…stronger chance than ever that your employer wants to help you with that resolution. More employers are offering workplace wellness programs. An annual survey of employer-provided health benefits found 3 out of 4 firms that offer health benefits offer some kind of wellness program, such as weight loss programs, biometric screening, nutrition counseling, or lifestyle coaching. Linking that program to…
…check. Back in the early 1990s, New York required insurers to sell to all comers, regardless of health status, but they didn’t require healthy people to maintain health coverage. As a result, premiums went through the roof, insurance companies stopped selling, healthy people dropped out, and the individual market all but collapsed. It was the proverbial insurance “death spiral.” Although…
…purchased a policy has stopped taking new patients by the time the enrollee attempts to schedule an appointment. Another regulatory option is to require prominently displayed announcements both online and on all narrow network plan print materials that state the network is limited and urge shoppers to review the provider directory before choosing a policy. There are all sorts of…
…the current federally based Marketplace system automatically dis-enrolls her from her health plan, if she purchased both at the same time. In this case, the enrollee was advised that, to keep her health plan but drop her SADP, the only way to do so is to stop paying premiums for the SADP but continue to pay premiums for her health…
…federal regulators decided early on to delay implementation of some of the new quality reforms in the law so they could focus on core operational issues. But that didn’t stop some states from recognizing the potential of the marketplaces to drive quality improvement and moving forward on their own. In their latest issue brief for The Commonwealth Fund, Sarah Dash,…
…month of the grace period). If a policyholder doesn’t pay all their outstanding premiums by the end of the grace period but actively selects a plan for the new benefit year, then the insurer cannot terminate their coverage in the new plan. And if a policyholder receiving an APTC once again stops paying premiums, insurers must provide a new 90-day…
…her baby need? And, why doesn’t her plan cover maternity services? Under the Affordable Care Act, isn’t maternity a required minimum essential benefit? Can She Switch Plans? Unfortunately, the answer is no. The open enrollment period for coverage in 2014 closed on March 31, 2014. There are life events, such as the loss of a job or a move, that…
…any of the caveats written into federal regulations, including the fact that the only way to qualify for a SEP is if you are already enrolled in a marketplace plan. So if you had purchased insurance outside the marketplace but then experienced a loss of income that made you eligible for tax credits, you do not qualify for a SEP….
…are not allowed to receive consideration directly from a health insurance or stop-loss issuer in connection with enrollment. 3) New standards prohibiting certain conduct. The proposed standards regarding providing gifts or promotional items, conducting “cold calling” type solicitation and using “robo” calling (automatic dialers) were finalized with some helpful clarifications. Gifts or promotional items, unless they are of nominal value,…
…as plan sponsors. Expatriate health plans could include lifetime and annual limits, would not have to provide preventive services, and these plans would not have limits on their administrative costs under the medical loss ratio requirements. (EHCCA Sec 2(a)). 2. A much broader group of people than Americans working oversees could be put into expatriate health plans. While the EHCCA…
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