New California Health Insurance Exchange Marketplace.

July 13, 2013 by Frank West

In the next few months you will be hearing about “Exchanges” for businesses & individuals on TV
and radio. The California health insurance exchange will begin to offer plans and enrollment after October 1st. with coverage taking effect January 1, 2014. The new marketplace will offer California Exchange and Off-Exchange health plans in addition to existing private plans. All new health plans will be offered on a guaranteed acceptance basis with all pre-existing conditions covered. More Exchange & Off-Exchange benefit details and rates should be available by August . It usually will only make sense for you to move to a health plan in the State Exchange if you are eligible for a tax subsidy. The Cal State exchange premium assistance offered is only for those who fall between 133% to 400% of the Federal Poverty Level based upon household income.
You can count on us! We’re your key health reform and exchange resource. We are ready to assist you every day–on the phone and in person providing you with time and cost saving programs. Please call us before you do anything with your current coverage and I will advise you on the best course of action that will provide quality coverage and save you money.

You may be better off keeping your existing health plan or alternatively consider the Off-Exchange and California Health Insurance exchange plans which may save you money and provide enhanced benefits. Our services will assist you in applying for a possible tax subsidy, selecting the best health plan, and enrollment process.

Thank you again for the pleasure of being of service and for your business!

Kind Regards,
Frank West

For fast online quotes, benefit details, & applications for health,
group health, medicare supplement, dental, and life insurance
please visit: https://frankwestinsurance.com

Frank West Insurance Services, LLC Ca Lic. # OG23770
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P.O. Box 721090 San Diego, Ca 92172
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Check Out The Following Informative Summaries:
Health Care Reform: What is a health insurance
exchange?
https://frankwestinsurance.com/health-care-reform-what-is-a-health-insurance-exchange/#comments

Individual Health Care Mandate Q&A
https://frankwestinsurance.com/individual-health-care-mandate-qa/#comments

Filed Under: Affordable Care Act, Health Care Reform, Health Insurance Exchange, San Diego Health Insurance Tagged With: Affordable Care Act, Health Care Reform, Health Insurance Exchange, individual mandate

Administration quietly announces another PPACA delay.

July 9, 2013 by Frank West

For a year, consumers will be on the honor system for subsidies under the Patient Protection and Affordable Care Act.

That’s what the Obama administration quietly announced Friday, days after unexpectedly announcing they would delay the employer mandate penalty for another year.

In a new 606-page rule published Friday, the administration said they would significantly scale back on the law’s requirements that the new exchanges verify consumers’ income and health insurance status until 2015, when stronger verification systems are in place.

In the meantime, the government will rely on consumers’ self-reported information.

Health insurance exchanges set up under PPACA are set to begin open enrollment Oct. 1. Enrollees with incomes ranging from 100 percent to 400 percent of the federal poverty line are eligible to receive tax subsidies to help them buy insurance. They also must not have access to insurance through their employer to qualify.

“The exchange may accept the applicant’s attestation regarding enrollment in eligible employer-sponsored plan . . . without further verification,” according to the final rule.

The administration has said they would conduct random checks to verify whether new applicants receive employer-sponsored insurance benefits, while also verifying income status.

But the new regulations from the Department of Health and Human Services said the 17 state-based exchanges would have until 2015 to do random checks, citing “legislative and operational barriers.”

In all 50 states, though, the federal government will scale back oversight of what applicants say they earn.

That move, some critics say, could lead some consumers to under report their income in order to qualify for federal tax subsidies, at least in states that are not expanding Medicaid coverage.

In the same rule, the government said it would give states until 2015 to roll out electronic notices because “states are at different places in the development of their eligibility and enrollment systems,” HHS said.

The rule is the latest setback in the health care overhaul law.

Last week, the administration announced it would not require employers with 50 workers or more to provide insurance benefits until 2015, a move business groups applauded but Republicans slammed as confirmation that “Obamacare costs too much and it isn’t working the way the administration promised.”

The administration has said the exchanges and other parts of the law are on target, and they are making delays and changes to better suit the public and employers.

Troy Underwood, CEO of Benefits Connect in Rancho Cordova, Calif. said, though, that he expects to see more PPACA delays and missed deadlines as the months go by.

“Platitudes, political favors and hope never replace a solid and realistic plan,” Underwood said. “As an expert in the processing and administration of employee benefits I can tell you the government’s efforts, even if well-intentioned, are grossly inefficient.

Filed Under: Affordable Care Act, Health Care Reform, Health Insurance Exchange, San Diego Health Insurance Tagged With: Affordable Care Act, Health Care Reform, Health Insurance Exchange

Patient Protection and Affordable Care Act (PPACA) Trainwreck.

July 3, 2013 by Frank West

The Obama administration’s move to delay until 2015 a requirement that employers offer health insurance or else face stiff penalties is yet another indication that the embattled law is a failure and should be repealed, Republicans and conservatives said on Tuesday.

“The president’s healthcare law is already raising costs and costing jobs,” House Speaker John Boehner said. “This announcement means even the Obama administration knows the ‘train wreck’ will only get worse.

“I hope the administration recognizes the need to release American families from the mandates of this law as well,” the Ohio Republican said. “This is a clear acknowledgment that the law is unworkable, and it underscores the need to repeal the law and replace it with effective, patient-centered reforms.”

“Obamacare costs too much and it isn’t working the way the administration promised,” said Senate Minority Leader Mitch McConnell of Kentucky. “The White House seems to slowly be admitting what Americans already know: Obamacare needs to be repealed and replaced with common-sense reforms that actually lowers costs for Americans.”

And Barney Keller, spokesman for the Club for Growth, called the delay “a transparently political ploy to help the Democrats who voted for it avoid the consequences at the ballot box in 2014. This just helps make the case that Obamacare should be completely repealed — period, exclamation point.”

The IRS, which is charged with implementing Obamacare, remains under fire for widespread mismanagement and for the targeting of tea party, conservative, and religious groups in evaluating their applications for tax-exempt status.

And the American Action Forum, a Washington advocacy group, said that Obamacare had so far cost a total of $30.8 billion and 111.4 million hours for completing paperwork alone.

The group said 55,742 employees — working 2,000 hours per year — would be needed to process all the red tape associated with Obamacare.

While the employer mandate was delayed with Tuesday’s announcement, the individual mandate — which requires individuals to obtain health insurance — presumably remains on schedule for 2014.

Filed Under: Affordable Care Act, Health Care Reform, Health Insurance, Health Insurance Exchange, San Diego Health Insurance Tagged With: Affordable Care Act, Health Care Reform

Can a state force business onto an health exchange?

July 3, 2013 by Frank West

Can a state force business onto an health insurance exchange?

Rep. Darrell Issa, R-Calif. (File photo)

Republicans are asking whether officials in Vermont and the District of Columbia really have the authority to force some or all health insurance business onto the new Patient Protection and Affordable Care Act (PPACA) exchanges.

Rep. Darrell Issa, R-Calif., and other leaders of the House Oversight and Government Reform have sent a letter asking about local officials’ ability to shut down non-exchange markets to U.S. Health and Human Services (HHS) Secretary Kathleen Sebelius.

The lawmakers also have sent similar letters asking about the matter to officials in Vermont and the District of Columbia.

D.C. officials are trying to get all individuals to buy coverage through its district-based exchange, and for all small groups to get their coverage through the exchange by 2015. Health insurance agents and brokers could still sell the coverage but would have to work with the exchange.

Vermont is trying to move its individual and small-group markets onto the Vermont exchange.

The D.C. proposal and the Vermont proposal are “inconsistent with principles of consumer choice and competition,” Issa and colleagues wrote in the letters.

State or D.C. efforts to eliminate non-exchange markets conflict with PPACA, which states that nothing in PPACA is supposed to keep companies from selling coverage outside an exchange or to keep individuals from buying coverage outside an exchange, the lawmakers said.

The D.C. and Vermont efforts to shut down non-exchange markets “violate the principle of voluntary participation in exchanges that was codified in PPACA and reaffirmed in your guidance when you wrote that ‘participation in a [small business exchange] is strictly voluntary for small employers,” the lawmakers told Sebelius.

D.C. officials have argued that they need to unify their individual and small-group markets on the district’s exchange because the district is too small to have successful, separate exchange and non-exchange markets.

In Vermont, state officials told the Associated Press that they believe PPACA gives states broad authority over regulation of any non-exchange health insurance markets under their jurisdiction and clearly gives states the authority to impose rules that are more strict than the rules imposed by PPACA.

Filed Under: Affordable Care Act, Health Insurance Exchange Tagged With: Health Care Reform, Health Insurance Exchange, Obamacare

Boehner: Obamacare ‘Train Wreck,’ ‘Unworkable’.

July 3, 2013 by Frank West

The announcement tonight of the delay of part of the implementation of Obamacare prompted Speaker of the House John Boehner to release this statement, saying the entire bill is a “train wreck” and “unworkable.”

“The president’s health care law is already raising costs and costing jobs. This announcement means even the Obama administration knows the ‘train wreck’ will only get worse. I hope the administration recognizes the need to release American families from the mandates of this law as well. This is a clear acknowledgment that the law is unworkable, and it underscores the need to repeal the law and replace it with effective, patient-centered reforms,” the statement reads.

Filed Under: Affordable Care Act, Health Care Reform, Health Insurance Exchange Tagged With: Affordable Care Act, Health Insurance Exchange, individual mandate, Obamacare

White House delays employer mandate requirement until 2015.

July 3, 2013 by Frank West

White House delays employer mandate requirement until 2015

By Sarah Kliff, Updated: July 2, 2013

The Obama administration will not penalize businesses that do not provide health insurance in 2014, the Treasury Department announced Tuesday.

Instead, it will delay enforcement of a major Affordable Care Act requirement that all employers with more than 50 employees provide coverage to their workers until 2015.

(Photo by Jessica Rinaldi/Reuters)

The administration said it would postpone the provision after hearing significant concerns from employers about the challenges of implementing it.

“We have heard concerns about the complexity of the requirements and the need for more time to implement them effectively,” Mark Mazur, Assistant Secretary for Tax Policy, wrote in a late Tuesday blog post. “We recognize that the vast majority of businesses that will need to do this reporting already provide health insurance to their workers, and we want to make sure it is easy for others to do so.”

The Affordable Care Act requires all employers with more than 50 full-time workers provide health insurance or pay steep fines. That policy had raised concerns about companies downsizing their workforce or cutting workers’ hours in order to dodge the new mandate.

In delaying the enforcement of that rule, the White House sidesteps those challenges for one year. It is also the second significant interruption for the Affordable Care Act, following a one-year delay on key functions of the small business insurance marketplaces.

Together, the moves could draw criticism that the administration will not be able to put into effect its signature legislative accomplishment on schedule.

Filed Under: Affordable Care Act, Group Health Benefits, Group Health Insurance, Health Insurance Exchange Tagged With: Affordable Care Act, Group Health, Group Medical Insurance, Health Care Reform, Health Insurance Exchange, Obamacare

15 PPACA provisions that will take effect in 2014.

June 27, 2013 by Frank West

The effective date of the Patient Protection and Affordable Care Act (PPACA) was March 23, 2010, although various provisions have their own effective dates from January 1, 2010, (the small business income tax credit) through 2018. The start of 2013 saw the launch of a number of key provisions, among them Medicare tax increases, limits on Health FSA deferrals and the requirement that W-2 reporting note employer and employee payments for certain health care items in 2012.

But 2014 is the year when most core pieces of PPACA will be put into effect, notably the mandates that employers with 50+ employees provide health insurance and that individuals obtain minimum essential health coverage for themselves and their dependents, whether or not they have access to coverage through their employer.

Equally momentous, beginning Jan. 1, 2014, states are required to have opened a state-run health insurance exchange, or to have partnered with the federal government to open an exchange. In theory, within these exchanges, insurance companies will compete for business on a transparent, level playing field, which should reduce costs and give individuals and small businesses the purchasing power enjoyed by big businesses. However, health reform does many things to increase costs by covering those who are now uninsurable and by increasing mandated benefits. Many predict these factors will far outweigh any efficiencies created by the exchanges and that health insurance prices will increase. If exchanges succeed, they will create the first viable alternative to the group markets for the younger than age sixty-five population.

Filed Under: Affordable Care Act, Health Care Reform, Health Insurance, Health Insurance Exchange Tagged With: Affordable Care Act, Health Care Reform, Health Insurance Exchange

Why a Health Insurance Penalty May Look Tempting.

June 22, 2013 by Frank West

Why a Health Insurance Penalty May Look Tempting .

Often, when the government wants you to do something, it makes you pay if you don’t. That would seem to be the case with Obamacare, which penalizes companies for not providing health care. But in that penalty, there could be a paradoxical result: dropping health coverage could save companies a lot of money.

$11,429

Employer portion of family health benefit, average current cost

$2,000

Employer penalty for not providing benefits under Obamacare

Once new health insurance exchanges are up and running in October, companies with 50 or more full-time employees will face a choice: Provide affordable care to all full-time employees, or pay a penalty. But that penalty is only $2,000 a person, excluding the first 30 employees. With an employer’s contribution to family health coverage now averaging $11,429 a year, taking that penalty would seem to yield big savings.

Yet there may be costs in employee satisfaction, especially if companies don’t raise pay enough to keep workers whole when they buy insurance on the exchanges.

“No one wants to drop health insurance and have unhappy employees,” says Rick Wald, who heads Deloitte’s employer health care consulting practice.

Few experts see immediate, big changes to existing employer-sponsored coverage. But that may change in time. A generation ago, defined-benefit pensions were prevalent. Not so today.

So why did the government set the penalty at $2,000?

Policy experts don’t agree on the rationale, and the White House didn’t respond to requests for comment. Perhaps the intent was to start a gradual shift from employer-sponsored coverage to the new exchanges. Or maybe the low amount was a compromise needed to pass the law.

Whatever the reason, the government is about to conduct a huge experiment in corporate decision-making.

By ANNA BERNASEK Published: June 22, 2013 New York Times Business Daily

Sources: 2012 Employer Health Benefits survey from the Kaiser Family Foundation and Health Research and Educational Trust; the Affordable Care Act

Filed Under: Group Health Benefits, Health Insurance Exchange Tagged With: Group Health, Group Medical Insurance, Health Insurance Exchange

What to Expect of the Small-Business Insurance Exchanges.

June 21, 2013 by Frank West

Looking to buy a small group plan from your state’s new health-insurance exchange? There’s a risk it won’t be ready to open on time in October.

A report released Wednesday from U.S. Government Accountability Office said that officials still have big tasks to complete, including reviewing plans that will be sold in the exchanges and training and certifying consumer aides who can help small businesses and individuals find plans. (See related article, “Health-Insurance Exchanges Are Falling Behind Schedule.”)

Eleven percent of 783 firms with less than $20 million in annual revenue said that their biggest concern regarding the health-care law is how the insurance exchanges will operate, according to an April survey by The Wall Street Journal and Vistage International Inc., a San Diego-based executive-mentoring group. That compares with 33% who said the cost of health care is their top concern.

If you own a small business and are looking to purchase a small-group plan from your state’s exchange, here’s what you need to know:

Is my small business eligible to buy insurance from an exchange?

The exchanges are limited to only businesses with 100 or fewer full-time-equivalent employees. Full-time equivalent is the number of employees on full-time schedules plus the number of employees on part-time schedules, converted to a full-time basis.

How would an exchange benefit my business?

The small-business exchanges are expected to make it easier for small employers to manage their health-benefits programs. An employer could make a single payment to an exchange, which would disburse the money to the various insurance providers covering its staff, among other benefits.

Also, small group plans purchased through an exchange could be less expensive than what’s available in the private marketplace. This is because the exchanges are expected to attract a large pool of participants, which theoretically would create more competition among insurers, thus resulting in lower insurance premiums.

Husband-and-wife business owners Chris and Maria Guertin of Minneapolis are among those hoping to find a small-group insurance plan within their budget through their state’s exchange. They say they currently can’t afford one to cover themselves, their one full-time employee and any recruits they hire in the future for Sport Resource Group Inc., a retail and wholesale company they started in 2006. But they would like to be able to offer health insurance as an employee benefit to attract and retain top talent in order to grow the business. “A group plan right now is too much,” says Mr. Guertin.

Who’s running the exchanges?

Seventeen states are running their own small business exchanges, with the federal Centers for Medicare and Medicaid Services carrying out the task on behalf of the remaining 33 states. For more information on the exchange in your state, visit www.healthcare.gov/marketplace.

What kind of plans will the exchanges offer?

The exchanges will offer insurance plans from private insurance companies. For 2014, employers in states where the federal government is running the exchange will be able to select just one plan to offer to workers. Which carriers will be participating and how many will vary by state. In some states, such as New Hampshire, only one insurance carrier has expressed interest in the small-business exchange.

When will I be able to start using my state’s exchange?

Though enrollment is slated to begin in October of this year, with plans to take effect in January 2014, the GAO report suggests they may not open in time. The 17 states running their own exchanges were late on an average of 44% of key activities that were originally scheduled to be completed by the end of March, it said.

There have been other setbacks as well. The federal government said in April that contrary to initial plans, it wouldn’t allow workers in the first year to choose between a range of insurance options offered through employers. For the first year, companies will select one plan to offer to workers.

Also, in some states only one insurance carrier has expressed interest in the small-business exchange. For example, regulators in New Hampshire have said they received applications from only one carrier, Anthem Blue Cross and Blue Shield, a unit of WellPoint Inc., WLP +2.48%to sell small group plans or individual policies next year. And in Washington state, officials have had to postpone the exchange altogether because they couldn’t find a carrier willing to offer small-business plans for all parts of the state.

Can I get a tax credit?

If you have fewer than 25 full-time equivalent employees, you may qualify for a tax credit of up to 35% of your premium costs this year and up to 50% in 2014.

Do I even need to buy a small-group plan?

Once your firm reaches 50 full-time equivalent employees, a penalty will kick in if you fail to provide coverage for employees who average 30 or more hours a week in a given month, starting in January. The penalty is $2,000 for each full-time employee in excess of 30 full-time employees. There are no penalties if part-time employees are not offered coverage. The government will rely on data about the composition of employers’ workforces this year in order to determine whether a firm will be liable.

Also, if an employer with 50 or more full-time equivalent employees does offer coverage, but the insurance doesn’t meet the law’s minimum requirements, there is a penalty of $3,000 for each worker who gets a federal subsidy through state insurance exchanges.

Write to Sarah E. Needleman at sarah.needleman@wsj.com

Filed Under: Group Health Benefits, Group Health Insurance, Health Insurance Exchange Tagged With: Group Health, Group Medical Insurance, Health Insurance Exchange

Can a state force business onto an health insurance exchange?

White House delays employer mandate requirement until 2015

By Sarah Kliff, Updated: July 2, 2013

Why a Health Insurance Penalty May Look Tempting .

By ANNA BERNASEK Published: June 22, 2013 New York Times Business Daily

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