Individual Health Insurance Markets Stabilization Final Rule April 13, 2017 by CMS The Centers for Medicare & Medicaid Services (CMS) issued the final Market Stabilization Rule, to help lower premiums and stabilize individual and small group markets and increase choices for Americans. Individuals obtaining coverage in the Marketplace created by the Affordable Care Act have [...]
New Expiration Date for Health Insurance Exchange Notices is April 30, 2017 The U.S. Department of Labor’s Employee Benefits Security Administration (EBSA) has extended the effective date of its model Health Insurance Exchange Notices through April 30, 2017. Previously, these model notices were set to expire on March 31, 2017. No other changes have [...]
Tuesday, March 21, 2017 Source: USA Today WASHINGTON — Republicans released a modified health care bill Monday, 3/20/17 in an attempt to shore up support among both conservatives and moderates for their legislation to replace the Affordable Care Act before the House votes Thursday — seven years to the day after President Obama signed the [...]
House to sue Obama over ACA’s employer mandate delay The U.S. House of Representatives will sue President Obama’s administration over delaying the implementation of an employer health insurance mandate in the Affordable Care Act. In 2013, President Obama changed the health care law without a vote of Congress. The ACA requires employers with 50 or [...]
The Court of Appeals for the District of Columbia just released its decision in Halbig v. Burwell. This case is a big big deal, since it addresses whether subsidies are only legally available through the state-run exchanges or both the federally-run and state-run exchanges. This particular court has ruled that the subsidies are available only [...]
Minimum Essential Coverage (MEC) are plans that only cover routine health services such as wellness benefits, preventive care and certain routine medical care. By definition, an MEC plan must cover all 63 CMS listed preventive care services. These plans do not provide traditional, major medical insurance coverage. The Affordable Care Act has two mandates. The [...]
There are three subsidies lawsuits all charging the same basic concept: that subsidies are illegal unless a state has set up its health insurance marketplace. For example, Florida and Texas has a Federal Exchange; Nevada has a state exchange. This charge is based on the specific wording of the law which states subsidies are for [...]
Grandfathered plans are not required to meet these PPACA requirements: Modified community rating (starting with the 2014 plan year; this only applies to insured small group plans) Coverage of preventive care without employee cost-sharing, including contraception for women Expanded claims and appeal requirements Limitations on out-of-pocket maximums (starting with the 2014 plan year) Essential health [...]