07 May 2015

Florida Hospital and Blue Cross

Florida Hospital and Florida Blue have reached an agreement in principle in contract negotiations.  Florida Blue will extend its existing contract with Florida Hospital through June 30, 2015 and Florida Blue customers will remain in-network of Florida Hospital.  A new contract will be effective July 1, 2015.

12 March 2015

Florida Blue, Florida Hospital have not come to contract agreement

According to the Orlando Sentinel, March 8, 2015, Florida Hospital and Florida Blue have failed to find agreement in a contract that is set to expire June 1.

Florida Blue is negotiating rates with all 23 Florida division hospitals and Adventist Health System physician groups.  Florida Blue officials said that if the two entities don’t reach an agreement, they will send out letters to providers and patients notifying them of alternatives.

The hospital has set up a phone line, 855-354-6775, and a website, floridahospital.com/floridablue, to answer questions and list facilities and insurance plans that would be affected.

03 March 2015

Substantial penalities by the Department of Labor (DOL)

Substantial penalties are enforceable by the Department of Labor (DOL) for employers who have arrangements that pay for or reimburse their employees and/or owners for an individual health insurance policy.  In other words, if your Company is paying for or reimbursing your employees or you for  an individual health care policy, then you are subject to these penalties.  The penalties are $100 a day per employee, up to $36,500 per employee per year.  These penalties do not apply to ACA compliant employer sponsored group health insurance plans.  If your Company is paying for or reimbursing you or anyone for any health insurance outside of the Company’s ACA compliant plan, you should stop immediately.  If you have questions, please call us.

09 February 2015

IS YOUR OBAMACARE DATA SAFE?

Excerpted from New York Times, January 25, 2015

If you’re concerned about online privacy, you’ve likely read a lot about what happens to the information you enter into sites like Facebook or Google.  But now another website is generating privacy worries:  Healthcare.gov.

 Ricardo Alonso-Zaldivar and Jack Gillum at The Associated Press report that the health insurance site has been sharing user data – possibly including characteristics like users’ age and income, as well as whether they’re pregnant – with companies like Google, Twitter and Facebook.  They write that “there is no evidence that personal information has been misused”, and that the administration says it has prohibited companies “from using the data to further their own business interests.” Still, they note, many find the practice troubling.

According to Dr. Hartzog, a law professor at Samford University who studies privacy says that “what government is engaging in here, if indeed they’re sharing anonymized data according to certain kinds of industry standards:, is in fact “common practice for lots of different websites, if not most websites,”

“Consumers should be concerned not just because it’s happening at Healthcare.gov but because it’s happening everywhere.”

 

18 December 2014

HAPPY HOLIDAYS

We would like to wish everyone a safe and Happy Holiday and a wonderful New Year!

13 November 2014

2015 Retirement Plan Limits Announced

 

The IRS has announced cost of living adjustments affecting dollar limitations for retirement plans and related items for tax year 2015. Highlights include:

  • The contribution limit for employees who participate in 401(k), 403(b), and most 457 plans is increased from $17,500 to $18,000.
    • The catch-up contribution limit for those aged 50 and over is increased from $5,500 to $6,000.
  • The limit on annual contributions to an individual retirement arrangement (IRA) remains unchanged at $5,500.  

The deduction for taxpayers making contributions to a traditional IRA is phased out for singles and heads of household who are covered by a workplace retirement plan and have modified adjusted gross incomes (AGI) between $61,000 and $71,000, up from $60,000 and $70,000 in 2014.

 

 
 
 

 

 

 

  • For married couples filing jointly, in which the spouse who makes the IRA contribution is covered by a workplace retirement plan, the income phase-out range is $98,000 to $118,000, up from $96,000 to $116,000.
  • For an IRA contributor who is not covered by a workplace retirement plan and is married to someone who is covered, the deduction is phased out if the couple’s income is between $183,000 and $193,000, up from $181,000 and $191,000.

 

05 November 2014

Little-known ACA enrollment period benefits small employers – HIX 11/5/14

The Affordable Care Act requires health insurance issuers to offer an annual one month special open enrollment period (fron Nov 15 – Dec 15) to employers in the small group market who do not meet the employee minimum participation or employer minimum contribution requirements.

There are specific situations where it will be beneficial, but it’s  important that the employer  work with a broker or adviser that  knows  the rules.

15 October 2014

Important IRS Updates for Section 125 Plans

 

 

Important IRS Updates for Section 125 Plans

October 1, 2014

 

 
Application of the Permitted Change Rules for Health Coverage under a 125 Cafeteria Plan. 

In IRS Notice 2014-55 (click here) released on September 18, 2014, the IRS addressed two specific situations in which a Section 125 cafeteria plan participant may cancel his/her group health coverage mid-plan year.

  • The first situation involves a participating employee whose hours of service are reduced so that the employee is expected to average less than 30 hours of service per week, but for whom the reduction does not affect the eligibility for coverage under the employer’s group health plan.
  • The second situation involves an employee participating in an employer’s group health plan who would like to cease coverage under the group health plan and purchase coverage through an Exchange or Marketplace established by ACA. 

The first situation would apply to an employee who experiences a decrease in hours, but remains eligible for the employer’s group health plan.  Employee had been in an employment status under which the employee was reasonably expected to average at least 30 hours per week and there is a change in that employee’s status so that the employee will reasonably be expected to average less than 30 hours of service per week after the change, even if that reduction change does not result in the employee ceasing to be eligible under the group health plan. In addition the employee, along with any related individuals, must state intent to enroll in Marketplace coverage or other minimum essential coverage, such as spouse’s group health plan or Medicare.  This other coverage will be effective no later than the first day of the second month following the month that includes the date the original coverage is cancelled.

 

The second situation provides for the ability of an employee to cancel group health coverage mid-year in order to enroll in the Marketplace no later than the day immediately following the last day of the original coverage that is cancelled.  Prior to this update, participants were not permitted to revoke group health plan coverage mid-year solely to enroll in a Marketplace plan.  For those employees with a calendar year cafeteria plan, employees could enroll in a Marketplace plan during open enrollment period and begin coverage January 1.  However, for those employees enrolled in group health plan in a non-calendar year cafeteria plan were essentially locked out of this option. IRS Notice 2014-55 alleviates the problem for non-calendar year plans by allowing them to amend their plan to allow for a Special Enrollment Period.  The Special Enrollment Period will allow participants to change their elections mid-year to enroll in a Marketplace plan during the Marketplace open enrollment period.

 

Other important factors to observe: 

  • The plan will rely on employee’s representation to enroll in Marketplace plan that will be effective no later than the day immediately following last day of the employer’s plan coverage.
  • The plan must be amended to allow for these additional mid-year election changes on or before the last day of the plan year in which the change is to take effect. (Click here to download the amendment)
  • The employee’s change is only prospective and under no circumstances can change be allowed retroactively.
  • These additional mid-year election changes do not apply to the Health FSA.
  • The employee will not be eligible for tax credits in the Marketplace as long as still eligible for the employer’s group health plan.
 
Other important Plan Updates for 2015:

  • Qualified Parking Benefits – Monthly maximum employee contribution: $250 (remains same as 2014)
  • Qualified Transit Passes and Van-Pooling Benefits – Combined monthly limit for transit passes and van-pooling expenses:  $130 (remains same as 2014)
  • Adoption Assistance Exclusion and Adoption Credit
    • Maximum employee contribution: $13,400 (up from $13,190 for 2014)
    • Maximum adoption credit: $13,400
    • Exclusion and credit will begin to phase out for individuals with modified adjusted gross incomes greater than $201,010 (up from $197,880 for 2014) and entirely phased out for individuals with modified adjusted gross incomes of $241,010 (up from $237,880 for 2014). 
  • Patient-Center Outcomes Research Trust Fund Fee (PCORI) sets the fee at $2.08 for the October 1, 2014 to October 1, 2015 policy and plan period. This is an increase from the $2.00 fee in effect for 2013 to 2014. 

We will keep you apprised of any changes or clarifications to these updates, and any other relevant updates if information becomes available.  

 

 

11 September 2014

Center for Medicare & Medicaid Services – Fact Sheet

The following is excerpted from the following website: http://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/aca_implementation_faqs18.html

 

Q1: On September 24, 2013, the USPSTF issued new recommendations with respect to breast cancer.5 What changes must plans make to comply with the new recommendations?

The USPSTF recently revised its “B” recommendation regarding medications for risk reduction of primary breast cancer in women. The September 2013 recommendation now says:

The USPSTF recommends that clinicians engage in shared, informed decisionmaking with women who are at increased risk for breast cancer about medications to reduce their risk. For women who are at increased risk for breast cancer and at low risk for adverse medication effects, clinicians should offer to prescribe risk-reducing medications, such as tamoxifen or raloxifene.

Accordingly, for plan or policy years beginning one year after the date the recommendation or guideline is issued (in this case, plan or policy years beginning on or after September 24, 2014), non-grandfathered group health plans and non-grandfathered health insurance coverage offered in the individual or group market will be required to cover such medications for applicable women without cost sharing subject to reasonable medical management.

11 September 2014

REMINDER

Empl0yers with Medicare eligible employees are required to notify CMS (Center for Medicare & Medicaid Svcs.) of creditable Rx coverage prior to October 15.  The disclosure form can be completed and submitted online at the following website:: http://www.cms.gov/creditablecoverage.