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Tuesday, July 30, 2013

Comedy website looks to make health insurance a laughing matter


Writers for the comedic video website Funny or Die are working on video scripts to encourage the site's audience to enroll in health insurance coverage. The material will not be political and instead will "focus more on the positive stuff and really how it relates to young people who aren't thinking about health care in a serious way," said Mike Farah, president of production. The Hill/Healthwatch blog (7/25)

Friday, July 26, 2013

SHOP tax credits explained


Firms with fewer than 25 employees can get up to a 50% tax credit next year if they join the Small Business Health Options Program, Small Business Administration Senior Policy Adviser Meredith Olafson said during a webcast. Some of the SHOP exchanges will offer only one plan next year, but employers should have multiple plans from which to choose in 2015, Olafson said. Average annual wages at qualified businesses must be $50,000 or lower, excluding owner, partner and family income; and employers must cover a certain percentage of employees' premiums. InvestmentNews (free registration) (

Can an Assisted Living Community Transfer my Mother without my Approval?

 

Question: My question is whether an Assisted Living Facility can transfer my mother to another facility without my approval, her financial and health care Agent. Apparently, Mom, who is 87 years old and has dementia, has been somewhat rowdy recently and apparently because of this behavior/acting out, the Assisted Living Facility has made a unilateral decision (without my input at all) to transfer her to another facility on the other side of town. Can this be done and what is my recourse?

Answer: In Florida, a resident in an assisted living facility has the right to at least 45 days’ notice of relocation or termination of residency unless a physician certifies that the resident requires an emergency relocation to a facility providing a more skilled level of care or the resident engages in a “pattern of conduct that is harmful or offensive to other residents.”. So, in your particular case, if the ALF has provided proper notice, they can transfer her for any reason or no reason. If they have not provided proper notice and it is not an emergency transfer as described above then you may have recourse. I suggest that you contact the Long Term Care Ombudsman Program through the Department of Elder Affairs for more specific guidance in your mother’s case. They can be reached at 1.888.831.04040 or at http://ombudsman.myflorida.com. There is no charge for these services.
- See more at: http://www.eldercarematters.com/eldercareanswers/2013/07/26/todays-qa-can-an-assisted-living-community-transfer-my-mother-without-my-approval/#sthash.3670sl0E.dpuf

Monday, July 15, 2013

Health Insurance Exchanges and how people buy Healt Insurance


Excerpt from a survey where people accessed the Health Insurance Exchanges and how they would purchase health insurance from the Washington Post 7/14/13.
                                                             

Still, the focus on price, including the effect of subsidies, is a constant. Consulting firm Booz & Co.'s pretend exchanges showed that premiums were the most important factor in plan selection, followed by cost-sharing features like deductibles. McKinsey & Co., which tested about 150,000 consumers, found most would opt for smaller arrays of doctors and hospitals to achieve discounts.
 

If you are wondering, then I will tell you that this is no different than how people have shopped for health insurance prior to Health Reform. All the fuss and muss over explaining options to most people has nothing to do with how the will shop and buy health insurance on the exchanges.
 

If this happens then it is my best guess that things won't go well and all insures who have higher prices will eventually cut their prices trying to compete or exit the exchange.

Friday, July 12, 2013

5 compliance considerations for employers


Business owners and health care providers should take steps now to comply with the next phase of the Affordable Care Act, attorney Pepper Crutcher writes. Employers should monitor forthcoming IRS guidance on the penalties and taxes it will and will not collect. Employers with "grandfathered" plans should determine the benefits and drawbacks of staying with those plans or making even small changes and losing grandfathered status, determine whether self-insurance is the best option, and consider offering scaled-back options. American City Business Journals/Birmingham, Ala.

Thursday, July 11, 2013


§  The crucial difference between ACA tax credits and subsidies
People with incomes between 100% and 400% of the federal poverty level might qualify for tax credits to offset health insurance premiums, and people with incomes between 100% and 250% of the poverty level may also qualify for subsidies to offset out-of-pocket costs. Consumers can apply in advance for the tax credit based on estimated income, and the funds will be sent to the insurer, but if income was underestimated and too much was paid to the insurer, consumers may owe the difference at tax time. Cost-sharing subsidies are also paid directly to insurers, but they need not be paid back if the consumer's income rises or was underestimated. Kaiser Health News/Capsules blog (7/10) LinkedIn Facebook Twitter Email this Story

Monday, July 08, 2013

Cadalic Plans under Health Care Refom

Cadillac insurance plan - Wikipedia, the free encyclopedia

en.wikipedia.org/wiki/Cadillac_insurance_plan

Informally, a Cadillac plan is any unusually expensive
health insurance plan, usually arising in discussions of medical-cost
control measures in the United States.[1][2][3][4] The term derives from
the Cadillac automobile, which has represented American luxury
since its introduction in 1902,[1]and as a health care metaphor dates
to the 1970s.[1] The term gained
popularity in the early 1990s during the debate over the
Clinton health care plan of 1993,[1] and was also widespread during
 debate over possible excise taxes on "Cadillac" plans during the
health care reforms proposed during the Obama administration.[1]
(Bills proposed by Clinton and Obama did not use the term
"Cadillac".)

The Patient Protection and Affordable Care Act
(as amended by the
Health Care and Education Reconciliation Act of 2010) imposes an
annual excise tax on plans with premiums exceeding $10,200 for
 individuals or $27,500 for a family (not including vision and dental
benefits) starting in 2018.[4]

Criticisms of these plans generally center on the small or
nonexistent co-pays, deductibles, or caps that encourage the
overuse of medical care, driving the cost up for the uninsured or
those on other plans, which some say necessitates a Cadillac tax.[citation needed]

A study published in Health Affairs in December 2009 found that
high-cost health plans do not provide unusually rich benefits to e
nrollees. The researchers found that only 3.7% of the variation in the
cost of family coverage in employer-sponsored health plans is
attributable to differences in the actuarial value of benefits.

Only 6.1% of the variation is attributable to the combination of
benefit design and plan type (e.g., PPO, HMO, etc.). The employer's
industry and regional variations in health care costs explain part of t
he variation, but most is unexplained. The researchers conclude
"…that analysts should not equate high-cost plans with Cadillac
plans, but that in fact other factors—industry and cost of medical
inputs—are as important in predicting whether a plan is a high-cost
plan. Without appropriate adjustments, a simple cap may exacerbate
rather than ameliorate current inequities."[5]

Healthcare Reform Update: Employers – Controlled Groups and Related Entities

Healthcare Reform Update: Employers – Controlled Groups and Related Entities

The Affordable Care Act (“ACA”) provision also known as Employer Shared Responsibility, mandates that employers who generally employ 50 or more full-time equivalents must offer group health insurance benefits to its full-time employees and their dependents or potentially pay a penalty. Employers can determine whether they meet the 50 or more full-time equivalent threshold for January 1, 2014 by using selected information from 2013. An important note, if two or more companies are “related” then the companies may be combined by the government for purposes of determining if the companies are subject to the Employer Shared Responsibility provisions.
Control group and related entities’ rules can be found in the Internal Revenue Code, including but not limited to, sections 414(b) and 414(c), which generally provide that employees of all companies which are members of a controlled group of entities and employees of trade[s] or business[es] (whether or not incorporated) which are under “common control” are to be treated as employed by a single employer. Companies with as little as 20% of common ownership may be considered part of a control group, while companies with 80% common ownership are usually presumed to be “related”. Another area that needs to be considered is affiliated service groups which provide integrated services to the public, parent-subsidiary, brother-sister entities and “family members” with ownership that may be attributed to a related person’s individual ownership interests. In addition, smaller entities with five or fewer persons which could include trusts are also legal entities which should be considered when deciding on who is part of a “control” group.
Lastly, the IRS has proposed anti-abuse provisions which will penalize employers who attempt to avoid the mandates of ACA. As always, please speak with competent legal and accounting professionals to address your specific circumstances.
http://www.irs.gov/uac/Newsroom/Questions-and-Answers-on-Employer-Shared-Responsibility-Provisions-Under-the-Affordable-Care-Act

Tuesday, July 02, 2013

Obama Administration delays


 
Importan Notice, Obama Administration Delays Tax on employers with 50 or more employees as required under ACA.
 


 

The Washington Post by Sarah Kliff -

July 2, 2013:

The Obama administration will not penalize businesses that do not provide health insurance in 2014, the Treasury Department announced Tuesday.

Instead, it will delay enforcement of a major Affordable Care Act requirement that all employers with more than 50 employees provide coverage to their workers until 2015.

The administration said it would postpone the provision after hearing significant concerns from employers about the challenges of implementing it.

“We have heard concerns about the complexity of the requirements and the need for more time to implement them effectively,” Mark Mazur, Assistant Secretary for Tax Policy, wrote in a late Tuesday blog post. “We recognize that the vast majority of businesses that will need to do this reporting already provide health insurance to their workers, and we want to make sure it is easy for others to do so.”

The Affordable Care Act requires all employers with more than 50 full-time workers provide health insurance or pay steep fines. That policy had raised concerns about companies downsizing their workforce or cutting workers’ hours in order to dodge the new mandate.

In delaying the enforcement of that rule, the White House sidesteps those challenges for one year. It is also the second significant interruption for the Affordable Care Act, following a one-year delay on key functions of the small business insurance marketplaces.

Together, the moves could draw criticism that the administration will not be able to put into effect its signature legislative accomplishment on schedule.