Obamacare: Practical Matters and the 5 Paths to Coverage

Posted on 24, Oct | Posted by gabrielle

As we enter into November of 2013 confusion about the Affordable Care Act prevails, but that’s not surprising, as there are a ton of new things to learn in order to understand how to make good decisions regarding health insurance coverage that’s right for you.

Public Law 111–148 The Patient Protection and Affordable Care Act passed into law on March 23, 2010 Since that date, there have been changes each year in health insurance, health care delivery and tax requirements. It is these three areas where most people have questions. Everyone is asking the right questions, though it’s not always easy to get answers. This article will explore some of those questions and provide practical answers.

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Michigan and the Health Insurance Exchange under PPACA

Posted on 13, Sep | Posted by gabrielle

The health insurance exchange is the Web-based portal through which individuals and small employer groups can comparison shop for “qualified” health insurance plans.

In November 2011 the Michigan Senate approved SB693 to set up Michigan’s exchange however, the Michigan House decided not to consider the measure until after the presidential elections on November 6th. States are required to submit a plan to run an exchange to the Federal Government by November 16th. The exchange must be functioning and available to begin accepting enrollments by October 1, 2013.

Gov. Rick Snyder has decided that in order to meet the deadlines, Michigan will accept the Federal-State Partnership to develop and run the Michigan Exchange. This brings $9.8 billion to the table in Federal Grant money for development of the Health Insurance Exchange. With this type of State-Federal partnership that Michigan could eventually convert to a fully state-run exchange.

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Business Owners – Is your company eligible for the Health Insurance Tax Credit for 2011??

Posted on 30, Nov | Posted by gabrielle

Here is information I have shared in the past. Always good to have a refresher. This is about the Health Insurance Tax Credit.

Eligible businesses may receive a credit worth up to 35% of their premium costs this year, increasing to 50% in 2014.

Eligibility requirements:

  • Qualifying employers must pay at least half the health care cost (single employee rate) for full-time employees
  • Qualifying employers must employ fewer than the equivalent of 25 full-time workers
  • Average annual employee wages (not including the owner’s or family members’) must be below $50,000

To learn more and to verify whether your business qualifies, contact your tax professional or go to irs.gov and click on “Affordable Care Act Tax Provisions.”

To review all your employee benefit issues and health insurance needs, contact Gabrielle at (616) 732-9000.

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Michigan’s 1% Claims Tax, Coming to your health insurance premium in January 2012

Posted on 30, Sep | Posted by gabrielle

Governor Snyder recently signed into law, Public Act 142. This law adds a 1% medical claims tax to our health insurance premiums starting in January 2012. Blue Cross and Blue Shield has put together a good FAQ regarding how this will work. This is a 1% tax on all medical, pharmacy and dental claims to a maximum of $10,000 in tax per insured for services received IN Michigan by a Michigan Resident. We won’t be taxed on claims that fall under our deductible, co-pays or co-insurance, costs we pay out-of-pocket or are reimbursed through HSA, HRA, Flexible Spending or other reimbursement arrangements. The tax is collected through the insurance company or third-party administrator and will be passed on to the consumers as a separate line item on the monthly premium invoices.

For Fully-Insured Groups and Individual Insureds the amount won’t be specific to your claims but will be an added cost based on all the claims for all the groups/individuals in your “risk pool” at your insurer.

For Self-Funded groups it looks like the insurer will figure the tax per client group based on actual claims paid the prior month. This could end up being a fairly large number if a group has a large claims month.

This new tax will be an additional cost over Premiums and Premium increases for 2012.

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