This Know Your Insurance Piece explains what the Affordable Care Act’s individual mandate is and how it affects you. It describes the penalty exemption for individuals who purchased health insurance coverage (either an Exchange plan or individual coverage outside of the Exchange) that was effective on or before May 1,2014.
Individual Insurance – What Does the Individual Mandate Mean to Me
This Employment Law Summary provides an overview of the benefits available to employees through their employers under workers’ compensation laws in California. This document reflects the changes that came in to effect in 2013.
This is some great input from one of our partners, Ameritas, on the importance of vision coverage. Thought it was important enough to share…
Vision insurance typically receives mixed reviews – some see the value and realize the importance of the coverage, but others think it’s not essential and it’s more of a “luxury” benefit. This week’s update is going to pass on information to show the great value of vision insurance, specifically on the eye exam.
A key point of vision insurance is to get insured’s to an annual comprehensive eye exam. I don’t mean an exam where you read letters on a Snellen chart – I mean a true comprehensive eye exam. The reason these exams are so valuable is the ability to detect vision conditions and other health problems. Here’s a quick list of conditions and diseases that can be detected through a comprehensive eye exam:
| Eye Conditions | Medical Conditions |
|---|---|
| Glaucoma | Cardiovascular disease |
| Cataracts | Demyelinating diseases |
| Macular Degeneration | Endocrine conditions |
| Diabetic Retinopathy | Inflammatory and Rheumatologic conditions |
| Infections of the eye | Neuromuscular diseases |
| Corneal Dystrophy | Tumors |
| Retinal Detachments | |
| Keratoconus |
There are huge benefits to detecting these conditions early. People can get treatment and many times not experience any damage, as long as these conditions are recognized early. Combine this with the fact that a person with a vision insurance plan is more likely to go in for an eye exam than if they didn’t have insurance – THAT is the reason vision insurance is so valuable! The coverage encourages preventive care and regular exams that helps keep people happy and healthy – and that’s the type of company employees are looking for! On top of the exam benefits, vision insurance helps members pay for vision corrective services (lenses, frames, etc) and helps save them a significant amount of money. So the next time you are prospecting or talking to a current client that does not have vision coverage, you’ll be able to explain and show them that vision insurance is a great value to add to the benefits package.
Covered California announced today that individuals who have started an online application by March 31 will have until April 15 to complete their application and to select a Covered California health plan. Note this applies to online applications only.
Individuals who start an online application by 11:59 p.m. on March 31, 2014 will have until 11:59 p.m. on April 15, 2014 to complete their application and select a plan. To start an application, individuals must take at least the following steps:
Individuals who complete their applications, and make their premium payment on time, will get coverage beginning May 1 and avoid the tax penalty for lack of insurance. Click here for information about how to pay and payment deadlines.
Again, the open enrollment completion period applies only to online applications. Paper applications must be completed (including plan selection) and postmarked by March 31, 2014 in order to meet the open enrollment deadline for Covered California health plans.
Certified Insurance Agents are encouraged to use Covered California’s online enrollment portal for starting applications by the March 31 deadline, and then use the next two weeks to help their clients complete the process.
After the end of open enrollment on March 31, consumers may be eligible for Covered California’s special enrollment period, which can be triggered by one of several “qualifying life events,” as defined under the Affordable Care Act. Some of those qualifying events include:
Low-cost or no-cost coverage through Medi-Cal is also available to consumers year-round, and they can check their eligibility and sign up on the Covered California website, through its Service Center or with the help of assisters.
Covered California also operates its Small Business Health Options Program (SHOP) year-round for businesses with 50 employees or fewer.
Covered California’s next open enrollment period, for 2015 coverage, will begin in fall 2014.
On Feb. 20, 2014, the Departments of Labor, Health and Human Services and the Treasury released final regulations on the Affordable Care Act’s 90-day waiting period limit. These regulations generally finalize provisions in proposed regulations issued in March 2013, with minimal changes. At the same time, the Departments released a separate proposed rule regarding a new provision permitting orientation periods under the 90-day waiting period limit.
Under these regulations, employers may require employees to successfully complete a reasonable and bona fide employment-based orientation period as a condition for eligibility for coverage under a plan. However, the orientation period may not exceed one month. In addition, the final regulations provide that a former employee who is rehired may be treated as newly eligible for coverage upon rehire, and may be required to satisfy the plan’s waiting period again.
The final regulations apply for plan years beginning on or after Jan. 1, 2015. However, the 2013 proposed regulations provided that the 90-day waiting period limit would apply for plan years beginning on or after Jan. 1, 2014. Thus, for plan years beginning in 2014, the Departments will consider compliance with either the 2013 proposed regulations or the final regulations to constitute compliance with the 90-day waiting period limit requirement.
Health Care Reform is up and running. This brief document explains how groups such as employees of large companies, children with pre-existing conditions and the elderly will be affected by the health care reform legislation. Helpful quick hit for those with questions.
Read the article here: HCR-What Does It Mean For You
The U.S. government has announced that the employer mandate, one of the most significant portions of the Affordable Care Act (ACA), will not be enforced until 2015.
Under the provision, companies with 50 or more full-time employees would have faced fines of up to $3,000 per employee if they didn’t offer their employees affordable health insurance.
The one year delay is designed to accomplish two goals:
Click here for more information directly from the Treasury Department’s website.
Health care reform brings preventative care benefits at no cost to you. What is covered? Find out here! Healthcare.gov
Covered California
California was the first state to create a health benefit exchange following the passage of federal health care law. Covered California is charged with creating a new insurance marketplace in which individuals and small businesses can get access to health insurance. With coverage starting in 2014, Covered California will help individuals compare and choose a health plan that works best for their health needs and budget.
To view the full booklet detailing Covered California, click here: CC Health Plans Booklet
A 3-page press release is available here: COVERED CA-HealthPlans
The high-level presentation is available here: Covered California HP Announcement
Model Notice
Per the PPACA, employers covered by the Fair Labor Standards Act (FLSA) are required to provide a notice to employees about the state’s health insurance exchanges. Originally, the deadline for offering the exchange notice was March 1, 2013. However, on May 8, 2013, the Department of Labor issued a technical release extending the date to October 1, 2013.
The notice must be provided in writing in a manner calculated to be understood by the average employee. It may be provided by first-class mail. Alternatively, it may be provided electronfically if the requirements of the Department of Labor’s electronic disclosure safe harbor at 29 CFR 2520.104b-1 are met.
There is no requirement to obtain an employee’s signature; however, an employer may want to track delivery and receipt of the notice.
The model notice is available here: Model Notice
