Tag Archives: Affordable Care Act

More ACA Changes: Start the New Year Informed

iStock_000058231982_LargePresident Obama has signed an agreement on two major legislative packages regarding the budget and tax agreements that were previously approved by Congress.

These bills included changes that affect several health care related provisions under the Affordable Care Act (ACA).

The ACA provisions included in the agreement would:

  • Delay implementation of the ACA Excise Tax (“Cadillac” tax) for two years, making it effective in 2020, instead of 2018
  • Implement a moratorium on the ACA 2.3 percent Medical Device Tax, which has already taken effect. This tax would not apply to sales for calendar year 2016 and 2017
  • Suspend the ACA Health Insurance Tax for one year (2017)
  • Extend a measure that prevents the federal government from shifting funds to pay for the ACA’s risk corridors program

Who Wants a Visit from the Department of Labor? No one!

Who Needs an ERISA Wrap Document?  According to the Department of Labor, every small business!

The Employee Retirement Income Security Act of 1974 (ERISA)  is a federal law that requires ALL employers to regularly  provide participants with a written document containing information regarding how their welfare benefits plan  work, as well as their plan rights and obligations.  This document is called a Summary Plan Description (SPD) and is required for all employee welfare benefits plans (medical, dental, vison, Life, disability, EAP, etc) as defined by ERISA.

The Dept of Labor (DOL) audits employer welfare benefit plans for compliance with ERISA. With ERISA compliance audits is on the rise, expect an audit within the next 5 years. Having the proper SPD will allow an employer to better prepare for an audit and will go a long way in showing good faith compliance with the law.

There may be penalties for employers who do not have a written SPD or who do not distribute one to participants.

We know of vendors who can help prepare the necessary ERISA wrap documents for your business.  Please contact us for additional information.

February 2015: The Good, Bad and Ugly of ObamaCare

GoodBadUglyHealthcareAs mentioned in previous blogs, the profession of providing health insurance for individuals changes monthly, sometimes weekly, and even daily! As of February 2015, here are the latest developments in ObamaCare and how it will impact people who have enrolled or are looking to enroll for coverage on the Federal Marketplace, healthcare.gov.

The “Good”
Anyone who hasn’t had health insurance coverage in 2014 and was assessed a tax penalty will have an opportunity to enroll between March 15 and April 30, as a “special enrollment” according to the Center for Medicare and Medicaid (CMS), the Federal agency that oversees the Federal Marketplace. Eligibility rules will apply, so please log on to www.healthcare.gov for more information.

The “Bad”
Last Friday, the Federal Government announced they sent out “incorrect” tax information to 800,000 people enrolled through the Federal Marketplace, namely the tax Form 1095-A.  In an effort to stave off incorrect tax filings, the Administration is contacting affected people by phone and email.  They are also advising consumers to log into their accounts on  to see if they were affected.  All corrected forms should be available by early March, officials said.

The “Ugly” 
According to the Associated Press, perhaps at least 50,000 of those affected have already filed their taxes!  The Government is promising to now work with those affected to correct the problem.

Stay tuned for more updates in the coming weeks as these issues start to unfold.

Don’t Delay in Knowing How Obamacare Impacts Your 2014 Taxes

Time:Tax preparation and filing is not on the top list of enjoyable experiences for most people. It requires tedious effort and documentation. This year, we will all have the added excitement of figuring out how the Affordable Care Act (ACA/Obamacare) figures into our 2014 tax filing.

For most of you, the good news is that the only change to your normal tax filing routine will be to “check” the box (line 61) on your 1040 tax form that indicates that you’ve had health insurance for the entire year of 2014.  If you have GROUP health insurance coverage (employer-based) or Medicare, then that’s all you have to do!  The law requires you to have “minimum essential coverage” which all group plans and individual health plans are considered. The only caveat to that is short-term health insurance, defined as less than twelve months, is NOT considered minimum essential coverage.

If you had have the “minimum essential coverage” for only part of 2014, it becomes more complicated.  That’s where a tax advisor comes into play. I share with clients that I spend a lot of money on accounting services each month, so I’m in no position to give tax advice. What I can recommend is to allow yourself time to do your own research and select a tax advisor sooner than later, since their busy season has already begun.

I feel the area of greatest confusion is for those who received a “premium tax credit” or Federal subsidy and purchased through coverage through www.healthcare.gov  because there is a reconciliation process between your estimated and actual 2014 household income.  In addition, those individuals will receive a Form 1095-A from the Federal Marketplace.  This document will be used to complete Form 8962 and then attached to the 1040.

The first year of tax filing will probably be bumpy for many people, particularly for those with complex family situations (i.e. divorce, dependent children, job loss, income change, covering young adults who file their own taxes, etc.).

We encourage clients to use the guide created by the IRS to help you navigate through the process. Here is a link to the IRS Guide on ACA Mandate 2014.

Special Enrollment Periods…Just the Tip of the Iceberg!

Copyright: <a href='http://www.123rf.com/profile__fla'>_fla / 123RF Stock Photo</a>The “open enrollment” period to purchase health insurance in Wisconsin, both on and off the exchange, for 2014 ended April 1, 2014. Under the new Federal Law, the only time an individual can purchase health insurance now is with a special enrollment period (SEP). That’s because medical underwriting no longer exists in the commercial market or on the Federal Marketplace/Exchange.

There are several life events that can trigger a special enrollment: a relocation, marriage, divorce, birth, death, adoption of a child (or foster care), loss of minimum essential coverage, or a change in income. These special enrollments are not easy.  I describe the process as confusing, convoluted and complex (the three C’s).

Each special enrollment for health insurance is “special” because every situation is different. There isn’t a standard SEP. Just like human beings and their DNA, I’m finding out that every SEP has its own set of complexities that the Federal Government is not yet equipped to handle. The Marketplace/Exchange website continues to have glitches, especially in cases of income changes and dependent coverage. Many questions do not make sense to the consumer about current and past coverage. In most instances, the system will automatically override your own desires and move dependents (children) from the health plan directly onto BadgerCare, even if you want to cover them privately.

I forewarn my clients that a special enrollment on the Federal Marketplace/Exchange can take anywhere from one to three hours (or longer). Remember, you aren’t considered covered until you pay your premium. You may also owe a fee (penalty) for the months you did not have coverage in 2014.  In addition, you want to try to be as accurate on your income for the Federal subsidies, because when your taxes are reconciled in 2015 (for the 2014 tax year), you may owe money back.

The next open enrollment period for individual health insurance begins on November 15, 2014 (for a January 1, 2015 effective date). If you want to avoid crashing into an “iceberg”, give us a call (920-955-1040)!   We are Federal Marketplace/Exchange certified and licensed agents with over 40 years of combined health insurance experience.

The “Expedia.com” of Healthcare is not Delivering

2012/04/12TraceyWe have been gearing up for over three years for October 1, 2013, with continuing education, on-line training modules, testing and certification, and broker summits/trainings in order to be prepared and ready to sell on the online Healthcare Exchange (www.healthcare.gov). With all the preparation and anticipation, here we sit today with no ability to sell on the Exchange, let alone quote or even view any plans!  Many of our individual clients in Wisconsin have been calling us, sharing their frustration, and we are no less frustrated as well.  Individuals in other states are penning articles about their experiences, just like Maggie Thurber for Ohio Watchdog.

We are taking healthcare reform one day and many times, one hour at a time, as we all continue to “navigate” through a new world of health insurance purchasing.  Our HIRSP clients have now received letters stating that their policies will be terminating December 31, and yet, here we are not able to help them fully.

Under these circumstances, here is my advice for health insurance seekers. If you (or your employees) are not eligible for the Federal subsidy (premium reduction) because of your household income, then there is no reason to remain frustrated with www.healthcare.gov. We can assist with quoting and enrollment directly with the insurance carriers, who are operating off of the Exchange.  And there are more options off the Exchange than on!  How’s that for more competition?

SHOP Exchanges For Small Businesses Hits a Snag!

Business person in a snag As we near the “opening day” of the Federally-Facilitated Health Care Marketplaces (Exchanges), yet another delay comes out of Washington.  The Small Business Health Options Plan (SHOP) that was scheduled to be functional the same day that the individual Marketplace is scheduled to open is now delayed. Surprised? I’m not in the least. And we still have four more days to the official opening of the on-line Marketplace that we have all been anxiously waiting for.  I wonder what else might happen in the next four days?

According to the Wall Street Journal, the Obama administration acknowledged for the first time yesterday (Thursday) that a “technical” problem is forcing them to delay the rollout of the SHOP, and that it will be unable to accept on-line enrollments/applications.  They go on to say that people close to the situation are also skeptical that the online marketplace for individuals will be ready.

My own experience in just trying to register on the Centers for Medicare and Medicad Services website/portal as a licensed agent and user of the Marketplace was a disaster and took more than one phone call. Therese in our office was told numerous times by numerous people (this after many phone calls) that I was in fact a minor and not eligible to be a user!  If just agent/agency registration was this cumbersome, what’s going to be next?

Model Notices for Health Care Reform: “Much Ado About Nothing?”

Shakespeare with computer.It’s another good day to “take a breath” in the world of Health Care reform, as we can now relax, knowing that employers are not going to be penalized for NOT distributing the Model Notices provided by the Department of Labor. Here is the proof of what I just shared, right on the Department of Labor’s (DOL) website.

The Department of Labor was quick to relay a few months ago that employers would be penalized if they did not adhere to the ACA guidelines of informing all employees (FT, PT and even seasonal) of the Federally-Facilitated Marketplace (aka Exchange) here in Wisconsin by October 1, 2013! Business owners were scrambling for find the right information to comply.

I wrote a blog update on August 16, relaying that although the notices were due October 1, I wasn’t in any big hurry to get clients too excited about complying, that there would indeed be plenty of time in late September to get these notices to their employees. My impetus for this was because of the other delays that we had already witnessed, namely the one year delay in the 50+ employee mandate of “play or pay”.

Interestingly enough, this update on the DOL website has very quietly been released with no fanfare no media frenzy or anything.  Do you wonder why?  I do, and I have a theory about it. However, at this point, I may keep the theory to myself and just watch this all unfold, as we count down the days to October 1st.  Does it ever feel like this is a case of deja vu?  Sounds like “Y2K” to me. No, the sky won’t fall, but I have to wonder what else may happen between now and October that we all might be thinking that it was “much ado about nothing.”

When Should A Business Send Employee Notices for ObamaCare?

With the Affordable Care Act (aka ObamaCare), businesses will be required to give all employees notification (no later than October 1, 2013), explaining their option to purchase health insurance (if they choose) through the Health Insurance Marketplace (aka Exchange) here in Wisconsin.

This notice provides employees basic information about the new Health Insurance Marketplace. We do have some clients here in Northeast Wisconsin working on these notices as I write this blog post. However, my personal opinion and concern with being efficient now and getting these notices out is this: What if the Federal Government delays the Exchanges at the eleventh hour?  What we have been witnessing over the past few months is any part of the Affordable Care Act can change and in many instances has changed.

My advice for business owners is to create a template for the notice to employees and wait to distribute them until we are sure that the Exchanges will be operational on October 1. For a small fee, we can help create those documents for clients who are interested.

Whatever we know about health insurance today is sure to change within the next three months. We all need to remain informed and try out best to stay calm while we prepare for the upcoming change!

Health Insurance With Several Northeast Wisconsin Chambers Comes to an End

After nearly two decades working with area Chambers, Network Health has decided not to renew their partnership.  As a result of the Affordable Care Act (ACA), there are two items that directly affected NHP’s decision. One is the requirement for community rating of small group health insurance and the other is the medical loss ratio requirement (MLR).

If you were covered under a Chamber health plan, your plan or rates will not change. It’s important for businesses to know they are no longer required to renew a Chamber membership in order to maintain current Network Health insurance coverage and rates.  However, as a long-term Chamber member ourselves, we believe in the value the area Chambers bring to our community and we encourage business owners to maintain their memberships.

At Hanson Benefits, we remain heavily involved with Healthcare Reform through various committees and working groups in Madison. We will keep you informed as vital information continues to be released.