplace etc.  If you are interested in a copy, send an email to info@coverage-ca.com.