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That’s why on April 19, Health and Human Services Secretary Kathleen Sebelius called on leading insurance companies to begin covering young adults voluntarily before the September 23 implementation date required by the new health reform law. Early implementation would avoid gaps in coverage for new college graduates and other young adults and save on insurance company administrative costs of dis-enrolling and re-enrolling them between May 2010 and September 23, 2010. Early enrollment will also enable young, overwhelmingly healthy people who will not engender large insurance costs to stay in the insurance pool.
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The White House Blog
More Support for Young Adults Posted by Nancy-Ann DeParle on April 27, 2010 at 12:24 PM EDT http://www.whitehouse.gov/blog/2010/04/27/more-support-young-adults |
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And we’re pleased to report that the following insurance companies are doing just that:
Blue Cross and Blue Shield of Alabama Blue Cross Blue Shield of Delaware Blue Cross and Blue Shield of Arizona, Inc. Blue Cross and Blue Shield of Florida Arkansas Blue Cross and Blue Shield Blue Cross and Blue Shield of Hawaii Blue Shield of California Blue Cross of Idaho Health Service Regence Blue Shield of Idaho Wellmark Blue Cross and Blue Shield of Iowa Health Care Service Corporation Blue Cross and Blue Shield of Kansas Blue Cross Blue Shield Association Blue Cross and Blue Shield of Louisiana WellPoint, Inc. CareFirst BlueCross and BlueShield Blue Cross and Blue Shield of Massachusetts Blue Cross and Blue Shield of Kansas City Blue Cross and Blue Shield of Michigan Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Minnesota Blue Cross and Blue Shield of Nebraska Blue Cross & Blue Shield of Mississippi Horizon Blue Cross and Blue Shield of New Jersey, Inc. HealthNow New York, Inc. The Regence Group Excellus Blue Cross and Blue Shield Capital BlueCross Blue Cross and Blue Shield of North Carolina Independence Blue Cross BlueCross BlueShield of North Dakota Highmark, Inc. Blue Cross of Northeastern Pennsylvania BlueCross and BlueShield of Tennessee Blue Cross and Blue Shield of Vermont Blue Cross & Blue Shield of Rhode Island Premera Blue Cross Blue Cross and Blue Shield of South Carolina Blue Cross and Blue Shield of Wyoming Kaiser Permanente Cigna Aetna United WellPoint Humana Capital District Physicians’ Health Plan (CDPHP), Albany, New York Capital Health Plan, Tallahassee, Florida Care Oregon, Portland, Oregon Emblem Health, New York, New York Fallon Community Health Plan, Worcester, Massachusetts Geisinger Health Plan, Danville, Pennsylvania Group Health, Seattle, Washington Group Health Cooperative Of South Central Wisconsin, Madison, Wisconsin Health Partners, Minneapolis, Minnesota Independent Health, Buffalo, New York Kaiser Foundation Health Plan Oakland, California Martin’s Point Health Care, Portland, Maine New West Health Services, Helena, Mt The Permanente Federation, Oakland, California Priority Health, Grand Rapids, Michigan Scott & White Health Plan, Temple, Texas Security Health Plan, Marshfield, Wisconsin Tufts Health Plan, Waltham, Massachusetts UCARE, Minneapolis, Minnesota UPMC Health Plan, Pittsburgh, Pennsylvania |
The White House Blog
More Support for Young Adults Posted by Nancy-Ann DeParle on April 27, 2010 at 12:24 PM EDT http://www.whitehouse.gov/blog/2010/04/27/more-support-young-adults |
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IRS Notice 2010-38 explains these changes and provides further guidance to employers, employees, health insurers and other interested taxpayers.
“These changes give employers a unique opportunity to offer a worthwhile benefit to their employees,” IRS Commissioner Doug Shulman said. “We want to make it as easy as possible for employers to quickly implement this change and extend health coverage on a tax-favored basis to older children of their employees.” |
Tax-Free Employer-Provided Health Coverage Now Available for Children under Age 27
IR-2010-53, April 27, 2010 http://www.irs.gov/newsroom/article/0,,id=222193,00.html |
Q: Who easily it will be implemented by IRS?
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Employees who have children who will not have reached age 27 by the end of the year are eligible for the new tax benefit from March 30, 2010, forward, if the children are already covered under the employer’s plan or are added to the employer’s plan at any time. For this purpose, a child includes a son, daughter, stepchild, adopted child or eligible foster child. This new age 27 standard replaces the lower age limits that applied under prior tax law, as well as the requirement that a child generally qualify as a dependent for tax purposes.
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Tax-Free Employer-Provided Health Coverage Now Available for Children under Age 27
IR-2010-53, April 27, 2010 http://www.irs.gov/newsroom/article/0,,id=222193,00.html |
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[Affordable Care Act]
The notice says that employers with cafeteria plans may permit employees to immediately make pre-tax salary reduction contributions to provide coverage for children under age 27, even if the cafeteria plan has not yet been amended to cover these individuals. Plan sponsors then have until the end of 2010 to amend their cafeteria plan language to incorporate this change. |
Tax-Free Employer-Provided Health Coverage Now Available for Children under Age 27
IR-2010-53, April 27, 2010 http://www.irs.gov/newsroom/article/0,,id=222193,00.html |
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The tax-favored status of group coverage, which provides that employers receive a tax deduction for the premiums or claims they pay and employees are not taxed on the value of those employer contributions, has advantages for firms and their workers.
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Business Insurance
January 18, 2010 Don't make health care taxes more taxing SECTION: NEWS; Pg. 0008 LENGTH: 336 words http://www.lexisnexis.com.remote.baruch.cuny.edu/hottopics/lnacademic/?verb=sf&sfi=AC00NBGenSrch |
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As Congress works on the final details of health care reform legislation, some of those tax changes are taking shape. As we report on page 1, congressional leaders, the White House and organized labor have worked out a deal in which employer-paid premiums above a certain level would be subject to a 40% excise tax. Revenues raised from the tax would be used to help fund federal premium subsidies for the low-income uninsured.
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Business Insurance
January 18, 2010 Don't make health care taxes more taxing SECTION: NEWS; Pg. 0008 LENGTH: 336 words http://www.lexisnexis.com.remote.baruch.cuny.edu/hottopics/lnacademic/?verb=sf&sfi=AC00NBGenSrch |
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As his committee moves closer to considering comprehensive health care reform legislation, Sen. Baucus
Enhanced Coverage Linking Sen. Baucus -Search using: * Biographies Plus News * News, Most Recent 60 Days voiced concerns about the current system in which employers can fully deduct group health care premiums as a business expense and the cost of the premiums is excluded from employees' taxable income. |
May 18, 2009
Lawmakers offer differing views on health care reform future BYLINE: Jerry Geisel LENGTH: 348 words http://www.lexisnexis.com.remote.baruch.cuny.edu/hottopics/lnacademic/?verb=sf&sfi=AC00NBGenSrch |
User as what it used to be-
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While not mentioning them by name, Sen. Baucus
Enhanced Coverage Linking Sen. Baucus -Search using: * Biographies Plus News * News, Most Recent 60 Days suggested tax breaks provided through health savings accounts also should be examined to ensure the benefits are structured fairly and efficiently. Under law, employees can take a tax deduction or reduce their taxable salaries by the amount of their HSA contributions, and accumulated interest on the contributions can be withdrawn tax-free to pay health care-related expenses. |
May 18, 2009
Lawmakers offer differing views on health care reform future BYLINE: Jerry Geisel LENGTH: 348 words http://www.lexisnexis.com.remote.baruch.cuny.edu/hottopics/lnacademic/?verb=sf&sfi=AC00NBGenSrch |
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That doesn't mean, though, that insurers can't raise their overall premiums to pay for the additional cost of covering more people. The government has estimated that extending coverage to adult children will increase family premiums by 0.7% in 2011.
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FINAL EDITION
Want to put your adult child on your insurance? Here's how; Your Money Every Tuesday BYLINE: Sandra Block SECTION: MONEY; Pg. 3B LENGTH: 821 words http://www.lexisnexis.com.remote.baruch.cuny.edu/hottopics/lnacademic/?verb=sf&sfi=AC00NBGenSrch |
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Previously, many insurers placed limits on coverage for older children. Some wouldn't cover children older than age 19 unless they were full-time students; others required older children to live at home to be eligible for coverage.
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FINAL EDITION
Want to put your adult child on your insurance? Here's how; Your Money Every Tuesday BYLINE: Sandra Block SECTION: MONEY; Pg. 3B LENGTH: 821 words http://www.lexisnexis.com.remote.baruch.cuny.edu/hottopics/lnacademic/?verb=sf&sfi=AC00NBGenSrch |
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Now, all children up to age 26 are eligible, as long as they don't have access to an employer-provided plan. "The child doesn't have to be your dependent, doesn't have to be living with you, can be married or unmarried, and doesn't have to be attending school," Abbott says.
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FINAL EDITION
Want to put your adult child on your insurance? Here's how; Your Money Every Tuesday BYLINE: Sandra Block SECTION: MONEY; Pg. 3B LENGTH: 821 words http://www.lexisnexis.com.remote.baruch.cuny.edu/hottopics/lnacademic/?verb=sf&sfi=AC00NBGenSrch |
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The provision takes effect Sept. 23 -- six months after enactment of the health care bill -- but insurers aren't required to offer the extended coverage until they start a new plan year. For plans that operate on a calendar year basis, that means Jan. 1.
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FINAL EDITION
Want to put your adult child on your insurance? Here's how; Your Money Every Tuesday BYLINE: Sandra Block SECTION: MONEY; Pg. 3B LENGTH: 821 words http://www.lexisnexis.com.remote.baruch.cuny.edu/hottopics/lnacademic/?verb=sf&sfi=AC00NBGenSrch |
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If your child is graduating from college this spring and doesn't have a job, talk to your employer or the company that's administering your insurance plan. Your child may need to buy a temporary insurance policy to cover her until your coverage becomes available.
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FINAL EDITION
Want to put your adult child on your insurance? Here's how; Your Money Every Tuesday BYLINE: Sandra Block SECTION: MONEY; Pg. 3B LENGTH: 821 words http://www.lexisnexis.com.remote.baruch.cuny.edu/hottopics/lnacademic/?verb=sf&sfi=AC00NBGenSrch |
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But the health care reform law states that providing extended coverage for adult children isn't taxable, even if they're not dependents, says Tracy Watts, a partner in Mercer's health and benefits business practice.
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FINAL EDITION
Want to put your adult child on your insurance? Here's how; Your Money Every Tuesday BYLINE: Sandra Block SECTION: MONEY; Pg. 3B LENGTH: 821 words http://www.lexisnexis.com.remote.baruch.cuny.edu/hottopics/lnacademic/?verb=sf&sfi=AC00NBGenSrch |
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List
Health care for adult children Nearly 80% of employers don't plan to extend coverage for adult children until required to by law.1 Plan to extend benefits to employees' dependents up to age 26 before the required effective date 16% Plan to extend benefits on the required effective date 78% Don't know 6% 1 -- for companies that offer benefits on a calendar-year basis, the required implementation date is Jan. 1, 2011; Source: Towers Watson |
FINAL EDITION
Want to put your adult child on your insurance? Here's how; Your Money Every Tuesday BYLINE: Sandra Block SECTION: MONEY; Pg. 3B LENGTH: 821 words http://www.lexisnexis.com.remote.baruch.cuny.edu/hottopics/lnacademic/?verb=sf&sfi=AC00NBGenSrch |
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Does it matter if my child is a dependent?
Not in the IRS definition of the word. The law makes it clear that a "dependent" for purposes of health insurance will not follow the tax definition, which demands that the parent pay most of the child's living expenses. According to Laura Baker, principal at Mercer, an employee benefits consulting firm, your child could have a job, be married, be living on his own and supporting himself and still qualify to be covered under your plan. |
Home Edition
PERSONAL FINANCE; Insuring your adult children; Healthcare overhaul extends coverage for offspring, but there are complications. BYLINE: Kathy M. Kristof SECTION: BUSINESS; Business Desk; Part B; Pg. 3 LENGTH: 954 words http://www.lexisnexis.com.remote.baruch.cuny.edu/hottopics/lnacademic/?verb=sf&sfi=AC00NBGenSrch |
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There's one caveat: Anyone, including a working-age child, who has access to employer-provided health insurance at his own job is expected to obtain coverage through his employer.
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Home Edition
PERSONAL FINANCE; Insuring your adult children; Healthcare overhaul extends coverage for offspring, but there are complications. BYLINE: Kathy M. Kristof SECTION: BUSINESS; Business Desk; Part B; Pg. 3 LENGTH: 954 words http://www.lexisnexis.com.remote.baruch.cuny.edu/hottopics/lnacademic/?verb=sf&sfi=AC00NBGenSrch |
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Katerina asks:
Is there anything in the bill that will put increased pressure on insurers like Anthem to back away from their intended 40-50% increases this year or will exchange oversight over such increases only begin years from now? (In other words, is there going to be so much time before regulation kicks in that insurers will be able to jack up their premiums like the credit card companies jacked up their interest rates?) There's nothing the bill will do to roll back past rate increases. But a lot of people are concerned that private insurers will jack their rates up in anticipation of the exchanges. This is not a concern I fully understand, to be honest. The virtue of a competitive market -- that is to say, a market in which it's easy for a lot of people to compare products and prices -- is that this sort of behavior is actually very difficult. |
Will insurers raise rates before health-care reform?
By Ezra Klein | March 22, 2010; 2:29 PM ET http://voices.washingtonpost.com/ezra-klein/2010/03/will_private_insurers_raise_ra.html |
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They way a market normally works is that if five of six players are overpricing their product, the sixth player will decide to get a whole mess of new customers by charging less, and then her competitors will be forced to follow suit lest they lose their market position... In other words, if two plans are holding their costs down and six plans are pushing their costs up, the structure of the subsidies will make it very hard for people to afford the overpriced plans, which will mean those plans will lose millions of customers.
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Will insurers raise rates before health-care reform?
By Ezra Klein | March 22, 2010; 2:29 PM ET http://voices.washingtonpost.com/ezra-klein/2010/03/will_private_insurers_raise_ra.html |
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Update As Jim notes in comments, insurers are exempt from antitrust law (though probably not for long), so collusion wouldn't be illegal. It would just be difficult to uphold.
That said, economist Austin Frakt notices that there's actually a policy that will directly police rate increases. "The rate reviews that take effect this year (85% and 80% loss ratio minimums in the large and small/individual markets, respectively) would be a means by which to cap rate increases," he e-mails. "Consumers are supposed to get rebates if those minimums are exceeded. Thus, the vast majority of rate increases will have to be justified by actual medical expenses." |
Will insurers raise rates before health-care reform?
By Ezra Klein | March 22, 2010; 2:29 PM ET http://voices.washingtonpost.com/ezra-klein/2010/03/will_private_insurers_raise_ra.html |
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According to health insurance provider’s top lobbyist in Washington, Karen Ignani, who is also the president of America’s Health Insurance Plans, the PricewaterhouseCoopers has a good reputation as a world class firm. The study completed by this firm, backed by America’s Health Insurance Plans, states specific numbers of how the health insurance reform will affect Americans. For example, the study states that in the future, the legislation would add at least $1700 a year to family coverage expenses. The premium costs for a single person would increase by $600 if the legislation did not go through.
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Health Insurance Companies Attack Health Care Reform
Submitted by Jenny Decker RN on 2009-10-13 http://www.emaxhealth.com/1272/72/34099/health-insurance-companies-attack-health-care-reform.html |
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Health care reform provisions taking effect in 2011 will drive premium costs higher, predicted Dr. Jeffrey Kang, chief medical officer at CIGNA Corp.
"If you're an employer that is currently covering dependents up to age 23, which is what most employers do, we're estimating the cost impact of covering dependents up to age 26 is roughly a 1.5 percent to 2 percent additional increase in premiums," Kang said. |
Health Care Reform Could Drive Premiums Higher
Stephen Miller. HRMagazine. Alexandria: Jun 2010. Vol. 55, Iss. 6; pg. 15, 1 pgs |
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"If you are an employer that has previously had no coverage of preventive care, then it's about a 3 percent to 4 percent increase on your premiums to introduce that benefit," he continued. "If you are covering preventive services but you have some cost-sharing on those services-whether co-pays or deductibles-then eliminating that cost-sharing may amount to an additional 1 percent to 2 percent increase."
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Health Care Reform Could Drive Premiums Higher
Stephen Miller. HRMagazine. Alexandria: Jun 2010. Vol. 55, Iss. 6; pg. 15, 1 pgs |
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Most companies with 100 or more employees are likely to have lifetime limits of $5 million to $10 million in place, Kang said. "Very few people actually hit that lifetime maximum, so the cost impact for large employers is perhaps only an additional tenth of a percent to a half percent of total premiums," he noted. However, he added that "for smaller employers with low lifetime maximums of $500,000 to $1 million, there could be a significant premium impact. I encourage those employers to consult with their insurance carriers for estimates of what the impact will be from a cost perspective."
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Health Care Reform Could Drive Premiums Higher
Stephen Miller. HRMagazine. Alexandria: Jun 2010. Vol. 55, Iss. 6; pg. 15, 1 pgs |
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low medical loss ratios (MLR)
The Patient Protection and Affordable Care Act establishes new minimum loss ratios for health insurers. Beginning on Jan. 1, 2011, insurers will be required to spend at least 80 cents of every premium dollar paid by individuals and small groups, and no less than 85 cents of premiums collected from large groups, on direct medical care expenses. Insurers that do not meet these thresholds will be required to rebate the difference to policyholders or deduct it from the subsequent year's premiums. |
Insurers get creative to reduce impact of reform
Joanne Wojcik. Business Insurance. Chicago: Apr 26, 2010. Vol. 44, Iss. 17; pg. 3, 2 pgs http://proquest.umi.com.remote.baruch.cuny.edu/pqdweb?did=2027705141&sid=1&Fmt=3&clientId=8851&RQT=309&VName=PQD |
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In anticipation of this change, some health insurers are shifting some cost-containment activities to the medical expense column from the administrative expense column on their ledgers, a report released this month by the chairman of a Senate committee contends.
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Insurers get creative to reduce impact of reform
Joanne Wojcik. Business Insurance. Chicago: Apr 26, 2010. Vol. 44, Iss. 17; pg. 3, 2 pgs http://proquest.umi.com.remote.baruch.cuny.edu/pqdweb?did=2027705141&sid=1&Fmt=3&clientId=8851&RQT=309&VName=PQD |
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The report criticized WellPoint's move, asserting that "boosting medical loss ratios through creative accounting will not fulfill the new law's goal of helping consumers realize the full value of their health insurance payments."
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Insurers get creative to reduce impact of reform
Joanne Wojcik. Business Insurance. Chicago: Apr 26, 2010. Vol. 44, Iss. 17; pg. 3, 2 pgs http://proquest.umi.com.remote.baruch.cuny.edu/pqdweb?did=2027705141&sid=1&Fmt=3&clientId=8851&RQT=309&VName=PQD |
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CIGNA Corp. said it is too early to say how the new MLR minimums will affect the company and, because the definitions still are being developed, the Philadelphiabased insurer doesn't intend to restate its MLR at this time.
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Insurers get creative to reduce impact of reform
Joanne Wojcik. Business Insurance. Chicago: Apr 26, 2010. Vol. 44, Iss. 17; pg. 3, 2 pgs http://proquest.umi.com.remote.baruch.cuny.edu/pqdweb?did=2027705141&sid=1&Fmt=3&clientId=8851&RQT=309&VName=PQD |
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Neither Hartford, Conn. -based Aetna Inc. nor Minnetonka, Minn.based UnitedHealth Group Inc. said they had altered their accounting practices or reclassified administrative expenses, saying they are awaiting a final definition of MLR.
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Insurers get creative to reduce impact of reform
Joanne Wojcik. Business Insurance. Chicago: Apr 26, 2010. Vol. 44, Iss. 17; pg. 3, 2 pgs http://proquest.umi.com.remote.baruch.cuny.edu/pqdweb?did=2027705141&sid=1&Fmt=3&clientId=8851&RQT=309&VName=PQD |
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While consumers and policymakers view low MLRs as evidence that an insurer is spending too much money on administration and profits and not enough on medical care, investors view a declining MLR as an indication that an insurer is reducing its risk and increasing its profit potential.
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Insurers get creative to reduce impact of reform
Joanne Wojcik. Business Insurance. Chicago: Apr 26, 2010. Vol. 44, Iss. 17; pg. 3, 2 pgs http://proquest.umi.com.remote.baruch.cuny.edu/pqdweb?did=2027705141&sid=1&Fmt=3&clientId=8851&RQT=309&VName=PQD |
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CURRENT MEDICAL LOSS RATIO
Expenses now counted in determining an insurer's medical loss ratio * Hospital/medical benefits * Other professional services * Outside referrals * Emergency room and out-of-town medical expenses * Prescription drugs * Aggregate write-ins for other hospital and medical costs * Incentive pool, withhold and bonus amounts, otherwise known as incentives * Net reinsurance recoveries* * Reinsurance recoveries are subtracted from expenses. POSSIBLE ADDITIONAL MEDICAL LOSS RATIO FACTORS Costs that may be added to calculate an insurer's medical loss ratio * Case management activities * Utilization review * Detection and prevention of payment for fraudulent reimbursements * Network access fees to preferred provider organizations and other network-based health plans * Consumer education relating solely to health improvement that relies on direct involvement of medical personnel** * Expenses for internal and external appeals processes ** Indudes smoking cessation and disease management programs Source: National Assn. of Insurance Commissioners |
Insurers get creative to reduce impact of reform
Joanne Wojcik. Business Insurance. Chicago: Apr 26, 2010. Vol. 44, Iss. 17; pg. 3, 2 pgs http://proquest.umi.com.remote.baruch.cuny.edu/pqdweb?did=2027705141&sid=1&Fmt=3&clientId=8851&RQT=309&VName=PQD |
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WASHINGTON--The government's top health official summoned health-insurance chief executives to the White House Thursday and told them they need to disclose more data justifying sharp premium increases.
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White House Confronts Insurers on Premiums; Obama Cites Rising Rates in Push for Health Overhaul, as Industry Executives Say Hospitals, Drug Makers Are to Blame
Janet Adamy, Avery Johnson. Wall Street Journal (Online). New York, N.Y.: Mar 5, 2010. http://proquest.umi.com.remote.baruch.cuny.edu/pqdweb?did=1976171851&sid=5&Fmt=3&clientId=8851&RQT=309&VName=PQD |
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Ms. Sebelius asked the companies to begin posting information online for consumers to explain how much of their revenue goes toward administrative costs, marketing and actual care, along with other details of the rate increases. She called for "greatly increased transparency about what indeed is going on."
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White House Confronts Insurers on Premiums; Obama Cites Rising Rates in Push for Health Overhaul, as Industry Executives Say Hospitals, Drug Makers Are to Blame
Janet Adamy, Avery Johnson. Wall Street Journal (Online). New York, N.Y.: Mar 5, 2010. http://proquest.umi.com.remote.baruch.cuny.edu/pqdweb?did=1976171851&sid=5&Fmt=3&clientId=8851&RQT=309&VName=PQD |
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The two sides couldn't agree whether insurers are highly profitable or just scraping by. Industry executives rolled out data showing their average profit margin was 2.2% last year, lower than other health industries. Ms. Sebelius cited figures showing that top insurers earned a collective $12 billion in profits last year, a 56% increase from the prior year, but that didn't account for one-time gains.
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White House Confronts Insurers on Premiums; Obama Cites Rising Rates in Push for Health Overhaul, as Industry Executives Say Hospitals, Drug Makers Are to Blame
Janet Adamy, Avery Johnson. Wall Street Journal (Online). New York, N.Y.: Mar 5, 2010. http://proquest.umi.com.remote.baruch.cuny.edu/pqdweb?did=1976171851&sid=5&Fmt=3&clientId=8851&RQT=309&VName=PQD |
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The short-term changes that the legislation requires will have a negative impact on insurer profits. Aside from the reduction in government payments to Medicare Advantage plans, insurers will no longer be able to sell policies with lifetime caps on insurance, exclude children from coverage on the basis of pre-existing conditions, or drop adults when they’re sick under a policy known as “rescission.”
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Big Winner in Healthcare Reform? Insurance Companies, Eventually
By Ken Terry | Mar 22, 2010 http://industry.bnet.com/healthcare/10002208/insurance-companies-stand-to-benefit-from-reform-in-long-run/ |
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a requirement that America’s Health Insurance Plans, the insurer trade association, has predicted will lead to an explosion in premiums because the legislation will not create universal coverage. In the early going, premiums are indeed predicted to rise to those who earn too much to merit government subsidies; but other individuals will see their premiums drop, according to the Congressional Budget Office.
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Big Winner in Healthcare Reform? Insurance Companies, Eventually
By Ken Terry | Mar 22, 2010 http://industry.bnet.com/healthcare/10002208/insurance-companies-stand-to-benefit-from-reform-in-long-run/ |
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In the long run, if insurance costs drop, more of the 23 million people (a third of them illegal immigrants) who remain uninsured will be able to afford coverage, and there will be less danger that people will buy it only after they get sick.
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Big Winner in Healthcare Reform? Insurance Companies, Eventually
By Ken Terry | Mar 22, 2010 http://industry.bnet.com/healthcare/10002208/insurance-companies-stand-to-benefit-from-reform-in-long-run/ |
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Also, people who are now covered by their employers will be able to buy insurance through the exchanges if the actuarial value of their plans is less than 60 percent and/or their share of the premiums costs more than 9.8 percent of their income. While it’s unclear how many people will be affected, moving them from a low-benefit employer-provided plan to a higher-benefit individual plan purchased in an insurance exchange should also raise revenues for insurance companies.
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Big Winner in Healthcare Reform? Insurance Companies, Eventually
By Ken Terry | Mar 22, 2010 http://industry.bnet.com/healthcare/10002208/insurance-companies-stand-to-benefit-from-reform-in-long-run/ |
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That’s a very small portion of health plan revenues and will be passed onto employers, in any event. And the $74 billion in other new taxes that will be levied on insurance companies to pay for reform is a rounding error compared to the size of the revenues they’ll get in the next decade.
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Big Winner in Healthcare Reform? Insurance Companies, Eventually
By Ken Terry | Mar 22, 2010 http://industry.bnet.com/healthcare/10002208/insurance-companies-stand-to-benefit-from-reform-in-long-run/ |
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So if this reform bill is so good for insurers, why have they opposed it, and why does the stock market view reform as bad for insurance companies? I think it’s because of short-term thinking: Instead of focusing on how the expansion of coverage will provide new business and shore up a rapidly eroding system, insurance executives and investors only see increased government regulation that will restrict the insurers’ freedom of action.
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Big Winner in Healthcare Reform? Insurance Companies, Eventually
By Ken Terry | Mar 22, 2010 http://industry.bnet.com/healthcare/10002208/insurance-companies-stand-to-benefit-from-reform-in-long-run/ |
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Recently issued regulations specify that a young adult can qualify for this coverage even if he or she is no longer living with a parent, is not a dependent on a parent’s tax return, or is no longer a student.
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Explaining Health Care Reform: Questions About the Extension of Dependent Coverage to Age 26
Information provided by the Kaiser Commission on Medicaid and the Uninsured Publication Number: 8065 Publish Date: 2010-05-12 http://www.kff.org/healthreform/8065.cfm |
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The law also states that young adults can only qualify for dependent coverage through group health plans that were in place prior to March 23, 2010 if they are not eligible for another employer-sponsored insurance plan. In other cases, a young adult can choose to remain insured through a parent’s dependent coverage even if the young adult
is eligible for other employer-sponsored coverage. |
Explaining Health Care Reform: Questions About the Extension of Dependent Coverage to Age 26
Information provided by the Kaiser Commission on Medicaid and the Uninsured Publication Number: 8065 Publish Date: 2010-05-12 http://www.kff.org/healthreform/8065.cfm |
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The dependent coverage extension takes effect on September 23, 2010, six months after the health reform law was enacted. At that time, when insurance plans start a new plan year, they will have to abide by the new dependent coverage rules. The law stipulates that the dependent coverage extension is effective for new plan years beginning on or after September 23, 2010. However, some insurers have said that they will begin to make the extension of dependent coverage available prior to September 2010 for individuals who would otherwise lose coverage.
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Explaining Health Care Reform: Questions About the Extension of Dependent Coverage to Age 26
Information provided by the Kaiser Commission on Medicaid and the Uninsured Publication Number: 8065 Publish Date: 2010-05-12 http://www.kff.org/healthreform/8065.cfm |
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Additional coverage options exist for uninsured young adults who are not able to take advantage of the early
enrollment that some insurers are offering for certain young adults. These young adults may be able to remain on a parent’s plan through COBRA if they aged off a parent’s coverage within the last 60 days. |
Explaining Health Care Reform: Questions About the Extension of Dependent Coverage to Age 26
Information provided by the Kaiser Commission on Medicaid and the Uninsured Publication Number: 8065 Publish Date: 2010-05-12 http://www.kff.org/healthreform/8065.cfm |
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2010cInsurance Reforms
Provide tax credits to small employers with no more than 25 employees and average annual wages of less than $50,000 that purchase health insurance for employees. |
Health Reform Implementation Timeline
Information provided by the Kaiser Commission on Medicaid and the Uninsured and the Health Care Marketplace Project Publication Number: 8060 Publish Date: 2010-06-15 |
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2014
Medicare Reduce Medicare Disproportionate Share Hospital (DSH) payments initially by 75% and subsequently increase payments based on the percent of the population uninsured and the amount of uncompensated care provided. Require Medicare Advantage plans to have medical loss ratios no lower than 85%. |
Health Reform Implementation Timeline
Information provided by the Kaiser Commission on Medicaid and the Uninsured and the Health Care Marketplace Project Publication Number: 8060 Publish Date: 2010-06-15 |
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Establishments with high percentages of jobs where workers make less than $30,000, on average, were generally less likely to offer than other establishments (Figure 2). Offer rates were much higher for firms where less than 90 percent of employees made less than $30,000. In establishments where 90 percent or more of employees made less than $30,000, the offer rate varied between 33 and 91 percent, depending on establishment size.
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Health Benefit Offer Rates and Employee Earnings
October 2008 http://www.kff.org/insurance/snapshot/chcm081508oth.cfm |
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For most establishment size categories, there was a general progression from lower to higher offer rates, as the percentage making less than $30,000 decreased
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Health Benefit Offer Rates and Employee Earnings
October 2008 http://www.kff.org/insurance/snapshot/chcm081508oth.cfm |
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This paper shows that, on average, establishments with lower-wage employees offer health benefits less frequently. For smaller establishments, offer rates are particularly lower when wages are low.
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Health Benefit Offer Rates and Employee Earnings
October 2008 http://www.kff.org/insurance/snapshot/chcm081508oth.cfm |
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NY Governor David Paterson Signs Law Capping Health Insurance Rates
The law, which extends to roughly three million people with small-employer-sponsored coverage or individually purchased policies, forces insurers to petition the New York Insurance Department before they may increase health insurance premiums. The state will then determine within 60 days if the rate increase is warranted. |
NY Gov. David Paterson Signs Bill Limited Health Insurance Premiums
Published: Thu 10 Jun 2010 Wendy Blair http://www.insurancerate.com/ny-gov.-david-paterson-signs-bill-limited-health-insurance-premiums.php |
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Of all the states in the U.S., New York has the highest annual average premiums for policies purchased individually--$6,630 for individuals and $13,296 for families as of 2009, which is over twice the national average, according to industry estimates.
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NY Gov. David Paterson Signs Bill Limited Health Insurance Premiums
Published: Thu 10 Jun 2010 Wendy Blair http://www.insurancerate.com/ny-gov.-david-paterson-signs-bill-limited-health-insurance-premiums.php |
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Saving New Yorkers Money
The new law also forces health insurers to spend at least 82 percent of premiums on health care instead of administrative expenses and profits, an increase from 80 percent for individual policies and 75 percent for small-business health plans. |
NY Gov. David Paterson Signs Bill Limited Health Insurance Premiums
Published: Thu 10 Jun 2010 Wendy Blair http://www.insurancerate.com/ny-gov.-david-paterson-signs-bill-limited-health-insurance-premiums.php |
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Changes Effective for Plan Years Beginning on or after September 23, 2010 or Earlier
Lifetime and annual limits prohibited. Effective for plan years beginning on or after September 23, 2010, lifetime and annual limits on the dollar value of benefits provided under a plan will not be permitted for any benefits that are “essential health benefits.” Essential health benefits include ambulatory services, emergency services, hospitalization, maternity and newborn care, mental health services, substance use disorder services, behavioral health treatment, prescription drug coverage, rehabilitative and habilitative services and devices, laboratory services, preventive care and wellness screenings, chronic disease management, and pediatric services.[16] HHS may, in its discretion, provide exceptions to the annual limit rule prior to January 1, 2014. This prohibition will affect all plans, including grandfathered plans.[17] |
Impact of the new health care reform law: what employers need to know
Neal Gerber & Eisenberg LLP Jeffrey J. Bakker, Patricia S. Cain and Stephanie B. Vasconcellos http://www.lexology.com/library/detail.aspx?g=5b1c9b2f-1265-488e-8678-5d69365c98db |
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Changes Effective for Plan Years Beginning on or after January 1, 2011
Availability of simple cafeteria plan for small employers. Small employers will have the opportunity to adopt a simple cafeteria plan, which will be deemed to satisfy nondiscrimination requirements without the need to satisfy complex numerical tests, starting January 1, 2011. To be eligible to adopt a small cafeteria plan, an employer must generally have an average of 100 or fewer employees during either of the two preceding years. A growing employer can generally continue to sponsor a simple cafeteria plan until it employs an average of 200 or more employees. |
Impact of the new health care reform law: what employers need to know
Neal Gerber & Eisenberg LLP Jeffrey J. Bakker, Patricia S. Cain and Stephanie B. Vasconcellos http://www.lexology.com/library/detail.aspx?g=5b1c9b2f-1265-488e-8678-5d69365c98db |
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An employer sponsoring a simple cafeteria plan must generally permit all employees with at least 1,000 hours of service in the prior year to participate and elect any benefit available under the plan. The employer may, however, exclude employees who have not attained age 21 with one year of service and those covered under a collective bargaining agreement. The employer must also make an annual contribution on behalf of each participant equal to either a uniform level (at least 2%) of compensation or an amount not less than the lesser of (i) 6% of compensation, or (ii) twice the participant’s salary reduction contribution.[25]
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Impact of the new health care reform law: what employers need to know
Neal Gerber & Eisenberg LLP Jeffrey J. Bakker, Patricia S. Cain and Stephanie B. Vasconcellos http://www.lexology.com/library/detail.aspx?g=5b1c9b2f-1265-488e-8678-5d69365c98db |
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III. Other Key Health Care Reform Changes Affecting Employers
Tax credit for small employers. Also effective immediately, certain small employers may qualify for tax credits for providing health insurance coverage to employees. The credits are available only to a company with 25 or fewer full-time equivalent employees earning an annual salary of $50,000 (indexed for inflation after 2013) or less. The company must pay at least half of its employees’ insurance premiums. From 2010 through 2013, the credits can be as high as 35% of the employer’s health care costs (25% for exempt organizations). In 2014 and beyond, credits are raised to as much as 50% of the employer’s health care costs (35% for exempt organizations). However, starting in 2014, employers must purchase coverage through a state health exchange to receive a credit, and the credits will be available for no more than two years. All tax credits are subject to phase-out if the number of employees exceeds 10 and/or the average wages exceed $25,000 (indexed for inflation after 2013). No credits are available for coverage provided to sole proprietors, partners, certain shareholders and owners, and their family members.[33] |
Impact of the new health care reform law: what employers need to know
Neal Gerber & Eisenberg LLP Jeffrey J. Bakker, Patricia S. Cain and Stephanie B. Vasconcellos http://www.lexology.com/library/detail.aspx?g=5b1c9b2f-1265-488e-8678-5d69365c98db |
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Cadillac plans taxed. Effective January 1, 2018, a new 40% excise tax on excess benefits under a “high-cost” or “Cadillac” health plans will take effect. The excess amount is generally equal to the cost of employer sponsored coverage less the applicable annual limitation.
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Impact of the new health care reform law: what employers need to know
Neal Gerber & Eisenberg LLP Jeffrey J. Bakker, Patricia S. Cain and Stephanie B. Vasconcellos http://www.lexology.com/library/detail.aspx?g=5b1c9b2f-1265-488e-8678-5d69365c98db |
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Cafeteria Plan:
One Time Set Up Fee (for both plan types) 1 - 25 employees $400.00 Full Plans with Flexible Spending Accounts 01 - 25 participants: $8.00 per month per participant |
http://www.benefitconsultinginc.com/our_fees.htm
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How do I know if my insurance plan is a "Cadillac plan"? Look at the cost. The finance committee defines high-cost or "Cadillac" as any plan with premiums higher than $8,000 for individuals or $21,000 for families. Keep in mind that these figures include everything you and your employer spend on health care except for the deductible: premiums for medical (the portions paid by you and by your employer), dental, and vision coverage, as well as any money you put into a flexible spending account, which allows you to set aside pretax money to cover medical costs.
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Do I have a "Cadillac Plan"?An Explainer health care FAQ.
By Christopher BeamPosted Wednesday, Oct. 14, 2009, at 6:23 PM ET http://www.slate.com/id/2232434 |
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The maximum credit is 35 percent of premiums paid in 2010 by eligible small business employers and 25 percent of premiums paid by eligible employers that are tax-exempt organizations. In 2014, this maximum credit increases to 50 percent of premiums paid by eligible small business employers and 35 percent of premiums paid by eligible employers that are tax-exempt organizations.
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http://www.irs.gov/newsroom/article/0,,id=220848,00.html
Tax Credits for Small Businesses New for 2010: Tax Credit Helps Small Employers Provide Health Insurance Coverage IR-2010-38, April 1, 2010 |
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The credit is specifically targeted to help small businesses and tax-exempt organizations that primarily employ low and moderate income workers. It is generally available to employers that have fewer than 25 full-time equivalent (FTE) employees paying wages averaging less than $50,000 per employee per year. Because the eligibility formula is based in part on the number of FTEs, not the number of employees, many businesses will qualify even if they employ more than 25 individual workers.
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http://www.irs.gov/newsroom/article/0,,id=220848,00.html
Tax Credits for Small Businesses New for 2010: Tax Credit Helps Small Employers Provide Health Insurance Coverage IR-2010-38, April 1, 2010 |
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