February 2014 - Employee Benefits I AP Benefit Advisors

Medicare head defends proposed regs

By Allison Bell, lifehealthpro.com Concerns about pharmaceutical manufacturers, community pharmacies and patients who need specific brand-name drugs dominated discussion yesterday during a hearing on proposed Medicare Part D prescription drug program regulations. But witnesses did touch on provisions relating to insurance plan design, especially in the written versions of their testimony. The House Energy & […]

Read More...

DOL: PPACA Final Rules on 90 Day Waiting Period

Today the U.S. Departments of Labor, Treasury, and Health and Human Services have announced the publication of final regulations implementing a 90-day limit on waiting periods for health coverage.   Under PPACA (the Patient Protection and Affordable Care Act), employers and plan sponsors are prohibited from sponsoring/offering health plans that have waiting periods in excess of […]

Read More...

Final IRS Regulations on Employer Shared Responsibility Provide Important Transition Relief and Make Other Important Changes to the Proposed Rules

From EBIA In a long-anticipated development, the IRS has finalized regulations for employer shared responsibility under Code § 4980H (also known as “play or pay”). Issued along with updated Q&As, the regulations provide important transition rules, including several forms of relief for employers first subject to penalties in 2015 and a delay in applicability (to 2016) for […]

Read More...

Obama administration delays PPACA Employer Mandate – again

Under regulations issued today (Monday, February 10, 2014) only employers with more than 100 full-time workers will be subject to fines in 2015 (unless they offer coverage). The “Employer Mandate”, originally due to take effect for January 1, 2014, but was delayed under prior guidance. The requirement that large employers provide their workers with health […]

Read More...

Risk Adjustments in Obamacare

Most of the commentators on the exchange roll out caution against the “death spiral,” in which failing to attract the young and healthy raises overall premiums. This further deters low-cost people from enrolling, resulting in even higher premiums. This is absolutely true in a normal market. But a new report from the actuarial consulting firm […]

Read More...