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HSA 2018 Limits

HSA 2018 Limits

HSA 2018 Limits

The IRS has released the 2018  Health Savings Account (HSA) inflation adjustments. To be eligible to make HSA contributions, an individual must be covered under a high deductible health plan (HDHP) and meet certain other eligibility requirements.

New HSA 2018  limits are as follows:

HSA Annual Contribution Limit:

 Single –  $3,450 ($3,400 in 2017)

Family – $6,900 ($6,750 in 2017)

Catch-up – $1,000 ($1,000 in 2017) for age 55+.

HDHP Minimum Annual Deductible: 

Single – $1,350  

Family – $2,700 

HDHP Out-of-Pocket Maximum: 

Single – $6,650 ($6,550 in 2017)

Family – $13,300 ($13,100 in 2017)

Age 55 Catch Up Contribution-As in 401k and IRA contributions, you are allowed to contribute extra if you are above a certain age. If you are age 55 or older by the end of year, you can contribute additional $1,000 to your HSA. If you are married, and both of you are age 55, each of you can contribute additional $1,000.

HSA/HDHP Market Growth

HSA holders own the assets in the accounts and can build up substantial sums over time.  Enrollment in HSA-compatible insurance plans has increased to 10 million earlier this year, from 1 million in March 2005, according to, America’s Health Insurance Plans (AHIP), a trade group.

HSAs were authorized starting in January 2004. Since then, AHIP has conducted a periodic census of health plans participating in the HSA/HDHP market.

  • The number of people with HSA/HDHP coverage rose to more than 11.4 in January 2011, up from 10.0 million in January 2010, 8.0 million in January 2009, and 6.1 million in January 2008.
  •  30 percent of individuals covered by an HSA plan were in the small group market, 50 percent were in the large-group market, and the    remaining 20 percent were in the individual market.
  •  14% of all workers in the private sector that have access to a Health Savings Account acc. to Bureau of Labor Statistics.
  •  States with the highest levels of HSA/HDHP enrollment were California, Ohio, Florida, Texas, Illinois and Minnesota.

HSA Advantages:

  • Opportunity to build savings – Unused money stays in your account from year to year and earns tax-free interest. The HSA also gives you an investment opportunity.
  • Tax-free contributions and earnings – You don’t pay taxes on contributions or earnings.
  • Tax Free Money allowed for non traditional Medical coverage– As per IRS Publication 502, unused moneys can be used  for dental,vision, lasik eye surgery, acupuncture, yoga, infertility etc.  Popular Examples
  • Portability – The funds belong to you, so you keep the funds if you change jobs or retire.

Our overall experience with HSAs have been positive  when employer funding is at minimum 50% using either the HSA or an HRA (Health Reimbursement Account-employer keeps unspent money).  Traditional plans trend of higher copays and new in network deductibles has also led to the popularity of an HSA.

Is your HSA compliant?  Which pre-tax qualified HSAFSAHRA spending card is right  for you? Please contact our team at Millennium Medical Solutions Corp (855)667-4621 for immediate answers.  Stay tuned for updates as more information gets released.  Sign up for latest news updates.

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Breaking: House Passes Obamacare Repeal & Replace

Breaking: House Passes Obamacare Repeal & Replace

Breaking: House Passes Obamacare Repeal & ReplaceBreaking: House Passes Obamacare Repeal & Replace

In a first step toward repealing and replacing Obamacare ie. Affordable Care Act (ACA), the  House of Representatives narrowly passed the American Health Care Act (AHCA) today by a vote 217-213. Every House Democrat and 20 House Republicans opposed the measure. The bill will now be sent to the U.S. Senate. Until this legislation is passed by the U.S. Senate and signed into law by President Trump, all existing ACA requirements remain in effect, including penalties for noncompliance.
Notable Provisions of the American Health Care Act
If signed into law, the American Health Care Act would, among other changes, make the following revisions to key features of the ACA over the next three years:

SIMILARITIES

  •  Pre-Exissting Conditions Covered: Under the Affordable Care Act, insurance companies are required to cover pre-existing conditions. This is still the case under the AHCA, but the creation of High Risk Pools, funded with $8 billion dollars was an added amendment to the AHCA.  Pools provide coverage if you have been locked out of the individual insurance market because of a pre-existing condition, and are subsidized by a state government. The premium is up to twice as much as individual coverage. Individuals who have a lapse in coverage of more than 63 days will be required to pay a 30 percent premium surcharge for 12 months when coverage is purchased.
  • Adult Coverage to Age 26 Covered: People who are under 26 years old can stay on their parents’ health insurance plan under both the ACA and the AHCA.
  • No Lifetime Cap: People who are under 26 years old can stay on their parents’ health insurance plan under both the ACA and the AHCA.

CHANGES

  • “Pay or Play”: Penalties for noncompliance with the “pay or play” coverage requirement (which mandates, in general, that employers with 50+  FT
    GOP Repeal & replace Provisions

    Click Image

     employees [including full-time equivalent employees] must offer affordable, minimum value coverage to their full-time employees, or pay a penalty tax) are zeroed outHowever, the Form 1094 & 1095 reporting requirements are unchanged by the bill.

  •  Individual Mandate: Penalties for noncompliance with the individual mandate are zeroed out, effectively repealing the mandate. In its place, the bill requires issuers in the individual or small group markets to impose a 30% penalty on the health insurance premiums of individuals who do not maintain continuous health insurance coverage.
  • Essential Health Benefits:   AHCA eliminates the requirement for Essential Health Benefits. The AHCA allows limited policies that are only in case of major illness or injury.
  •  HSA Contribution Limits: Limits on contributions to health savings accounts (HSAs) are increased to equal the inflation-adjusted annual out-of-pocket expenses limitation imposed on high deductible health plans (currently $6,550 (self-only coverage)/$13,100 (family coverage)).
  •   Health FSA Contribution Limits: Limits on contributions to health flexible spending arrangements (health FSAs) are eliminated.
  •  Tax Credits for Individual Coverage: Replaces the ACA’s premium tax credits for individual market coverage with advanceable, refundable tax credits adjusted for both age and income.
  •  Market Reforms: Permits states to seek waivers from the ACA’s essential health benefits and age and health status community rating requirements.
  • Medicaid: Allows states to elect to receive federal Medicaid funding via a block grant or per capita allotment, and alters the ACA’s Medicaid expansion.

The chart below summarizes some of the significant changes made by the AHCA.

Affordable Care Act (ACA)

American Health Care Act (AHCA)

Mandates

  • Individual mandate
  • Employer mandate on applicable large employers (ALEs)
  • No individual or employer mandate effective retroactive to Jan. 1, 2016
  • Insurers can impose a one year 30% surcharge on consumers with a lapse in continuous coverage (individual and small group market)

Assistance

  • Income-based subsidies for premiums that limit after-subsidy cost to a percent of income
  • Cost sharing reductions for out-of-pocket expenses
  • Age-based refundable tax credits for premiums, phased out for higher incomes
  • No cost sharing reductions for out-of-pocket expenses
  • ACA subsidies phased out after 2019; AHCA credits effective in 2020

Medicaid

  • Matching federal funds to states for anyone who qualifies
  • Expanded eligibility to 138% of poverty level income
  • Federal funds granted to states based on a capped, per-capita basis starting in 2020
  • States can choose to expand Medicaid eligibility, but would receive less federal support for those additional persons

Premium Age Differences

  • 3:1
  • 5:1 (and the MacArthur amendment would allow a higher ratio)

Health Savings Account Limits

  • $3,400/$6,750
  • Contribution limits increased to maximum out-of-pocket limit for HDHP coverage
  • $6,550/$13,100 (effective retroactively to Jan. 1, 2017)

“Cadillac” Tax

  • Cadillac tax on high-cost employer plans implemented in 2020
  •  Cadillac tax on high-cost employer plans delayed until 2026

Other Taxes

  • 3.8% tax on net investment income
  • Limit placed on contributions to flexible spending accounts
  • Annual health insurance provider tax
  • Over-the-counter medication excluded as qualified medical expense
  • 0.9% Medicare tax on individuals with an income higher than $200,000 or families with an income higher than $250,000
  • Repeal of these taxes retroactive to the beginning of 2017 (except for the repeal of the Medicare tax, which would begin in 2023)

Essential Health Benefits

  • Individual and small group plans are required to offer ten essential health benefits
  • Under the MacArthur amendment, individual and small group plans are required to offer the ten essential health benefits, but a waiver option is available
  • Some Medicaid plans are not required to offer mental health and substance abuse benefits

MacArthur Amendment

The following chart summarizes the changes made to the AHCA by the MacArthur amendment.

Insurance Market Provisions

The MacArthur amendment:

  • Reinstates Essential Health Benefits (EHB) as the federal standard (removes ability of states to define EHBs, but see waiver option)
  • Maintains the following provisions of the AHCA:
    • Prohibition on preexisting condition exclusions
    • Prohibition on discrimination based on gender
    • Guaranteed availability and renewability of coverage
    • Coverage of adult children to age 26
    • Community Rating rules (but see waiver option)
Limited Waiver Option States may obtain waivers from certain federal standards, in the interest of lowering premiums and expanding the number of enrollees. States could seek waivers from:

  • Essential Health Benefits (states could set their own definition of EHBs for the individual and small group markets starting in 2020, and increase the age rating ratio above 5:1 starting in 2018)
  • Community rating rules, except for the following categories, which are not waivable:
    • Gender
    • Health Status (unless the state has established a high-risk pool or is participating in a federal high risk pool)
Limited Waiver Requirements States must explain how the waiver will benefit the insurance market in their state, such as reducing average premiums, increasing enrollment, stabilizing premiums for individuals with pre-existing conditions, or increasing the choice of health plans.,Applications are automatically approved within 60 days unless denied by HHS.

 

As always, please contact us info@medicalsolutiosncorp.com for a compliance review of your benefits offering. Click here to read the American Health Care Act in its entirety.

Taming the junk food cravings hormones

Taming the junk food cravings hormones

Taming the junk food cravings hormones

From our wellness partner, Cleveland Clinic

Ever sneak a late-night snack after a big dinner, or binge late into the night? Eating a huge meal, then going to sleep, is the sumo wrestler diet. Your body can’t process or burn those extra calories. So it stores them as fat, leading to weight gain and prediabetes. In functional medicine, we look at root causes, like how powerful hormones can trigger your night-time food cravings. Learn how to stop them.

See:  Break Your Sugar Addiction in 10 Days (Infographic)

 

Trump’s First Legislative Effort Fails as G.O.P. Pulls Bill to Repeal Obamacare

Trump’s First Legislative Effort Fails as G.O.P. Pulls Bill to Repeal Obamacare

Trump’s First Legislative Effort Fails as G.O.P. Pulls Bill to Repeal Obamacare

THE NEW YORK TIMES
By ROBERT PEAR, JULIE HIRSCHFELD DAVIS, JENNIFER STEINHAUER and THOMAS KAPLAN
MARCH 24, 2017

WASHINGTON — House Republican leaders, facing a revolt among conservatives and moderates in their ranks, pulled legislation to repeal the Affordable Care Act from consideration on the House floor Friday afternoon in a humiliating defeat for President Trump on the first legislative showdown of his presidency.

Paul D. Ryan, the House speaker, rushed to the White House shortly after noon to tell Mr. Trump he did not have the votes for a repeal bill that had been promised for seven years — since the day President Barack Obama signed his landmark health care act into law.

Mr. Trump, in a telephone interview moments after the bill was pulled, blamed Democrats and predicted that they would seek a deal within a year after, he asserted, “Obamacare explodes” because of higher premiums. The president said he did not fault Mr. Ryan and said that he was pleased to move past his first legislative fight. He maintained that he was merely going along with the House bill.

But the effort to win passage was hardly kept secret. Vice President Mike Pence and Tom Price, the health secretary, rushed to Capitol Hill for a late appeal to House conservatives, but their pleas fell on deaf ears.

“You can’t pretend and say this is a win for us,” said Representative Mark Walker, Republican of North Carolina, who conceded it was a “good moment” for Democrats.

“Probably that champagne that wasn’t popped back in November may be utilized this evening,” he said.

At 3:30 p.m., Mr. Ryan called Republicans into a closed-door meeting to deliver the news that the bill would be pulled, with no plans to try again. The meeting lasted five minutes.

“We’re going to go home and spend time with our families and time with our constituents, and one day I hope we can eventually repeal,” said Representative Chuck Fleischmann, Republican of Tennessee.

The Republican bill would have replaced the Affordable Care Act, known informally as Obamacare, which mandated that almost everyone have health insurance, with a system of age-based tax credits to purchase health insurance plans.

But it never won over conservatives who wanted a far more thorough eradication of the Affordable Care Act. Nor did it have the backing of more moderate Republicans who were anxiously aware of the Congressional Budget Office’s assessment that the bill would leave 24 million more Americans without insurance.

With the House’s most hard-line conservatives holding fast against it, the bill’s support collapsed Friday after more rank-and-file Republicans came out in opposition, including Representatives Rodney Frelinghuysen of New Jersey, the soft-spoken chairman of the House Appropriations Committee, and Barbara Comstock of Virginia, whose suburban Washington district went handily for the Democrat nominee, Hillary Clinton, in November.

“Seven years after enactment of Obamacare, I wanted to support legislation that made positive changes to rescue health care in America,” Mr. Frelinghuysen wrote in a statement. “Unfortunately, the legislation before the House today is currently unacceptable as it would place significant new costs and barriers to care on my constituents in New Jersey.”

In the end, Republican leaders doomed the bill by agreeing to eliminate federal standards for the minimum benefits that must be provided by certain health insurance policies.

“This provision is so cartoonishly malicious that I can picture someone twirling their mustache as they drafted it in their secret capitol lair last night,” said Representative Jim McGovern, Democrat of Massachusetts. “This backroom deal will kill the requirement for insurance companies to offer essential health benefits such as emergency services, maternity care, mental health care, substance addiction treatment, pediatric services, prescription drugs and many other basic essential services.”

Defeat of the bill could be a catalyst if it forces Republicans and Democrats to work together to improve the Affordable Care Act, which virtually every member of Congress believes needs repair. Democrats have been saying for weeks that they want to work with Republicans on such changes, but first, they said, Republicans had to abandon their drive to repeal the law.

President Trump, through his budget director, Mick Mulvaney, told House Republicans on Thursday night that he was giving them this one chance to repeal the Affordable Care Act. If they failed, Mr. Mulvaney told them, the president would live with his predecessor’s law.

Rejection of the repeal bill may also prompt Republicans to reconsider the political strategy they were planning to use for the next few years.

“We have to do some soul-searching internally to determine whether or not we are even capable of functioning as a governing body,” said Representative Kevin Cramer, Republican of North Dakota. “If ‘no’ is your goal, it’s the easiest goal in the world to reach.”

Representative Robert Pittenger, Republican of North Carolina, offered this advice to hardline conservatives who helped sink the bill: “Follow the example of Ronald Reagan. He was a master, he built consensus. He would say, ‘I’ll take 80 percent and come back for the other 20 percent later.’”

Failure of the House effort leaves the Affordable Care Act in place, with all the features Republicans detest.

The Republican bill would have repealed tax penalties for people who go without health insurance, rolled back federal insurance standards, reduced subsidies for the purchase of private insurance and set new limits on spending for Medicaid, the federal-state program for more than 70 million low-income people. The bill would also have repealed taxes imposed by the Affordable Care Act on health insurance providers, manufacturers of prescription drugs and medical devices, and many high-income people.

The bill would also have cut off federal funds to Planned Parenthood for one year.

Mr. Ryan said the bill included “huge conservative wins.” But those provisions were ultimately not enough.

Don’t Tax My Workplace Health Plan

Don’t Tax My Workplace Health Plan

Don’t Tax My Workplace Health Plan

Infographic_Employer_Exclusion_Final_160801ISSUE SUMMARY

Don’t Tax My Workplace Health Plan. Congress is currently considering healthcare reform proposals that would eliminate or place a cap on the employer-tax exclusion for health insurance. These proposals would undermine the employer-sponsored health insurance system that provides coverage for more than 175 million Americans. Eliminating the exclusion would eliminate most of the advantages of employer-sponsored insurance, while capping it would degrade the benefit and serve as a tax increase for middle-class Americans.

Lets highlight one particular issue of concern to most of our clients. Today, employers may deduct as a valid business expense the full cost of health insurance and other employee benefits. One of the considerations being discussed would restrict this tax-advantaged status.

The infographic  paints a picture of the importance of job-based health insurance and how valuable it is for employers as well as for American workers and their families.

Impact on American Workers

  • A study by the City University of New York School of Public Health  found that the “Cadillac Tax” will hit the middle class the hardest.
  • A study by the Economic Policy Institute found that because the tax is focused on high premiums, not high levels of coverage, companies that tend to pay higher premiums — such as small businesses and employers with a high proportion of sick workers — could wind up paying the tax even though their benefits are not particularly generous. Also, if employers try to avoid the tax by shifting to less generous plans, workers will likely suffer when it comes to their overall compensation, even if they get a boost in wages to make up for the lost health benefits.
  • The tax will disproportionately affect women, older employees and certain geographic areas. A 2014 report by actuarial and benefits consulting firm Millimani dentified that geography could potentially account for a 69.3% variation in premium. For example, a plan that would cost $9,189 in one area would cost $15,556 elsewhere. The report also demonstrates that the 40% tax’s age and gender adjustment fails to compensate for the impact those factors have on premiums when combined with a high-cost geographic area and/or lower provider discounts.
  • According to a 2014 study by Truven Health Analytics, the 40% tax will result in a cost increase of up to $480 per employee per year for plans that are expected to incur the tax. Early retirees are projected to incur the tax at a much higher rate than active employees, with 81% of such plans likely to trigger the tax.
  • A study by the American Health Policy Institute estimated the 40% tax “could cost 12.1 million employees an average of $1,050 in higher payroll and income taxes per year, if employers increase their taxable wages as they reduce the cost of health care benefits. Alternatively, these employees could see up to a $6,150 reduction in their health care benefits and little or no increase in their pay.”

Impact on Employers

  • An issue brief by the Kaiser Family Foundation found that “a meaningful percentage of employers would need to make changes in their health benefits” to avoid the 40% tax, and this percentage grows significantly over time unless employers are able to keep heath plan cost increases at low levels. In fact, 19 percent of employers already in 2015 have a plan that would exceed the threshold when flexible spending accounts are included in the calculation. These firms would need to reduce their current plan costs over the next several years to avoid the tax. By 2028, 42% of employers would have plans where costs would exceed the threshold for some or all employees. And if health plan premiums continue to grow faster than inflation, as expected, all employers will eventually be affected by the tax.
  • According to Tower-Watson survey48% of employers believe the plans they provide will be affected the first year the law is implemented. And that rises to 82% of employers by 2023, just five years later.
  • The Lockton Companies wrote in a 2015 benefits guidance document, “When we project five and ten years into the future, based on current guidance, the majority of our clients will eventually trigger the tax.”
  • Eventually, the 40% tax will apply to modest plans, not just high-cost coverage as intended. A recent study by actuarial and benefits consulting firm Mercer, found that the Federal Employees Health Benefits Program’s (FEHBP) Blue Cross Blue Shield standard option plan was projected to hit the 40% tax soon after it was originally set to go into effect.
  • A study by the American Bankers Association’s HSA Council found that “If your current HSA-qualified family health plan costs more than $17,000, including wellness programs, your firm is likely to incur excise tax liability in 2018 if anyone makes a maximum contribution.”

Impact on Health Benefits

  • The actuarial and benefits consulting firm Aon Hewitt reported in 2015 that 33% of employers surveyed are increasing deductibles and other cost-sharing, to avoid being on a trajectory to trigger the tax when it goes into effect. But fully 40% of employers expect at least one plan to unavoidably hit the tax threshold regardless.
  • A survey conducted by the National Business Group on Health found that 42% of employers said they will increase employee cost-sharing, and 37% said they will reduce spousal subsidies or implement a surcharge for covering them to minimize the impact of the excise tax.
  • A survey of 700 employers by Mercer in 2015 found that anticipation of the 40% tax is already leading many employers to consider excluding employees’ spouses from their health policies or imposing a surcharge for including them. The survey found that the tax has consistently been the primary concern of employers since passage of the Affordable Care Act.
  • The 40% tax is triggered when the value of an individual’s health plan exceeds the threshold — a supposedly high-end number for “Cadillac” plans. But a 2013 Mercer survey found that the average price of all employer-provided health plans in the state of Florida, for example, was already approaching the threshold — years before the tax is set to go into effect.

Because its thresholds are indexed to general inflation instead of faster-growing medical inflation, more plans will be hit by the tax every year. The tax thresholds are indexed to the Consumer Price Index, which the Congressional Budget Office (CBO) estimates will rise annually by 2.4% on average over the next decade. But the Centers for Medicare and Medicaid Services (CMS) projects private health care spending to rise 5.8% on average each year, as health care costs increase significantly faster than general inflation. This insufficient indexing of the thresholds means more and more plans will trigger the tax, and to a greater extent, over time.

Take Action Today:

  • Tell Congress to Oppose Eliminating or Capping the Employer Exclusion – click here
  • Join Fight the Cadillac Tax  – click here.

Contact Us Now    Learn how our Agency is helping buinsesses thrive in today’s economy. Please contact us at info@medicalsolutionscorp.com or (855)667-4621. 

Ancillary Benefits Fill Benefits Gaps

Ancillary Benefits Fill Benefits Gaps

Ancillary Benefits Fill Benefits Gaps  Voluntary Benefits

The one constant in healthcare today is increasing costs.  According to data from Kaiser, premiums have increased 50% over the past eight years with family plans reaching an all-time high of $18,142 for the year in 2016. The good news is Ancillary Benefits Fill Benefits Gaps.

Employees love dental and vision products, they are the second and third most requested employee benefits. Research continues to show that dental and vision plans can be effective preventive healthcare tools that may lower medical claims costs overall. Early symptoms of high blood pressure, diabetes and other diseases can be detected in an eye exam before showing up in a physical. Life insurance can help employees protect their loved ones by providing a monetary benefit to cover the cost of a funeral or a debt health insurance also does not provide income protection in the event of a death.

Voluntary benefits as an industry has increased 257% over the past twenty years, with the greatest growth in the past five years coming specifically from supplemental health benefits such as accident, critical illness, cancer, and hospital indemnity insurance. These benefits can all provide employees with a cost effective way to fill in the holes created by high deductible health plans by paying first dollar benefits directly to employees upon diagnosis or occurrence of medical events. By making these benefits available at the workplace, employees gain access to more affordable rates and waived or simplified underwriting not available to them individually as well as the convenience of payroll deduction and often the added perk of portability.

Ancillary benefits are affordable, too. Purchasing these benefits at a group level is more affordable than if purchased on an individual basis. Cost is limited for three reasons:

  • As group insurance products, the risk is spread through a large population, which keeps premiums reasonably priced.
  • If your business takes advantage of Section 125 of the IRS code, premiums are paid with pre-tax dollars.
  • The cost can either be completely covered by the employer or shared with the employees by arranging an employer-employee split.

There are two ways ancillary benefits can be funded: voluntary or employer-contributory. On employer-contributory ancillary benefits, the employer usually pays 50 to 100 percent of the premiums. On voluntary plans, the employer may contribute 0 to 49 percent of the premiums.

Through payroll deduction, employees pay whatever portion of the premiums that the employer does not cover. Then when an employee uses their benefits, a claim is submitted and benefits are paid directly to the network-contracted provider or to the member (if a network provider is not used). For life insurance claims, the beneficiary is paid directly (in the event of a death).

There are many reasons why an employer may contribute more or less of the cost of an ancillary benefit. Companies may only cover the full cost of their health plan, and let employees choose to purchase a voluntary dental or vision plan. Others may find that offering employer-contributory ancillary plans encourages more employees to enroll.

There are several benefits for employers and employees when choosing to add on ancillary benefits.

For employers:

  • Lower employer FICA contributions if your business takes advantage of Section 125 so that employees can use pre-tax dollars for these benefits
  • The value of ancillary benefits is high among employees and would enhance the employer’s reputation among employees.
  • Offering ancillary benefits make your business more competitive in the employment marketplace.  With them, you can compete with other employers who may already provide these value-added benefits.
  • Employers do not pay for voluntary ancillary benefits or can share the cost with employees to keep costs down while pleasing employees.

For employees:

  • They can use pre-tax dollars to pay for ancillary benefits, thus lowering their taxable income.
  • The cost is affordable.  Risk is spread among a large group of people to keep the premiums reasonable.
  • Ancillary products respond to workers’ needs to access important benefits, such as dental insurance, vision insurance and group term life insurance.
  • With ancillary dental and vision benefits, workers can get preventative care, not just care when a problem develops.
  • They can enjoy the peace of mind and security that comes with ancillary benefits and group insurance.

With 77% of workers saying the benefits package is an important factor in their decision to accept or reject a job, and with 70% of employers today offering voluntary benefits as part of their total benefits package, employers in 2017 would be at a clear disadvantage to not be offering voluntary benefits to their employees. (EBRI, 2015) (LifeHealthPro, 2014) Voluntary supplemental health benefits can help fill the gaps created by changing medical plan designs, meet the needs of an ever-increasing diverse workforce, and attract and retain top talent – all at no cost to an employer’s bottom line.

For more information regarding ancillary benefits, please contact us today.

 

Here’s How Trump Will Change Obamacare

Here’s How Trump Will Change Obamacare

Leading article on the direction of TRUMPCARE we’ve read thus far. Former president Barack Obama’s budget director, Peter Orszak thinks Obamacare will be replaced through the waiver process.

Here’s How Trump Will Change Obamacare

By Peter R. Orszag FEB 14, 2017 6:00 AM EST

Promises made by Donald Trump and Republicans in Congress to repeal and replace the Affordable Care Act are proving to be more complicated than they sounded on the campaign trail. With reality now setting in, what’s most likely to happen?

I expect to see Republicans stage a dramatic early vote to repeal, with legislation that includes only very modest steps toward replacement — and leave most of the work for later. Next, the new administration will aggressively issue waivers allowing states to experiment with different approaches, including changes to Medicaid and private insurance rules. At some point, then, the administration will declare that these state experiments have been so successful, Obamacare no longer exists.

In other words, the repeal vote will be just for show; the waivers will do most of the heavy lifting.

I predict something like this will happen because of two core challenges that stand in the way of Republicans’ replacing the ACA through legislation: the need for so-called community rating and the need to have 60 votes in the Senate to pass a comprehensive new health-care law.

First, community rating. It is one of the basic building blocks needed to create a workable private insurance market — whether Democrats or Republicans are doing the building. If your insurance covers a pre-existing condition but at a cost of, say, $100,000, that doesn’t really help. Community rating requires that your premium be the same as that of other people in your area, no matter how unhealthy you are.

With community rating in place, the next step is to recognize how easy it is to game the system: People can just wait until they get sick, then buy insurance at the community rate. To discourage that practice, the system needs to give people some strong incentive to purchase insurance before they get sick. The Affordable Care Act used an individual mandate; most Republican plans instead propose a requirement for continuous coverage. That is, people enjoy access to community-rated premiums in the future only if they have kept themselves insured over some period of time in the past.

Given the costs involved, subsidies are also needed to ensure that low- and moderate-income households can afford the coverage. This overall structure means that younger, healthier people implicitly subsidize older, sicker people.

Such are the inescapable constraints imposed by community rating. Community rating could be discarded, as Mark Pauly of the University of Pennsylvania has argued. Pauly instead proposes that insurance companies be allowed to vary people’s premiums according to their health status, and that general revenue be used to pay sicker people’s higher premiums. This would require substantial new taxes, however, which is presumably a nonstarter in a Republican plan. In any case, it would only make the transfers to older, sicker people more explicit.

The second challenge is more nakedly political: Without a substantial change in Senate procedure, a bill to fully replace the Affordable Care Act, including changes to insurance rules, will require 60 votes. Republicans have only 52, so at least eight Democratic senators would need to be persuaded to go along. This is a much tougher assignment, especially since the administration will already be calling in legislative favors on ongoing confirmations, the debt limit, tax reform and other issues.

The Republicans’ desire to hold an early partisan vote repealing the ACA (through the reconciliation process that requires only a simple majority in the Senate) seems too strong to resist. The repeal will probably be set to become effective in the future, perhaps 2019 or 2020.

This vote will probably be closer than many people think, given the concerns that some moderate Republican senators have expressed about repealing the ACA with no replacement ready. Some far-right Republicans may also balk at anything less than a full immediate repeal. For the White House, however, the closeness of the vote will be a feature rather than a bug, because it will create the impression that the vote is significant.

The repeal legislation will probably include some modest steps toward replacing the ACA, but these will be mostly symbolic measures such as allowing insurance companies to sell across state lines (which by itself would do little to lower people’s premiums). The hard work of a creating comprehensive replacement is then likely to get bogged down in legislative muck.

But the administration can use its expansive waiver authority to allow states to experiment with both Medicaid and the individual insurance markets. As these 50 flowers bloom, President Trump could at some point declare victory and assert that the ACA has been sufficiently reformed.

This approach, whatever its potential substantive shortcomings, provides a major political benefit: The administration would not necessarily own the many problems that inevitably would remain. In response to any particular complaint in a specific state, the administration could simply shrug its shoulders and direct the inquiry to the relevant governor.

This outlook assumes that the Republican leadership in Congress isn’t willing, or lacks the votes, to change the Senate’s traditional rules, and that a comprehensive replacement for the ACA will indeed require 60 votes. If that changes, all bets are off.

This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.

To contact the author of this story:
Peter R. Orszag  at porszag5@bloomberg.net

To contact the editor responsible for this story:
Mary Duenwald  at mduenwald@bloomberg.net

Trump Order and ACA

Trump Order and ACA

White_HouseTrump Order and ACA

President Trump signed an Executive Order on Jan 20 Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pending Repeal. As a practical matter, he can’t repeal it “line-by-line on day one” of his Presidency. So he did the next best thing: sign an Executive Order.

While lawmakers work on a repeal and replacement plan, here are 5 things you should know. The executive order will:

  1. End the individual mandate.
  2. Expand Medicaid waivers and provide states more flexibility to implement healthcare programs.
  3. Encourage the creation of interstate insurance markets to “the maximum extent permitted by the law.”
  4. Remove ACA taxes, including some placed on health insurance and pharmaceutical companies, in addition to waiving PPACA taxes, fees, and penalties.
  5. Grant leaders of the Department of Health and Human Services (HHS) and other agencies to exercise greater discretion. This includes the ability to waive, defer, or grant an exception to any provision that would impose a fiscal burden on a state or place a financial or regulatory burden (cost, fee tax, penalty) on individuals, families, healthcare providers, and patients.

We will soon know whether the Executive Order is more symbolic or has practical effects.   Employers should continue to comply with the provisions in current law, until official guidance provides otherwise.

No Tax Restarts

No Tax Restarts

No Tax Restarts

No need to wait till next Jan 1st to make changes.  No tax restarts are good news for PEO prospective groups. Federal Tax Restarts Are No Longer An Issue  The significant added expense of having to pay tax restarts often postponed or ended the PEO conversation for many of our prospective clients. It was an important consideration since companies were not eligible for tax restart credits and the cost of the restarts often diminished the financial value proposition of partnering with a PEO.

Example: A group starting a plan in May would have to pay for annual FICA and FUTA all over again with new PEO. A PEO is considered a different employer group.

Moving forward, there are no federal tax restarts to worry about. FICA and FUTA wage bases will not restart when an employer joins a PEO. Ask us about our Quick Start Program to ensure a smooth start to our personalized PEO model, and offers perks for your staff.

Contact us to learn more about our Quick Start Program on-boarding processs but here are the high points:

  1. You’ll have access to the best healthcare providers, coupled with the pricing that is offered to much larger companies.
  2. Your Worker’s Compensation rate may favorably adjust since you will be “adopted” under the PEO and their typically much better rates.
  3. You’ll have a partner that will help build systems for recruiting, hiring, employee administration and more.
  4. You’ll also have experts who will work with you to establish and maintain policies and programs, including workplace safety, sexual harassment, diversity and others that are typically required by law.

While this certainly is not going to fix everything in the ever growing PEO industry, it’s a huge leap forward and offers clarity. If you would like to explore how a PEO can help your company, contact us and we will be happy to help you.

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Medicare 2017 Deductibles Announced

Medicare 2017 Deductibles Announced

Medicare 2017 Deductibles Announced

2017 Medicare Parts A & B Premiums and Deductibles Announced. On October 18, 2016, the Social Security Administration announced that the cost-of-living adjustment (COLA) for Social Security benefits will be 0.3 percent for 2017. Because of the low Social Security COLA, a statutory “hold harmless” provision designed to protect seniors, will largely prevent Part B premiums from increasing for about 70 percent of beneficiaries. Among this group, the average 2017 premium will be about $109.00.  A modest increase compared to $104.90 for the past four years.

For the remaining roughly 30 percent of beneficiaries, the standard monthly premium for Medicare Part B will be $134.00 for 2017, a 10 percent increase from the 2016 of $121.80. Because of the “hold harmless” provision covering the other 70 percent of beneficiaries, premiums for the remaining 30 percent must cover most of the increase in Medicare costs for 2017 for all beneficiaries. This year, as in the past, the Secretary has exercised her statutory authority to mitigate projected premium increases for these beneficiaries. While continuing to maintain a prudent level of reserves to protect against unexpected costs. The Department of Health and Human Services (HHS) will work with Congress as it explores budget-neutral solutions to challenges created by the “hold harmless” provision.

“Medicare’s top priority is to ensure that beneficiaries have affordable access to the care they need,” said CMS Acting Administrator Andy Slavitt. “We will continue our efforts to improve affordability, access, and quality in Medicare.”
Medicare Part B beneficiaries below are not subject to the “hold harmless” provision.  These groups represent approximately 30 percent of total Part B beneficiaries.

  •  This  includes beneficiaries who do not receive Social Security benefits
  • those who enroll in Part B for the first time in 2017
  • those who are directly billed for their Part B premium
  • those who are dually eligible for Medicaid and have their premium paid by state Medicaid agencies
  •  those who pay an income-related premium

CMS also announced that the annual deductible for all Medicare Part B beneficiaries will be $183 in 2017 (compared to $166 in 2016). Premiums and deductibles for Medicare Advantage and prescription drug plans are already finalized and are unaffected by this announcement.

CLICK HERE FOR 2017 MEDICARE INFORMATION

For a custom one-on-one review of the right Medicare Supplemental Plan for you please contact us- Millennium Medical Solutions Corp (855)667-4621.