This document discusses health care reform updates including:
1) Existing requirements that plan sponsors must comply with such as dependent coverage, annual limits, and preventive care.
2) The exchange notice requirement where employers must notify employees about health insurance exchanges.
3) Fees plan sponsors and insurers must pay including the Patient-Centered Outcomes Research fee and the reinsurance program fee.
To ensure that you are equipped with all of the latest ACA news and regulations, this POMCO Group presentation provides the latest information on the following key mandates for 2015 and beyond:
- The Transitional Reinsurance Fees
- 2015 Out-of-Pocket Limit Requirements
- Contraceptive Mandate
- Benefits for Same-Sex Spouses
- Employer Mandate: Pay or Play
- FSAs and Excepted Benefits
- Employer Reporting Requirements
- Exchange Notification for Laid-off Employees
- Health Plan Identifiers
- Health Plan Certification
Please note that the content in this webinar was current as of October 29, 2014.
Be sure you’re traveling in the right direction. From financial concerns to sound solutions, let’s talk about the challenges you face as you navigate the road toward retirement.
To ensure that you are equipped with all of the latest ACA news and regulations, this POMCO Group presentation provides the latest information on the following key mandates for 2015 and beyond:
- The Transitional Reinsurance Fees
- 2015 Out-of-Pocket Limit Requirements
- Contraceptive Mandate
- Benefits for Same-Sex Spouses
- Employer Mandate: Pay or Play
- FSAs and Excepted Benefits
- Employer Reporting Requirements
- Exchange Notification for Laid-off Employees
- Health Plan Identifiers
- Health Plan Certification
Please note that the content in this webinar was current as of October 29, 2014.
Be sure you’re traveling in the right direction. From financial concerns to sound solutions, let’s talk about the challenges you face as you navigate the road toward retirement.
Madam Speaker
In A Tale of Two Cities, Charles Dickens opens with:
“It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity… we were all going direct to Heaven, we were all going direct the other way...”
So too is the present time. As a country, we stand at a crossroads. We can choose a path of hope; or a path of despair. We can go directly to Heaven, or as Dickens so politely puts it, we can go the other way.
A brief description of how using an HSA in conjuction with a qualifed major medical HDHP can help control premiums and put you the consumer back in control of your healthcare dollars. Currently 9 million people enrolled in an HSA qualified plan.
This presentation provides an overview of eligibility for government financial assistance programs through Covered California and provides instructions for enrolling in a Covered California health plan.
Madam Speaker
In A Tale of Two Cities, Charles Dickens opens with:
“It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity… we were all going direct to Heaven, we were all going direct the other way...”
So too is the present time. As a country, we stand at a crossroads. We can choose a path of hope; or a path of despair. We can go directly to Heaven, or as Dickens so politely puts it, we can go the other way.
A brief description of how using an HSA in conjuction with a qualifed major medical HDHP can help control premiums and put you the consumer back in control of your healthcare dollars. Currently 9 million people enrolled in an HSA qualified plan.
This presentation provides an overview of eligibility for government financial assistance programs through Covered California and provides instructions for enrolling in a Covered California health plan.
These slides were part of a South Central Alabama Development Commission Facebook live training 08/21/20 describing the State Health Insurance Services provided by that agency.
HRSA requirements for a compliant sliding fee scaleCompliatric
The Health Center Compliance Manual outlines the requirements of both the program legislation and implementing regulations. The most recent updates to the Manual from HRSA provided some needed clarification in a number of areas, including the Sliding Fee Discount Program that is central to the Health Center Program. This webinar will outline the Sliding Fee requirements and provide examples and best practices for Community Health Centers to consider.
The Health Center Compliance Manual outlines the requirements of both the program legislation and implementing regulations. The most recent updates to the Manual from HRSA provided some needed clarification in a number of areas, including the Sliding Fee Discount Program that is central to the Health Center Program. This webinar will outline the Sliding Fee requirements and provide examples and best practices for Community Health Centers to consider.
Affordable Care Act - Healthcare Reform Briefing for CareermindsCareerminds
2014 and Beyond – What’s Next in Employer Sponsored Healthcare Plans
Next year will be a significant year for employer sponsored health care. With the onset of numerous benefit and eligibility mandates as well as the introduction of public medical exchanges, employers are taking a closer look of the healthcare benefits they traditionally offer employees in the US. Join us to learn about the changes in the health insurance market. We will discuss how these changes impact employer strategies and how employers will interact with the public exchanges. Beyond the employer impact we will address how the changing market will impact employees who are subject to the individual mandate beginning in 2014.
By the end of this webcast participants will be able to:
• Identify key changes HR and Benefits functions to know and do as a result of these changes
• Identify key changes required for 2014
• Discuss emerging healthcare cost trends
• Understand how employers will interact with the public exchanges
• Review emerging employer strategies including the interworkings of private exchanges
ABOUT THE PRESENTER:
Jennifer Calhoun Mohl is a Partner and senior consultant in Mercer’s Philadelphia health and benefits practice. She assists clients with various consulting assignments, including the design, administration, financing, and regulatory compliance of health and welfare benefit plans for both active and retiree populations. In addition, Jennifer serves as a relationship manager on client assignments that involve multiple Mercer offices and multiple lines of business.
In addition, Jennifer has assisted with the implementation and operations of benefit programs, including communications, outsourcing and call center support. Recently, she has served as the lead health and benefit strategist on client assignments involving multiple lines of business – with a particular focus on mergers and acquisitions.
Jennifer serves as one of Mercer’s National Health and Benefits spokeswomen. She has been quoted in various periodicals including, Managed Care Report, O&P Business News, The Philadelphia Inquirer, Philadelphia Business Journal, Money Magazine and has been featured on Money Matters Today on CN8.
Prior to joining Mercer in 1999, Jennifer began her consulting career with Towers Perrin in 1994. She was also a legislative intern in Washington for the New York State legislature with a particular focus on employment issues including the 1993 National Healthcare Initiative spearheaded by (at time first-lady), Hillary Clinton. Jennifer received a BS in Industrial and Labor Relations at the New York State School of Industrial and Labor Relations at Cornell University.
The pending Healthy Ohio 1115 Medicaid waiver would require nearly all non-disabled adults on Ohio Medicaid to pay premiums. If approved by the federal government, the waiver would result in a greater number of uninsured Ohioans as well as increased Medicaid administrative costs and complexity.
Speakers include:
* Tara Britton, Public Policy Fellow, The Center for Community Solutions
* Nita Carter, Project Director, UHCAN Ohio
Digital Transformation and IT Strategy Toolkit and TemplatesAurelien Domont, MBA
This Digital Transformation and IT Strategy Toolkit was created by ex-McKinsey, Deloitte and BCG Management Consultants, after more than 5,000 hours of work. It is considered the world's best & most comprehensive Digital Transformation and IT Strategy Toolkit. It includes all the Frameworks, Best Practices & Templates required to successfully undertake the Digital Transformation of your organization and define a robust IT Strategy.
Editable Toolkit to help you reuse our content: 700 Powerpoint slides | 35 Excel sheets | 84 minutes of Video training
This PowerPoint presentation is only a small preview of our Toolkits. For more details, visit www.domontconsulting.com
Premium MEAN Stack Development Solutions for Modern BusinessesSynapseIndia
Stay ahead of the curve with our premium MEAN Stack Development Solutions. Our expert developers utilize MongoDB, Express.js, AngularJS, and Node.js to create modern and responsive web applications. Trust us for cutting-edge solutions that drive your business growth and success.
Know more: https://www.synapseindia.com/technology/mean-stack-development-company.html
Attending a job Interview for B1 and B2 Englsih learnersErika906060
It is a sample of an interview for a business english class for pre-intermediate and intermediate english students with emphasis on the speking ability.
Kseniya Leshchenko: Shared development support service model as the way to ma...Lviv Startup Club
Kseniya Leshchenko: Shared development support service model as the way to make small projects with small budgets profitable for the company (UA)
Kyiv PMDay 2024 Summer
Website – www.pmday.org
Youtube – https://www.youtube.com/startuplviv
FB – https://www.facebook.com/pmdayconference
Putting the SPARK into Virtual Training.pptxCynthia Clay
This 60-minute webinar, sponsored by Adobe, was delivered for the Training Mag Network. It explored the five elements of SPARK: Storytelling, Purpose, Action, Relationships, and Kudos. Knowing how to tell a well-structured story is key to building long-term memory. Stating a clear purpose that doesn't take away from the discovery learning process is critical. Ensuring that people move from theory to practical application is imperative. Creating strong social learning is the key to commitment and engagement. Validating and affirming participants' comments is the way to create a positive learning environment.
RMD24 | Retail media: hoe zet je dit in als je geen AH of Unilever bent? Heid...BBPMedia1
Grote partijen zijn al een tijdje onderweg met retail media. Ondertussen worden in dit domein ook de kansen zichtbaar voor andere spelers in de markt. Maar met die kansen ontstaan ook vragen: Zelf retail media worden of erop adverteren? In welke fase van de funnel past het en hoe integreer je het in een mediaplan? Wat is nu precies het verschil met marketplaces en Programmatic ads? In dit half uur beslechten we de dilemma's en krijg je antwoorden op wanneer het voor jou tijd is om de volgende stap te zetten.
Implicitly or explicitly all competing businesses employ a strategy to select a mix
of marketing resources. Formulating such competitive strategies fundamentally
involves recognizing relationships between elements of the marketing mix (e.g.,
price and product quality), as well as assessing competitive and market conditions
(i.e., industry structure in the language of economics).
Enterprise Excellence is Inclusive Excellence.pdfKaiNexus
Enterprise excellence and inclusive excellence are closely linked, and real-world challenges have shown that both are essential to the success of any organization. To achieve enterprise excellence, organizations must focus on improving their operations and processes while creating an inclusive environment that engages everyone. In this interactive session, the facilitator will highlight commonly established business practices and how they limit our ability to engage everyone every day. More importantly, though, participants will likely gain increased awareness of what we can do differently to maximize enterprise excellence through deliberate inclusion.
What is Enterprise Excellence?
Enterprise Excellence is a holistic approach that's aimed at achieving world-class performance across all aspects of the organization.
What might I learn?
A way to engage all in creating Inclusive Excellence. Lessons from the US military and their parallels to the story of Harry Potter. How belt systems and CI teams can destroy inclusive practices. How leadership language invites people to the party. There are three things leaders can do to engage everyone every day: maximizing psychological safety to create environments where folks learn, contribute, and challenge the status quo.
Who might benefit? Anyone and everyone leading folks from the shop floor to top floor.
Dr. William Harvey is a seasoned Operations Leader with extensive experience in chemical processing, manufacturing, and operations management. At Michelman, he currently oversees multiple sites, leading teams in strategic planning and coaching/practicing continuous improvement. William is set to start his eighth year of teaching at the University of Cincinnati where he teaches marketing, finance, and management. William holds various certifications in change management, quality, leadership, operational excellence, team building, and DiSC, among others.
RMD24 | Debunking the non-endemic revenue myth Marvin Vacquier Droop | First ...BBPMedia1
Marvin neemt je in deze presentatie mee in de voordelen van non-endemic advertising op retail media netwerken. Hij brengt ook de uitdagingen in beeld die de markt op dit moment heeft op het gebied van retail media voor niet-leveranciers.
Retail media wordt gezien als het nieuwe advertising-medium en ook mediabureaus richten massaal retail media-afdelingen op. Merken die niet in de betreffende winkel liggen staan ook nog niet in de rij om op de retail media netwerken te adverteren. Marvin belicht de uitdagingen die er zijn om echt aansluiting te vinden op die markt van non-endemic advertising.
Improving profitability for small businessBen Wann
In this comprehensive presentation, we will explore strategies and practical tips for enhancing profitability in small businesses. Tailored to meet the unique challenges faced by small enterprises, this session covers various aspects that directly impact the bottom line. Attendees will learn how to optimize operational efficiency, manage expenses, and increase revenue through innovative marketing and customer engagement techniques.
LA HUG - Video Testimonials with Chynna Morgan - June 2024Lital Barkan
Have you ever heard that user-generated content or video testimonials can take your brand to the next level? We will explore how you can effectively use video testimonials to leverage and boost your sales, content strategy, and increase your CRM data.🤯
We will dig deeper into:
1. How to capture video testimonials that convert from your audience 🎥
2. How to leverage your testimonials to boost your sales 💲
3. How you can capture more CRM data to understand your audience better through video testimonials. 📊
3.0 Project 2_ Developing My Brand Identity Kit.pptxtanyjahb
A personal brand exploration presentation summarizes an individual's unique qualities and goals, covering strengths, values, passions, and target audience. It helps individuals understand what makes them stand out, their desired image, and how they aim to achieve it.
1. Health Care Reform UpdateHealth Care Reform Update
Presented by:
Andy Impastatoy p
Vice President – Client Compliance
2. Political OutlookPolitical Outlook
• Status quo federal electionsStatus quo federal elections
• State legislative attacks
– PPACA is here to stayPPACA is here to stay
• Louisiana Exchange
– Federal government’s roleg
• Medicaid expansion
– Will Louisiana expand?p
• Pending litigation
• Future litigation
This publication is provided for educational and informational purposes only and does not contain legal advice. You should not act on any information provided without consulting legal
counsel. To comply with U.S. Treasury Regulations, we also inform you that, unless expressly stated otherwise, any tax advice contained in this communication is not intended to be used and
cannot be used by any taxpayer to avoid penalties under the Internal Revenue Code.
Proprietary and Confidential. Not for Distribution
g
3. Existing RequirementsExisting Requirements
• Plan sponsors must confirm they are inPlan sponsors must confirm they are in
compliance with all applicable requirements that
have become effective since the Act’s passage
• Plan sponsors taking a “wait and see” approach
must get in gear
• DOL has ramped up enforcement regarding
existing requirements
This publication is provided for educational and informational purposes only and does not contain legal advice. You should not act on any information provided without consulting legal
counsel. To comply with U.S. Treasury Regulations, we also inform you that, unless expressly stated otherwise, any tax advice contained in this communication is not intended to be used and
cannot be used by any taxpayer to avoid penalties under the Internal Revenue Code.
Proprietary and Confidential. Not for Distribution
4. Existing RequirementsExisting Requirements
• Grandfathered Plans (GF)Grandfathered Plans (GF)
– Impermissible changes
• Elimination of benefits
• Any increase in percentage cost-sharing
• Increase in fixed-amount cost-sharing
– 15% above medical inflation is allowed
• Decrease in employer contribution
– Five percentage points
• Certain changes to annual limitsCertain changes to annual limits
– Disclosure requirements
– Recordkeeping requirements
This publication is provided for educational and informational purposes only and does not contain legal advice. You should not act on any information provided without consulting legal
counsel. To comply with U.S. Treasury Regulations, we also inform you that, unless expressly stated otherwise, any tax advice contained in this communication is not intended to be used and
cannot be used by any taxpayer to avoid penalties under the Internal Revenue Code.
Proprietary and Confidential. Not for Distribution
5. Existing Requirements
• Dependent coverage (GF*)
Existing Requirements
Dependent coverage (GF )
• Prohibition on lifetime limits
• Restrictions on annual limitsRestrictions on annual limits
• Pre-existing conditions for children
• Patient protections (GF)• Patient protections (GF)
• Preventive care (GF)
• Internal and external claim review (GF)• Internal and external claim review (GF)
This publication is provided for educational and informational purposes only and does not contain legal advice. You should not act on any information provided without consulting legal
counsel. To comply with U.S. Treasury Regulations, we also inform you that, unless expressly stated otherwise, any tax advice contained in this communication is not intended to be used and
cannot be used by any taxpayer to avoid penalties under the Internal Revenue Code.
Proprietary and Confidential. Not for Distribution
6. Existing Requirements
• Expanded women’s preventive care (GF)
Existing Requirements
Expanded women s preventive care (GF)
• Medical Loss Ratio (MLR) Rebates
• Summary of benefits and coverageSummary of benefits and coverage
• W-2 reporting
• Additional Medicare tax for HCEs• Additional Medicare tax for HCEs
• Elimination of Part D subsidy deduction
• Flexible spending account (FSA) caps• Flexible spending account (FSA) caps
This publication is provided for educational and informational purposes only and does not contain legal advice. You should not act on any information provided without consulting legal
counsel. To comply with U.S. Treasury Regulations, we also inform you that, unless expressly stated otherwise, any tax advice contained in this communication is not intended to be used and
cannot be used by any taxpayer to avoid penalties under the Internal Revenue Code.
Proprietary and Confidential. Not for Distribution
7. Exchange NoticeExchange Notice
• OverviewOverview
– Employer disclosure requirement
• Written notice• Written notice
• Existence of Exchange (now called Marketplace)
• Eligibility of subsidyg y y
• Consequences of dropping employer coverage
• Original deadline March 1, 2013
This publication is provided for educational and informational purposes only and does not contain legal advice. You should not act on any information provided without consulting legal
counsel. To comply with U.S. Treasury Regulations, we also inform you that, unless expressly stated otherwise, any tax advice contained in this communication is not intended to be used and
cannot be used by any taxpayer to avoid penalties under the Internal Revenue Code.
Proprietary and Confidential. Not for Distribution
8. Exchange NoticeExchange Notice
• OverviewOverview
– DOL extended deadline on January 24, 2013
DOL issued temporary guidance on May 8– DOL issued temporary guidance on May 8,
2013
• Technical Release 2013-12Technical Release 2013 12
• Model Exchange Notices
• Revised COBRA Election Notice
This publication is provided for educational and informational purposes only and does not contain legal advice. You should not act on any information provided without consulting legal
counsel. To comply with U.S. Treasury Regulations, we also inform you that, unless expressly stated otherwise, any tax advice contained in this communication is not intended to be used and
cannot be used by any taxpayer to avoid penalties under the Internal Revenue Code.
Proprietary and Confidential. Not for Distribution
9. Exchange NoticeExchange Notice
• Applicability (Employer)Applicability (Employer)
• PPACA § 1512 added § 18B of the FLSA
• Applies to employers subject to FLSAApplies to employers subject to FLSA
• Broad definition of employer
– Employs one or more employees
– Engaged in interstate commerce
– $500,000 in annual volume of business*
B d d fi iti f l• Broad definition of employee
• Most employers are subject to the
requirement
This publication is provided for educational and informational purposes only and does not contain legal advice. You should not act on any information provided without consulting legal
counsel. To comply with U.S. Treasury Regulations, we also inform you that, unless expressly stated otherwise, any tax advice contained in this communication is not intended to be used and
cannot be used by any taxpayer to avoid penalties under the Internal Revenue Code.
Proprietary and Confidential. Not for Distribution
requirement
10. Exchange NoticeExchange Notice
• Applicability (Employee)Applicability (Employee)
• New and existing employees
• Full time and part time employees• Full-time and part-time employees
• Plan enrollment status is immaterial
Separate notice to dependents is not• Separate notice to dependents is not
required
This publication is provided for educational and informational purposes only and does not contain legal advice. You should not act on any information provided without consulting legal
counsel. To comply with U.S. Treasury Regulations, we also inform you that, unless expressly stated otherwise, any tax advice contained in this communication is not intended to be used and
cannot be used by any taxpayer to avoid penalties under the Internal Revenue Code.
Proprietary and Confidential. Not for Distribution
11. Exchange NoticeExchange Notice
• TimingTiming
– New employee
• Time of hiring beginning October 1 2013• Time of hiring beginning October 1, 2013
• Within 14 days of start date
– Existing employeeExisting employee
• No later than October 1, 2013
– Provided automaticallyProvided automatically
– Free of charge
This publication is provided for educational and informational purposes only and does not contain legal advice. You should not act on any information provided without consulting legal
counsel. To comply with U.S. Treasury Regulations, we also inform you that, unless expressly stated otherwise, any tax advice contained in this communication is not intended to be used and
cannot be used by any taxpayer to avoid penalties under the Internal Revenue Code.
Proprietary and Confidential. Not for Distribution
12. Exchange NoticeExchange Notice
• DeliveryDelivery
– May be provided first-class mail
May be provided electronically– May be provided electronically
• DOL electronic safe harbor rules
Guidance is unclear on other methods of– Guidance is unclear on other methods of
delivery
• Part of new employee materialsPart of new employee materials
• Hand delivery
This publication is provided for educational and informational purposes only and does not contain legal advice. You should not act on any information provided without consulting legal
counsel. To comply with U.S. Treasury Regulations, we also inform you that, unless expressly stated otherwise, any tax advice contained in this communication is not intended to be used and
cannot be used by any taxpayer to avoid penalties under the Internal Revenue Code.
Proprietary and Confidential. Not for Distribution
13. Exchange NoticeExchange Notice
• Model NoticesModel Notices
– Model for employers who offer coverage
• All or some employees• All or some employees
– Model for employers who do not offer
coveragecoverage
– Employers can use model notices
– Employers can use modified versionEmployers can use modified version
• Provided meets the content requirements
This publication is provided for educational and informational purposes only and does not contain legal advice. You should not act on any information provided without consulting legal
counsel. To comply with U.S. Treasury Regulations, we also inform you that, unless expressly stated otherwise, any tax advice contained in this communication is not intended to be used and
cannot be used by any taxpayer to avoid penalties under the Internal Revenue Code.
Proprietary and Confidential. Not for Distribution
14. Fees
• Patient centered outcomes research fee
Fees
Patient centered outcomes research fee
(PCOR)
Plan years ending after September 30 2012– Plan years ending after September 30, 2012
– $1 per covered life for first year
$2 per covered life for plan years ending– $2 per covered life for plan years ending
October 1, 2013
Amount adjusted by Treasury Department for– Amount adjusted by Treasury Department for
plan years ending after September 30, 2014
– Fee will phase out (sunset) in 2019
This publication is provided for educational and informational purposes only and does not contain legal advice. You should not act on any information provided without consulting legal
counsel. To comply with U.S. Treasury Regulations, we also inform you that, unless expressly stated otherwise, any tax advice contained in this communication is not intended to be used and
cannot be used by any taxpayer to avoid penalties under the Internal Revenue Code.
Proprietary and Confidential. Not for Distribution
Fee will phase out (sunset) in 2019
15. Fees
• Patient centered outcomes research fee
Fees
Patient centered outcomes research fee
(PCOR)
– Insurer has to pay fee for insured plans
– Plan sponsor has to pay fee for self-funded plans
– Prescribed formulas for determining covered lives
Fee will be reported on IRS Form 720 annually– Fee will be reported on IRS Form 720 annually
– Fee will be paid annually (by July 31st of each year)
– Carriers will pass this fee on as a premium increasep p
This publication is provided for educational and informational purposes only and does not contain legal advice. You should not act on any information provided without consulting legal
counsel. To comply with U.S. Treasury Regulations, we also inform you that, unless expressly stated otherwise, any tax advice contained in this communication is not intended to be used and
cannot be used by any taxpayer to avoid penalties under the Internal Revenue Code.
Proprietary and Confidential. Not for Distribution
16. Fees
• Reinsurance program fee
Fees
Reinsurance program fee
– Effective 2014-2016
– Fully insured = carrier*Fully insured carrier
– Self insured = plan (can use TPA)
– Intended to stabilize premiums in individual market
– Major medical products only
– Prescribed methods for counting covered lives
– Reported and paid to HHS on a calendar year basis
– Proposed amount of $5.85 PMPM or $70 PMPY
• HHS has proposed flat rate of $63
This publication is provided for educational and informational purposes only and does not contain legal advice. You should not act on any information provided without consulting legal
counsel. To comply with U.S. Treasury Regulations, we also inform you that, unless expressly stated otherwise, any tax advice contained in this communication is not intended to be used and
cannot be used by any taxpayer to avoid penalties under the Internal Revenue Code.
Proprietary and Confidential. Not for Distribution
• HHS has proposed flat rate of $63
17. FeesFees
• Insurance industry feeInsurance industry fee
– Effective 2014 (permanent)
Fully insured = carrier*– Fully insured = carrier
– Does not apply to self-insured plans
Intended to pay for exchange subsidies– Intended to pay for exchange subsidies
– Estimated amount of $9 PMPM or $108
PMPYPMPY
This publication is provided for educational and informational purposes only and does not contain legal advice. You should not act on any information provided without consulting legal
counsel. To comply with U.S. Treasury Regulations, we also inform you that, unless expressly stated otherwise, any tax advice contained in this communication is not intended to be used and
cannot be used by any taxpayer to avoid penalties under the Internal Revenue Code.
Proprietary and Confidential. Not for Distribution
18. Community RatingCommunity Rating
• Rating limitationsRating limitations
– “Small” (Non-GF) groups only
Premiums can vary only for:– Premiums can vary only for:
• Coverage category
• Rating area (established by States)Rating area (established by States)
• Age (3:1)
• Tobacco use (1.5:1)( )
– Will result in large premium increases
This publication is provided for educational and informational purposes only and does not contain legal advice. You should not act on any information provided without consulting legal
counsel. To comply with U.S. Treasury Regulations, we also inform you that, unless expressly stated otherwise, any tax advice contained in this communication is not intended to be used and
cannot be used by any taxpayer to avoid penalties under the Internal Revenue Code.
Proprietary and Confidential. Not for Distribution
19. Plan Design ChangesPlan Design Changes
• Prohibition on pre-existing condition exclusionProhibition on pre existing condition exclusion
• Prohibition on annual limits
• Restriction on waiting periods (90 days)Restriction on waiting periods (90 days)
• Essential health benefits (GF) (no large)
• Deductible caps ($2 000 /$4 000) (GF) (no• Deductible caps ($2,000 /$4,000) (GF) (no
large)
• Out of pocket caps ($6 250 / $12 500) (GF)• Out of pocket caps ($6,250 / $12,500) (GF)
This publication is provided for educational and informational purposes only and does not contain legal advice. You should not act on any information provided without consulting legal
counsel. To comply with U.S. Treasury Regulations, we also inform you that, unless expressly stated otherwise, any tax advice contained in this communication is not intended to be used and
cannot be used by any taxpayer to avoid penalties under the Internal Revenue Code.
Proprietary and Confidential. Not for Distribution
20. Questions & AnswersQuestions & Answers
This publication is provided for educational and informational purposes only and does not contain legal advice. You should not act on any information provided without consulting legal
counsel. To comply with U.S. Treasury Regulations, we also inform you that, unless expressly stated otherwise, any tax advice contained in this communication is not intended to be used and
cannot be used by any taxpayer to avoid penalties under the Internal Revenue Code.
Proprietary and Confidential. Not for Distribution 20