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Affordable Care Act (ACA)

Affordable Care Act for California. Latest news and updates for ACA medical insurance for businesses and individuals

2016 Oct 07

Can an employer contribute different amounts towards employee medical insurance?

By |October 7th, 2016 |Categories: ACA, Large Group Medical Insurance Articles, Small Group Health Insurance|

NOTE: The answer to this question requires compliance with both the HIPAA Nondiscrimination Requirements and the IRS Section 125 Nondiscrimination Rules.  IRS Nondiscrimination Rules apply when employees make pre-tax paycheck contributions for employee benefits using a Section 125 Premium Only Plan (POP). If you are a client of Benefits [...]

2015 Sep 02

Need health insurance outside of the open enrollment period – consider the California Major Risk Plan (MRMIP)

By |September 2nd, 2015 |Categories: Individual Medical Insurance Articles, ACA, Covered California, Health Benefit Exchange|

If you didn't sign up for individual health insurance in California during the open enrollment period, you're not stuck.  A little known state program, Major Risk Medical Insurance Plan (MRMIP), may be your saving grace.  While no insurance company will offer you coverage outside of the open enrollment period unless [...]

2015 Jan 19

Do Employers Need to Give Employees IRS Form 1095-C in 2014 for Health Insurance Coverage in 2014?

By |January 19th, 2015 |Categories: ACA, Health Insurance Reform, Large Group Medical Insurance Articles|

The good news is that in July, 2013 the IRS issued Notice 2013-45 which gave large employers “transitional relief” from the “shared responsibility” penalties.... Accordingly, neither the reporting requirements nor the employer shared responsibility provisions apply for 2014.

2014 Nov 25

Group Health Insurance Rates Increase for 2015

By |November 25th, 2014 |Categories: ACA, Health Insurance Reform, Large Group Medical Insurance Articles, Small Business Articles|

Last week the Los Angeles Times reported that large employers estimate that the cost of group health insurance will increase about 5% in 2015. I was quoted in the last two paragraphs of the article, talking about the 2015 rate increases for California small businesses. We've seen rates increase from a few percent to twenty percent depending on the characteristics of the employees. While there are winners and losers among California employers; we have been able to change our clients to different insurance companies and different plans so that in most cases they won't have any increase and many of our clients will pay less for group health insurance in 2015 than they did in 2014.

2014 Nov 07

For the Third Time DOL & IRS say an Employer Can NOT reimburse employees for individual health insurance plans

By |November 7th, 2014 |Categories: (SHOP) Covered California Small Business Articles, ACA, Health Insurance Reform, Individual health insurance vs group health insurance, Individual Medical Insurance Articles, Large Group Medical Insurance Articles, Small Business Articles|

Today the U.S. Department of Labor released yet another notice/guidance/ "FAQ" instructing employers that "an employer health care arrangement cannot be integrated with individual market policies to satisfy the market reforms."  Obstinate vendors continue to push their high cost TPA services and claim that an employer can cancel a [...]

2014 Oct 08

Vivity: the new hope for health care

By |October 8th, 2014 |Categories: ACA, Changes in Medical Care, Large Group Medical Insurance Articles, Small Business Articles|

Right before my eyes I saw the top executives from the top hospitals with the top executive from the top insurance company pledge to offer high quality medical care at lower cost. They described how they have aligned incentives for everyone to provide top patient care. If they can do that cost-effectively, they will share in the savings. If not, they will collectively share in the loss...This is a game-changer for health insurance.

2014 Oct 05

Group Health Insurance vs Individual Coverage: Compare After-Tax Cost, Provider Networks & Plan Benefits

By |October 5th, 2014 |Categories: ACA, Covered California, Health Insurance Reform, Individual health insurance vs group health insurance, Individual Medical Insurance Articles, Large Group Medical Insurance Articles, Small Business Articles|

Perhaps a company could give employees a salary bonus or "taxable discretionary wellness stipend" so that employees can buy their own individual medical coverage. If you’re considering a salary bonus or "wellness stipend" for employees to purchase their own individual medical insurance you should consider the following... Tax and worker’s comp savings are THE major reasons that companies sponsor group health insurance plans rather than offering a taxable stipend or salary bonus...A salary bonus or taxable wellness stipend for health insurance is extremely tax inefficient and forces employees to purchase inferior health insurance plans in the individual market.

2014 Aug 15

Should a company reimburse employees’ INDIVIDUAL health insurance cost rather than sponsor a GROUP medical plan?

By |August 15th, 2014 |Categories: ACA, Covered California, Health Benefit Exchange, Health Insurance Reform, Individual Medical Insurance Articles, Large Group Medical Insurance Articles, Small Business Articles|

With the high cost of health insurance many companies are considering alternative financing arrangements to group health plans.   The Affordable Care Act (i.e., ACA, Obama Care, Health Care Reform) created exchanges to help individuals purchase their own coverage.  Also, the ACA forbids insurance companies from asking questions about preexisting [...]

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