Reform Update: More on Employer Shared Responsibility

Q & A:  Employer Shared Responsibility

Starting in 2015, employers of at least 50 full-time employees will be subject to the Employer Shared Responsibility provisions under section 4980H of the Internal Revenue Code (added to the Code by the Affordable Care Act).

Q. I understand that the Employer Shared Responsibility provisions apply only to employers employing at least a certain number of employees. How many employees must an employer have to be subject to the Employer Shared Responsibility provisions?

A. To be subject to the Employer Shared Responsibility provisions for a calendar year, an employer must have employed during the previous calendar year at least 50 full-time employees or a combination of full-time and part-time employees that equals at least 50.

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New 51-100 Choice Portfolio Hitting Stride

Health Net’s first-on-the-market sales solution presenting big opportunities.

New 51-100 Choice Portfolio

The new 51–100 Choice offering from Health Net has hit the ground running…fast! Powered by ingenuity and the flexibility to give employers choices tailored to groups of 51–100 eligible employees, this first-on-the-market portfolio has created great new opportunities to create new sales!

51-100 Choice: Win-win advantages!

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Premium Payment Extension!

Western Region Brokers Individual & Family Plans

15th of Month Premium Payment Extension

Health Net changes initial premium payment deadline to the 15th of the effective month – February through May – for all consumers enrolling via Covered California, Cover Oregon and the Health Insurance Marketplace in Arizona.

In an effort to connect more consumers with affordable health insurance coverage, Health Net is extending the initial premium payment deadline for all members enrolling through the new marketplaces for February through May effective dates. The new 15th of the effective month deadline gives consumers nearly three weeks longer to pay.

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Premium Payment Deadline Extension Clarification: Arizona

For Arizona Brokers

Arizona Individual & Family Plans

Health Net of Arizona, Inc. and Health Net Life Insurance Company (“Health Net”) extend initial premium payment deadline to January 31, 2014 for consumers who enrolled via the Health Insurance Marketplace for a January 1, 2014 or February 1, 2014 effective date.

In our rush to share the good news about the extension, we didn’t spell out the facts as clearly as we intended. Today, we are following up on our January 15, 2014 post to ensure you have the details you and your clients need.

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Clarification on Premium Payment Deadline Extension: California

For California Brokers

California Individual & Family Plans

Health Net of California extends initial premium payment deadline to January 31, 2014 for consumers who enrolled via Covered California for a January 1, 2014 or February 1, 2014 effective date.

In our rush to share the good news about the extension, we didn’t spell out the facts as clearly as we intended. Today, we are following up on our January 15, 2014 post to ensure you have the details you and your clients need.

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Important Notice Regarding California SBG January Renewal Premium Bills

For California Brokers

California SBG employer groups renewing January 2014 may receive bills that show an incorrect monthly premium due – one that reflects the premium amounts for their 2013 plan. This issue primarily affects HMO plan premiums effective January 1, 2014.

Groups are being instructed to pay the premium amount shown on their bill by the stated due date in order to maintain continuous health care coverage.

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Reform Q & A: New Cost-sharing Limitations

Background information


Public Health Service (PHS) Act section 2707(b), as added by the Affordable Care Act, provides that a group health plan shall ensure that any annual cost-sharing imposed under the plan does not exceed the limitations provided for under section 1302(c)(1) and (c)(2) of the Affordable Care Act.

Section 1302(c)(1) limits annual cost-sharing amounts for plan or policy years beginning in 2014 to $6,350 for self-only coverage and $12,700 for coverage of two or more enrollees. The term “cost-sharing” includes deductibles, coinsurance and copayments, but does not include premiums, balance billed amounts for non-network providers, or spending for non-covered services.

Section 1302(c)(2) limits deductibles for small business employer-sponsored plans to $2,000 for self-only coverage and $4,000 for coverage of two or more enrollees.

 

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Reform Update: Reporting Minimum Value

Options for employers, what Health Net is doing

 

The Affordable Care Act requires that employers notify current employees about the health insurance marketplaces (Marketplaces) by October 1, and notify employees hired after that date at the time of hire. The notice includes stating whether a group health plan meets the minimum value standard.

The minimum value standard is applicable to plans effective January 1, 2014 and later. However the notice has to go out in 2013, causing confusion for many about whether to report minimum value for current 2013 coverage or planned 2014 coverage. Initial guidance from regulators has not been clear.

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Update to Health Net’s Notice of Privacy Practices (NOPP)

Safeguarding your client’s privacy and protected health information is a top priority at Health Net. To do this, we continually update our privacy practices to comply with current laws and regulations. The department of Health and Human Services (HHS) has stated that health plans with access to Personal Health Information (PHI) must update their NOPP – and post it on their websites – to reflect the changes listed below by September 23, 2013.

 

Health Net’s updated NOPP can now be found on the website at www.healthnet.com > Privacy > Notice of Privacy Practices.

 

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Reform Update: Essential Health Benefits (Final Rule)

Essential Health Benefits, Actuarial Value & Accreditation Standards

 

Background information

On February 20, 2013, the U.S. Department of Health and Human Services (HHS) released a final rule that details standards for health insurers related to coverage of essential health benefits (EHBs) and actuarial value. In addition, the final rule includes a timeline for qualified health plans to be accredited in the federally-facilitated exchange and provides an application process for the recognition of additional accrediting entities for purposes of certifying qualified health plans.

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