Last week the House voted the unpopular Obamacare Cadillac Tax to be permanently repealed 419-6. However, much like a bad cold, the Health Insurance Tax (the HIT) is back for 2020. Website Stop The Hit calculates $5,000 as the average tax for a 10 man small business for example.
Who’s affected?
No one escapes the $16 billion HIT. The return of the Health Insurance Tax (HIT) means higher costs and fewer jobs for hardworking Americans. Absent immediate Congressional action to delay the HIT, small businesses and families will face $500 on average in higher premiums for 2020. To make matters worse, the increased cost burden on small businesses from the HIT could result in the U.S. workforce being reduced by 152,000 to 286,000 jobs over a decade. Te HIT is projected to increase premiums for seniors by $241.
How much for 2020?
For Small business, this translates to an estimated 2.5%-3% added surcharge. For States like NYS where there is already approx. 16% added surcharge to high premiums, this becomes daunting. It is no surprise the unpopular HIT was suspended. In 2017, payers escaped making $13.9 billion in payments due to the moratorium, according to a 2018 analysis by Oliver Wyman, commissioned by UnitedHealth Group. This may have saved consumers billions on their insurance coverage.“The taxes on health insurance are non-deductible for federal tax purposes for health insurers,” the report explained.
In some states, such as Vermont, the price of insurance would have more than quadrupled. The payer trade group published a fact sheet on this. “Allowing a tax to resume in 2020 valued at an annual level of $16 billion, would saddle individual market consumers, small businesses, state Medicaid programs, and Medicare Advantage enrollees with higher health care costs,
Can this be repealed?
Relief from the health insurance tax would result in real savings to the American people. We strongly urge Congress to provide an additional two-year suspension of the health insurance tax by passing H.R. 1398.
Calculates how the HIT affects your State and your business, here.
Take action now: tell Congress to repeal the HIT! Join small business owners across the country in stopping the HIT. Sign the petition here.
Learn more about how we are successfully helping navigate SMB for 20+ years. If you have any questions or would like additional information, please contact us at 855-667-4621 or info@medicalsolutionscorp.com.
On June 13, 2019, the Departments of Labor, Health & Human Services and Treasury released final rules concerning Health Reimbursement Arrangements (HRAs). The 497-page rule includes the creation of two new types of HRAs, the “Individual Coverage HRA” and the “Excepted Benefit HRA.”
Advantages of the Individual Coverage HRA:
Funds can be used to reimburse the employee’s premiums for an individual health insurance policy.
Reimbursements made to employees do not count towards the employee’s taxable wages.
The employer can choose to roll-over unused amounts into the following year.
Coverage can be offered to different classes of employees (e.g.; full-time, part-time, seasonal, salaried, hourly)
An offer of the Individual Coverage HRA represents an “offer of coverage” under the employer mandate, however, contributions must meet affordability guidelines. The IRS will release further guidelines regarding this later.
Individual HRA restrictions:
An offer of an Individual Coverage HRA cannot be made to any employee that is offered a traditional group health plan.
If an offer of coverage is made to a class of employees, there is a minimum class size that is required. Size is typically 10% of that specific class of employees. For example, if an employer has 200 employees, a minimum of 20 employees would have to be in a specified class.
Contributions can be in any amount that the employer chooses, but contributions must be consistent for all employees in a specified class.
The employer must provide notice of the Individual Coverage HRA to employees.
The employer must be able to substantiate that the employee is enrolled in an individual plan or Medicare (model notices are available).
The employer must notify employees on an annual basis that the individual health insurance is NOT subject to ERISA.
The final rule also created the “Excepted Benefit HRA” which, starting in January of 2020, will permit employers to finance additional medical care. Employees can use the HRA without having to be enrolled in the group’s traditional health plan.
“Excepted Benefit HRA” include:
The annual contribution is capped at $1,800.
It must be offered in conjunction with a group health plan, but there is no requirement for the employee to enroll in that plan.
The “Excepted Benefit HRA” cannot be used to fund group health or Medicare premiums.
It can fund premiums for dental, vision, or short-term limited duration insurance.
Effective Date:
Employers who want to offer the “Individual Coverage HRA” for January 1, 2020, can do so but employees will need to enroll in an individual plan during the 2019 open enrollment period (November 1, 2019 – December 15, 2019).
If you have any questions or would like additional information, please contact us at 855-667-4621 or info@medicalsolutionscorp.com.
The NYS 2020 Rate Requests filings were released today. The total weighted average increases were a modest 8.4% for Individual Market and 12.0% Small Group Market. Final rate approval expected early August. The past reductions averaged 10-50%.
The lower requests reflect a stabilizing ACA market. Insurers’ financial performance improved nationwide last year to its highest level since the passage of the law. The average medical-loss ratio, which represents the portion of premiums spent on medical claims and quality improvement, was 70% last year in the individual market nationwide. That led to plans paying $800 million in rebates for failing to meet requirements on medical spending, according to the Kaiser Family Foundation.
This early filing request deadline request requirement is not an Obamacare requirement. As per NY State Law carriers are required to send out notices of rate increase filings to groups and subscribers.These are simply requests and the state’s Department of Financial Services has authority to modify the final rates. But they are the first indication of what New Yorkers can expect when shopping for health insurance on the individual marketplace at the end of this year.
Background:
By contrast last year’s NYS 2019 Rate Request early filing request were higher at 7.5% small group and an astounding 24% for individuals. The NYS final August 2020 rate approval are expected to be lower. For example, the final filing rates were approved NYS 2019 Final Rates Approved at a modest 3.8% small group and 8.6% for individuals. Using these past figures one projects a 2019 Final Rates of 5% small groups and 8% individuals.
A spokeswoman for the state Health Plan Association said insurers have worked to control costs, which have been driven up by rising prescription drug prices and state mandates that require coverage of certain services.
“Our member health plans have been committed to making health care more affordable, working hard to rein in rising health care costs and contain their own costs,” she said. “The proposed premium rate requests are reasonable, reflecting the cost of care.”
In the small-group market, insurers asked for a weighted average 12% boost in 2020 after they were granted a 3.8% bump for this year. UnitedHealthcare’s Oxford, which controls more than half of the small-group market, asked for a 15.9% increase, which was the highest among all plans. Oscar, at 15.8%, was close behind. Notably, Healthfirst has requested a 5% reduction.
Conclusion
Defined Contribution Choice: Instead, the correct approach for a small business in keeping with simplicity is a defined contribution model using a Private Exchange. This is a true defined contribution empowering employees with the choice of leading insurers offering paperless technologies integrating HRIS/Benefits/Payroll. Both employee and employers still gain tax advantage benefits under the business. Also, the benefits, rates and network size are superior under a group plan as THE RISK OUTLINED ABOVE ARE HIGHER FOR INDIVIDUAL MARKETS THAN SMALL GROUP PLANS.
To be clear: These trends affect a small subset of the insurance market—non-group plans that cover less than 2 percent of the population. Many qualify for tax credits that lower their net costs and reduce or eliminate the impact of year-to-year rate increases.However, non-group customers with incomes above 400% of the poverty level ($48,560 for a single adult) get no subsidy—and feel the full brunt of any hikes.
Resource
You may view the NYS 2019 Rate Requests DFS press release, which includes a recap of the increases requested and approved by clicking here.
For a custom analysis detailing YOUR upcoming 2019-2020 renewal please contact our team at Millennium Medical Solutions Corp (855)667-4621. We work in coordination with Navigators to assist with Medicaid, CHIP Child Health Plus, Family Health Plus and Medicare Dual Eligibles. We have Spanish, Russian, and Hebrew speakers available. Quotes can also be viewed on our site.
The IRS has released the 2020 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 2020 limits are as follows:
2020
2019
HSA Annual Contribution Limit
$3,550 $7,100
$3,500 – Single $7,000 – Family
HDHP Minimum Annual Deductible
$1,400 $2,800
$1,350 – Single $2,700 – Family
HDHP Out-of-Pocket Maximum
$6,900 $13,800
$6,750 – Single $13,300 – Family
Age 55+ Catch-Up Provision
$1,000 $2,000
$1,000- Single $2,000 – Husband/Wife
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.
For a copy of Revenue Procedure 2017-37 please click on the link below: https://www.irs.gov/pub/irs-drop/rp-18-30.pdf
Is your HSA compliant? Which pre-tax qualified HSA, FSA, HRA 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.
Governor Murphy announced that the state will seek to run its own ACA marketplace in 2021 to allow greater control over its health insurance market. New Jersey took this step to “protect New Jersey from actions taken by the Trump Administration to roll back the hard-fought protections afforded by the ACA,” according to Governor Murphy.
Running a state-based exchange will give the state more control over different aspects of the market. These aspects include having control over the open enrollment period, having more access to data, the ability to conduct targeted outreach, and allowing user fees to fund exchange operations, consumer assistance, outreach and advertising.
New Jersey has already passed a few laws that have decreased average rates by 9.3% in 2019. The laws include an individual mandate, a reinsurance program, and legislation that protects consumers from surprise balance billing. The individual mandate’s penalty is related to the average cost of a bronze plan in New Jersey, and will be assessed on state tax returns. The revenue collected from this penalty will go into state funding for the reinsurance program. The reinsurance program was approved by CMS in August 2018. The reinsurance program reimburses insurers for 60 percent of the cost of claims over $40,000, up until claims reach $215,000.
New Jersey is also proposing codifying major ACA provisions into state law. The protections the Murphy Administration is looking into codifying include:
prohibiting preexisting conditions exclusions
requiring dependent coverage to age 26
requiring coverage of Essential Health Benefits
prohibiting lifetime and annual limits
requiring coverage without cost sharing for preventative services
NJ’s announcement that they will run a state-based exchange comes at a time when President Trump’s Administration has declared that it backs a full invalidation of the ACA. This position furthers the earlier decision by the administration when the Justice Department argued that there were only grounds to strike down the ACA’s consumer protections.
If you would like to know more about MMS Corp and pre-tax benefits for your company, contact us today.
Another Patriots Super Bowl can give a Jets fan such as myself heartburn but with good reason. As folks gear up for Super Bowl Sunday to watch the New England Patriots face the LA Rams they’ll indulge in their favorite game-day foods, share a few laughs and lament the fact that the Monday after the Super Bowl is not a recognized as a national holiday.
Eight Super health facts as presented by Hartford Healthcare.
Player size has changed (and it matters): One of the biggest differences between Super Bowl I and Super Bowl LIII is the size of the players. This year, the averageNFL player stands 6 feet 2 and weighs almost 250 pounds. Contrast that to Super Bowl I, when the biggest football player on the world champion Green Bay Packers roster was Gale Gillingham, who was only 255 pounds. The average adult male in the United States is 5 feet 9 and 195 pounds. The United States has the highest rate of obesity in the world with more than 109 million people considered obese. When comparing that to the country’s population, more than 30 percent of people in America are overweight.
Concussion is a MUCH bigger deal than ever before: Recent concussion tests have sparked nationwide conversation surrounding the connection between head injuries and contact sports, specifically football. In high schools across the country, 47 percent of all reported sports concussions are from football. Dr. Subramani Seetharama, a physiatrist and sports medicine specialist at the Hartford HealthCare Bone & Joint Institute who is also the medical director of the Sports Health and Concussion Clinic programs, says parents and athletes should not get caught up in the moment when dealing with potential concussions.“I tell kids, if you have a headache, get off the field immediately,” said Dr. Seetharama. “Studies show if they continue playing, there is a 40 percent chance they will have a prolonged symptom scale and they’re going to miss school.”
Sprains, strains and ACL injuries, too:Aside from concussions, there are other dangers to the body from playing football. The most common
football injuries are musculoskeletal injuries, such as ligament sprains and muscle strains. Knee injuries are common in football, with most occurring in the anterior or posterior cruciate ligaments (ACLs and PCLs). Most ACL injuries in football happen on non-contact plays, usually when the foot becomes stuck on the playing surface.“Not everyone who tears their ACL will hear or feel a pop,” said Dr. Clifford Rios, orthopedic surgeon and board-certified in sports medicine at the Hartford HealthCare Bone & Joint Institute. “When an ACL injury typically happens, the play goes one way and the athlete plants a foot with the knee partially flexed. Then they’ll try to turn the body away from the direction their foot is facing and push off to change direction, ultimately causing the injury.”
Football players like to eat – a lot: The average person in America eats approximately 3,600 calories a day – that’s quite a bit more than the 1,800-2,200 calories a day recommended for the average adult male. Unless, of course, you are a pro football player. The average 300-pound NFL player may eat up to 9,000 calories a day.“There isn’t a ‘magic number’ to determine how many calories you should eat,” said May Harter, MS, RD, CD-N, a registered dietitian at The Hospital of Central Connecticut. “The amount of calories you should eat per day really depends on a variety of factors, including your age, gender, medical history, and how much daily physical activity you typically engage in.”
Chicken wings are a BIG thing (so is pizza): This Super Bowl weekend, nearly 1.3 billion chicken wings will be consumed in the country. To give perspective, imagine a straight line of chicken wings end-to-end from Hartford to Los Angeles – 28 times over. The pizza company industry is also grateful for the biggest sporting event of the year, as many businesses will see their orders double on Super Bowl Sunday.
Don’t forget the guacamole: Wings and pizza aren’t the only items on the menu on Super Bowl Sunday. More than 8 million pounds of guacamole will be consumed as well. The good news for guacamole lovers? Avocados are on the healthier side, low in saturated fat and packed with about 20 vitamins and minerals.“Avocados are loaded with heart-healthy monounsaturated fatty acids that are good for your heart health,” says Harter. “Like any food, they are good in moderation. They can lower your cholesterol while increasing your fiber and potassium intakes.”
The high-fat spread is delish — but at what price to your health?:All that delicious food can comes at a price. Antacid sales are expected to increase by roughly 20 percent on the day after the Super Bowl. And 6 percent of people in America will call in sick the day after, and not all of them are just hoping to celebrate their team’s victory for an extra day. A recent Tulane University study found evidence that Super Bowl parties help spread the flu. The study showed that between 1974 and 2009, cities with teams in the Super Bowl experienced an 18 percent increase in influenza deaths that season. Be sure to wash your hands before and after eating and don’t forget your hand sanitizers!
The Super Bowl wasn’t always an evening affair: Once the big game is over and you finally climb into bed, you may realize it’s only a short while before you need to be back up and ready for work the next day. One major difference between the first Super Bowl and now is the game’s start and end times. This year’s Super Bowl is scheduled to kick off at 6:30 p.m. Factor in all the commercials and a halftime show that’s 30 minutes long (15 minutes longer than the average football game halftime), and the game can easily go past 10 p.m. The first Super Bowl started at 1 p.m. EST (which was 10 a.m. local time in Los Angeles, where the game was held) and the game ended well before anyone’s bedtime. Though it may be tough to get enough sleep after the Super Bowl, Dr. Brett Volpe, a board-certified sleep specialist at MidState Medical Center’s Sleep Care Center, stresses the importance of getting back on a regular sleep schedule for the rest of the week and staying away from caffeine when possible. “A lot of people don’t realize that caffeine has a half-life of 12-16 hours,” said Dr. Volpe. “High-caffeine foods and drinks we take in the morning can potentially affect our sleeping that night, especially in younger adults and children. An irregular sleep schedule makes it harder for our brain and body to rest properly and it’s almost like intentionally putting yourself through jet lag.”
It’s a super caloric day but if you fall from your New Year’s resolution let it be just one day – SUPER BOWL SUNDAY. Enjoy!
perspective, imagine a straight line of chicken wings end-to-end from Hartford to Los Angeles – 28 times over. The pizza company industry is also grateful for the biggest sporting event of the year, as many businesses will see their orders double on Super Bowl Sunday.
The Super Bowl wasn’t always an evening affair: Once the big game is over and you finally climb into bed, you may realize it’s only a short while before you need to be back up and ready for work the next day. One major difference between the first Super Bowl and now is the game’s start and end times. This year’s Super Bowl is scheduled to kick off at 6:30 p.m. Factor in all the commercials and a halftime show that’s 30 minutes long (15 minutes longer than the average football game halftime), and the game can easily go past 10 p.m. The first Super Bowl started at 1 p.m. EST (which was 10 a.m. local time in Los Angeles, where the game was held) and the game ended well before anyone’s bedtime. Though it may be tough to get enough sleep after the Super Bowl, Dr. Brett Volpe, a board-certified sleep specialist at MidState Medical Center’s Sleep Care Center, stresses the importance of getting back on a regular sleep schedule for the rest of the week and staying away from caffeine when possible. “A lot of people don’t realize that caffeine has a half-life of 12-16 hours,” said Dr. Volpe. “High-caffeine foods and drinks we take in the morning can potentially affect our sleeping that night, especially in younger adults and children. An irregular sleep schedule makes it harder for our brain and body to rest properly and it’s almost like intentionally putting yourself through jet lag.”