This document summarizes the impacts of the American Recovery and Reinvestment Act of 2009 (ARRA) on COBRA continuation health coverage. It outlines that ARRA provides eligible individuals who lost their job between September 2008 and December 2009 a premium reduction of 65% for COBRA coverage for up to 9 months. It also provides an extended election period for those who did not previously elect COBRA. Employers can reimburse themselves for the reduced premium amount through payroll tax credits. The document provides details on eligibility, coverage periods, impacts to individuals, group health plans and employers, and taxation implications of the premium reductions.
The document provides an overview of recent changes to benefits laws as of June 15, 2009. It summarizes new laws regarding equal mental health and substance abuse benefits under the new health care reform law, coverage of medical leaves for students under Michelle's Law, the COBRA premium subsidy under the stimulus bill, changes to FMLA regulations, expanded FMLA leave for military families, an expanded definition of disability under the ADA, new Medicare reporting requirements, a ban on genetic discrimination, special enrollment rights under HIPAA, and changes to HIPAA privacy and security rules.
The document summarizes provisions of the American Recovery and Reinvestment Act of 2009 regarding subsidies for COBRA health insurance premiums. It provides details on eligibility requirements, the amount of subsidies, how subsidies are administered and reimbursed, notification requirements, and income limits for receiving subsidies. The key points are that the Act provides subsidies of 65% of COBRA premiums for involuntarily terminated workers for up to 9 months, subsidies are claimed as a tax credit by employers/plans, and certain income thresholds apply for subsidy eligibility.
The Health Care and Education Affordability Reconciliation Act of 2010 was recently passed by the House and will be signed into law 03/30/2010. NAHU (National Association for Health Underwriters) published a comprehensive timeline of the changes coming over the next few years. Please contact me with any questions.
This document provides an overview of the COBRA provisions in the American Recovery and Reinvestment Act of 2009. Key points include that qualified beneficiaries can pay a reduced COBRA premium of 35% for up to 9 months, with the remaining 65% reimbursed through a payroll tax credit to employers. Those eligible generally had involuntary job termination from September 2008 to December 2009 and are eligible for COBRA. Notices must be provided to eligible individuals about the premium reduction and extended election periods.
The document provides a timeline for key provisions of the Affordable Care Act (ACA) being implemented between 2010-2014. Some 2010 provisions included requiring plans to cover adult children up to age 26, prohibiting pre-existing condition exclusions for children, covering preventive care with no cost sharing, and establishing a high-risk pool. An improved claims/appeals process and rebates for the Medicare Part D "donut hole" also took effect in 2010. Future provisions will expand insurance coverage and reforms through 2014.
Intertwined Guidelines: Untangling Your Enrollment Notice Requirementbenefitexpress
This document discusses various notices that must be provided to participants in group health plans. It separates the notices into those that are required for all plans, those required for all plans but not annually, and notices required for plans meeting specific criteria. For each notice, it provides details on who must provide the notice, who it must be provided to, and the timeline for delivering the notice. Notices discussed include the SBC, HIPAA special enrollment rights, Medicare Part D creditable coverage, CHIP, and various COBRA required notices.
The document provides an overview of recent changes to benefits laws as of June 15, 2009. It summarizes new laws regarding equal mental health and substance abuse benefits under the new health care reform law, coverage of medical leaves for students under Michelle's Law, the COBRA premium subsidy under the stimulus bill, changes to FMLA regulations, expanded FMLA leave for military families, an expanded definition of disability under the ADA, new Medicare reporting requirements, a ban on genetic discrimination, special enrollment rights under HIPAA, and changes to HIPAA privacy and security rules.
The document summarizes provisions of the American Recovery and Reinvestment Act of 2009 regarding subsidies for COBRA health insurance premiums. It provides details on eligibility requirements, the amount of subsidies, how subsidies are administered and reimbursed, notification requirements, and income limits for receiving subsidies. The key points are that the Act provides subsidies of 65% of COBRA premiums for involuntarily terminated workers for up to 9 months, subsidies are claimed as a tax credit by employers/plans, and certain income thresholds apply for subsidy eligibility.
The Health Care and Education Affordability Reconciliation Act of 2010 was recently passed by the House and will be signed into law 03/30/2010. NAHU (National Association for Health Underwriters) published a comprehensive timeline of the changes coming over the next few years. Please contact me with any questions.
This document provides an overview of the COBRA provisions in the American Recovery and Reinvestment Act of 2009. Key points include that qualified beneficiaries can pay a reduced COBRA premium of 35% for up to 9 months, with the remaining 65% reimbursed through a payroll tax credit to employers. Those eligible generally had involuntary job termination from September 2008 to December 2009 and are eligible for COBRA. Notices must be provided to eligible individuals about the premium reduction and extended election periods.
The document provides a timeline for key provisions of the Affordable Care Act (ACA) being implemented between 2010-2014. Some 2010 provisions included requiring plans to cover adult children up to age 26, prohibiting pre-existing condition exclusions for children, covering preventive care with no cost sharing, and establishing a high-risk pool. An improved claims/appeals process and rebates for the Medicare Part D "donut hole" also took effect in 2010. Future provisions will expand insurance coverage and reforms through 2014.
Intertwined Guidelines: Untangling Your Enrollment Notice Requirementbenefitexpress
This document discusses various notices that must be provided to participants in group health plans. It separates the notices into those that are required for all plans, those required for all plans but not annually, and notices required for plans meeting specific criteria. For each notice, it provides details on who must provide the notice, who it must be provided to, and the timeline for delivering the notice. Notices discussed include the SBC, HIPAA special enrollment rights, Medicare Part D creditable coverage, CHIP, and various COBRA required notices.
This document is an IRS Form 1095-C reporting health insurance coverage information for an employee. It provides information about the employee, their employer, and the health coverage offered to the employee. If the employer's health plan is self-insured, it also lists family members covered under the plan along with their coverage months. The form instructions explain how to read the codes on the form and direct the recipient where to find more information about the Affordable Care Act and tax provisions.
Constructing HRA: Blueprints for Solid Administrationbenefitexpress
Learn the ins and outs of offering a private benefits marketplace for your employees, HRA administration, and various agencies regulating what's included.
Latest and Greatest in HRA's and Cafeteria Plansbenefitexpress
This webinar covers:
• New guidance in the Health FSA carryover requirements
• Can individual premiums be reimbursed under HRA's or cafeteria plans?
• New rules on integrated HSA's and standalone HRA's
• When are health FSA's subject to Health Reform?
• New reporting and disclosure requirements
The American Recovery and Reinvestment Act of 2009 provides a subsidy of 65% of COBRA premiums for involuntarily terminated employees for up to 9 months. Eligible individuals include those terminated between September 1, 2008 and December 31, 2009. Employers must provide retroactive notice by April 19, 2009 to all terminated employees from September 1, 2008 onward about their potential COBRA subsidy eligibility. Employers can recoup the 65% subsidy amount through payroll tax credits.
The document provides an overview of key provisions and timelines in the Senate healthcare reform bill that was passed in 2010:
- Individuals can keep current health policies on a grandfathered basis until 2014 when state health insurance exchanges will be set up.
- Small businesses are eligible for tax credits to help pay employee premiums starting in 2010.
- Several new consumer protections and benefit requirements go into effect for plans in 2010-2014, including coverage of preexisting conditions for children, preventive care with no cost sharing, and allowing adult children to stay on parents' plans until age 26.
- Health insurance exchanges with standardized plans will be set up in each state starting in 2014, along with penalties for individuals
COBRA provides temporary continuation of health coverage when it would otherwise be lost due to certain events like job loss. It applies to employers with 20+ employees and provides qualified beneficiaries like employees, spouses, dependents up to 36 months of continued coverage at group rates. When coverage is lost due to job loss, reduction in hours, divorce or other qualifying events, beneficiaries must be notified of COBRA rights and have 60 days to elect continued coverage by paying premiums. Coverage can end earlier for non-payment of premiums or obtaining other coverage, and conversion to individual policies must be offered at the end of the continuation period.
The Consolidated Omnibus Budget Reconciliation Act (COBRA) allows individuals to continue their group health plan coverage in certain situations. Specifically, COBRA requires group health plans to offer continuation coverage to covered employees and dependents when coverage would otherwise be lost due to certain specific events...
The document provides an end-of-year wrap-up and reminders relating to Affordable Care Act (ACA) compliance in 2015. Key updates include: the Supreme Court agreeing to hear a case on premium tax credits; guidance clarifying that "skinny plans" must meet minimum value standards; and FAQs further prohibiting cash incentives for individual coverage. It also reminds readers of ACA provisions taking effect in 2015, such as out-of-pocket limits and the employer shared responsibility requirement.
ACA (mis)Management: What Everyone Has Learned & the Game Plan for 2017benefitexpress
The document discusses three proposals for reforming the Affordable Care Act from Trump's campaign, House Republicans, and Secretary of Health and Human Services Tom Price. It outlines key elements of each proposal, including repealing the individual and employer mandates, establishing tax credits for health insurance, and allowing cross-state purchasing. The document also examines potential changes to other welfare programs and the tax code under a Trump administration.
The document provides a summary of the key provisions and implementation timelines of the Affordable Care Act (ACA) health reform legislation passed by Congress and signed into law by President Obama in 2010. It outlines what is required in the immediate future in 2010, as well as changes phased in between now and 2014 such as establishing insurance exchanges, essential benefits packages, and penalties for individuals and employers who do not obtain qualified health insurance coverage. The summary concludes by encouraging questions and feedback from readers to help with understanding and implementing the complex health reform law.
This document provides an overview of the nuts and bolts of COBRA. It discusses what COBRA is, who it applies to, qualifying events, qualified beneficiaries, required notices, costs, length of coverage, termination of coverage, penalties for non-compliance, and common mistakes made with COBRA. It aims to explain the key aspects of administering and complying with COBRA requirements for employers.
Health Reform Bulletin 120 | Proposed Reliant Regulations.CBIZ, Inc.
The latest HRB provides insight into the following: Proposed Regulations: Expatriate Health Plans, Excepted Benefit Plans, Essential Health Benefits relating to Lifetime and Annual Limits, and Individual Shared Responsibility Requirements; IRS Releases Draft 2016 Forms 1094/1095.
This letter provides guidance to states on implementing a new Medicaid eligibility group established by the Affordable Care Act. It outlines that starting in April 2010, states have the option to cover all non-disabled, non-elderly adults with incomes up to 133% of the federal poverty level. It describes rules for determining income eligibility and required benchmark benefits. States must submit amendments to their Medicaid plans by June 30, 2010 to implement this option starting April 1, 2010.
This document defines various health insurance terms used in the Affordable Care Act and Washington state programs. It provides definitions for over 50 terms related to health plans, coverage, costs, eligibility and other key concepts. The document is intended to help consumers understand and navigate their health insurance options.
The document discusses new IRS requirements for reporting the cost of employer-sponsored health coverage on employee W-2 forms beginning in 2012. It provides guidance on calculating the reportable cost and which types of coverage must and need not be included. Reporting is required for employers filing 250 or more W-2s and will apply to most types of employer-sponsored health plans. Failure to comply can result in penalties of up to $1,500,000. Employers have flexibility in determining costs and should rely on payroll systems and IRS notices for guidance.
This document summarizes several key provisions of the 2010 health reform law and how they may impact employees. It outlines new restrictions on lifetime and annual dollar limits on coverage, requirements for preventive services coverage without cost sharing, an extension of dependent coverage until age 26, and standards for uniform coverage documents and reporting of medical loss ratios.
This document discusses the state of internet usage and social media in South Africa. It provides statistics on the number of internet users, Facebook users, bloggers, MXit users, and LinkedIn users in South Africa. It notes that many South African Facebook users are still young, as they access Facebook through their educational institutions. It argues that local hosting of internet platforms and services could help connect communities and familiarize more South Africans with basic web tools. Several new South African blogging, social networking, and mobile sites are highlighted as helping to build the foundations for the future of internet usage in South Africa.
The MXit Presentation: Study Stats & Social MediaEshaam Rabaney
The document discusses MXit, a free instant messaging application developed in South Africa. It provides statistics on MXit's user base, which is estimated to be over 10 million users. MXit sees high levels of activity, with over 1 billion messages sent and received per month on the platform within South Africa alone. The document also outlines how businesses can advertise on MXit through splash screen advertisements, branded portals, and direct messages. Potential social media marketing initiatives on MXit that are discussed include contests, crowd-sourcing, and providing customer support. Finally, the new MXit Evo Web Chat feature is highlighted, which allows integrating MXit chat functionality into websites.
MWEB's "FTWSA" Social Media Campaign Analysis & InsightsEshaam Rabaney
The document summarizes MWEB's "Free the Web South Africa" social media campaign. The campaign began on March 1st, 2010 with Facebook ads promoting more affordable internet access. By March 15th, the fan page had grown to 10,000 fans who were eagerly awaiting the announcement. On March 17th, MWEB revealed themselves as the leaders of the movement and launched new low-cost broadband packages. The campaign was centered around engaging users on Facebook and gained over 16,000 fans and 300 Twitter followers within 72 hours. The campaign leveraged South African online culture and sparked conversation to build anticipation around more affordable internet access.
This document is an IRS Form 1095-C reporting health insurance coverage information for an employee. It provides information about the employee, their employer, and the health coverage offered to the employee. If the employer's health plan is self-insured, it also lists family members covered under the plan along with their coverage months. The form instructions explain how to read the codes on the form and direct the recipient where to find more information about the Affordable Care Act and tax provisions.
Constructing HRA: Blueprints for Solid Administrationbenefitexpress
Learn the ins and outs of offering a private benefits marketplace for your employees, HRA administration, and various agencies regulating what's included.
Latest and Greatest in HRA's and Cafeteria Plansbenefitexpress
This webinar covers:
• New guidance in the Health FSA carryover requirements
• Can individual premiums be reimbursed under HRA's or cafeteria plans?
• New rules on integrated HSA's and standalone HRA's
• When are health FSA's subject to Health Reform?
• New reporting and disclosure requirements
The American Recovery and Reinvestment Act of 2009 provides a subsidy of 65% of COBRA premiums for involuntarily terminated employees for up to 9 months. Eligible individuals include those terminated between September 1, 2008 and December 31, 2009. Employers must provide retroactive notice by April 19, 2009 to all terminated employees from September 1, 2008 onward about their potential COBRA subsidy eligibility. Employers can recoup the 65% subsidy amount through payroll tax credits.
The document provides an overview of key provisions and timelines in the Senate healthcare reform bill that was passed in 2010:
- Individuals can keep current health policies on a grandfathered basis until 2014 when state health insurance exchanges will be set up.
- Small businesses are eligible for tax credits to help pay employee premiums starting in 2010.
- Several new consumer protections and benefit requirements go into effect for plans in 2010-2014, including coverage of preexisting conditions for children, preventive care with no cost sharing, and allowing adult children to stay on parents' plans until age 26.
- Health insurance exchanges with standardized plans will be set up in each state starting in 2014, along with penalties for individuals
COBRA provides temporary continuation of health coverage when it would otherwise be lost due to certain events like job loss. It applies to employers with 20+ employees and provides qualified beneficiaries like employees, spouses, dependents up to 36 months of continued coverage at group rates. When coverage is lost due to job loss, reduction in hours, divorce or other qualifying events, beneficiaries must be notified of COBRA rights and have 60 days to elect continued coverage by paying premiums. Coverage can end earlier for non-payment of premiums or obtaining other coverage, and conversion to individual policies must be offered at the end of the continuation period.
The Consolidated Omnibus Budget Reconciliation Act (COBRA) allows individuals to continue their group health plan coverage in certain situations. Specifically, COBRA requires group health plans to offer continuation coverage to covered employees and dependents when coverage would otherwise be lost due to certain specific events...
The document provides an end-of-year wrap-up and reminders relating to Affordable Care Act (ACA) compliance in 2015. Key updates include: the Supreme Court agreeing to hear a case on premium tax credits; guidance clarifying that "skinny plans" must meet minimum value standards; and FAQs further prohibiting cash incentives for individual coverage. It also reminds readers of ACA provisions taking effect in 2015, such as out-of-pocket limits and the employer shared responsibility requirement.
ACA (mis)Management: What Everyone Has Learned & the Game Plan for 2017benefitexpress
The document discusses three proposals for reforming the Affordable Care Act from Trump's campaign, House Republicans, and Secretary of Health and Human Services Tom Price. It outlines key elements of each proposal, including repealing the individual and employer mandates, establishing tax credits for health insurance, and allowing cross-state purchasing. The document also examines potential changes to other welfare programs and the tax code under a Trump administration.
The document provides a summary of the key provisions and implementation timelines of the Affordable Care Act (ACA) health reform legislation passed by Congress and signed into law by President Obama in 2010. It outlines what is required in the immediate future in 2010, as well as changes phased in between now and 2014 such as establishing insurance exchanges, essential benefits packages, and penalties for individuals and employers who do not obtain qualified health insurance coverage. The summary concludes by encouraging questions and feedback from readers to help with understanding and implementing the complex health reform law.
This document provides an overview of the nuts and bolts of COBRA. It discusses what COBRA is, who it applies to, qualifying events, qualified beneficiaries, required notices, costs, length of coverage, termination of coverage, penalties for non-compliance, and common mistakes made with COBRA. It aims to explain the key aspects of administering and complying with COBRA requirements for employers.
Health Reform Bulletin 120 | Proposed Reliant Regulations.CBIZ, Inc.
The latest HRB provides insight into the following: Proposed Regulations: Expatriate Health Plans, Excepted Benefit Plans, Essential Health Benefits relating to Lifetime and Annual Limits, and Individual Shared Responsibility Requirements; IRS Releases Draft 2016 Forms 1094/1095.
This letter provides guidance to states on implementing a new Medicaid eligibility group established by the Affordable Care Act. It outlines that starting in April 2010, states have the option to cover all non-disabled, non-elderly adults with incomes up to 133% of the federal poverty level. It describes rules for determining income eligibility and required benchmark benefits. States must submit amendments to their Medicaid plans by June 30, 2010 to implement this option starting April 1, 2010.
This document defines various health insurance terms used in the Affordable Care Act and Washington state programs. It provides definitions for over 50 terms related to health plans, coverage, costs, eligibility and other key concepts. The document is intended to help consumers understand and navigate their health insurance options.
The document discusses new IRS requirements for reporting the cost of employer-sponsored health coverage on employee W-2 forms beginning in 2012. It provides guidance on calculating the reportable cost and which types of coverage must and need not be included. Reporting is required for employers filing 250 or more W-2s and will apply to most types of employer-sponsored health plans. Failure to comply can result in penalties of up to $1,500,000. Employers have flexibility in determining costs and should rely on payroll systems and IRS notices for guidance.
This document summarizes several key provisions of the 2010 health reform law and how they may impact employees. It outlines new restrictions on lifetime and annual dollar limits on coverage, requirements for preventive services coverage without cost sharing, an extension of dependent coverage until age 26, and standards for uniform coverage documents and reporting of medical loss ratios.
This document discusses the state of internet usage and social media in South Africa. It provides statistics on the number of internet users, Facebook users, bloggers, MXit users, and LinkedIn users in South Africa. It notes that many South African Facebook users are still young, as they access Facebook through their educational institutions. It argues that local hosting of internet platforms and services could help connect communities and familiarize more South Africans with basic web tools. Several new South African blogging, social networking, and mobile sites are highlighted as helping to build the foundations for the future of internet usage in South Africa.
The MXit Presentation: Study Stats & Social MediaEshaam Rabaney
The document discusses MXit, a free instant messaging application developed in South Africa. It provides statistics on MXit's user base, which is estimated to be over 10 million users. MXit sees high levels of activity, with over 1 billion messages sent and received per month on the platform within South Africa alone. The document also outlines how businesses can advertise on MXit through splash screen advertisements, branded portals, and direct messages. Potential social media marketing initiatives on MXit that are discussed include contests, crowd-sourcing, and providing customer support. Finally, the new MXit Evo Web Chat feature is highlighted, which allows integrating MXit chat functionality into websites.
MWEB's "FTWSA" Social Media Campaign Analysis & InsightsEshaam Rabaney
The document summarizes MWEB's "Free the Web South Africa" social media campaign. The campaign began on March 1st, 2010 with Facebook ads promoting more affordable internet access. By March 15th, the fan page had grown to 10,000 fans who were eagerly awaiting the announcement. On March 17th, MWEB revealed themselves as the leaders of the movement and launched new low-cost broadband packages. The campaign was centered around engaging users on Facebook and gained over 16,000 fans and 300 Twitter followers within 72 hours. The campaign leveraged South African online culture and sparked conversation to build anticipation around more affordable internet access.
Silicon Cape, The Silicon Valley Of AfricaEshaam Rabaney
The document summarizes the launch and growth of Silicon Cape, an initiative to create a technology hub in Cape Town, South Africa. It describes how Justin Stanford and Vinny Lingham launched Silicon Cape in September 2009 and it grew rapidly, reaching over 200 signups in a few hours, 300+ in 24 hours, and 900+ members within a short period. The document outlines Silicon Cape's vision of attracting entrepreneurs, investors, and technical talent to foster startup growth. It highlights some successful startups that emerged from Silicon Cape and notes the region's universities and natural beauty that attract and retain talent.
Thinking about Social Media in South AfricaEshaam Rabaney
The number of internet users in South Africa has passed 5 million. Regulatory changes allowing smaller ISPs to enter the market with more competitive packages drove a 15% growth. Laying of the $600 million Seacom undersea cable linking South Africa to Europe is expected to increase connections and speed. Arthur Goldstuck predicts South Africa will reach 6 million internet users by the end of 2010.
The document provides additional questions and answers from the IRS regarding the COBRA premium assistance provisions. Key points covered include: 1) employers have flexibility in determining if a termination was involuntary; 2) seasonal and temporary workers whose contracts expire can be considered involuntary terminations; 3) reserve and National Guard duty is an involuntary termination regardless of leave status; and 4) individuals have flexibility in choosing the effective date of their COBRA coverage within limits of the subsidy period.
Model COBRA Continuation Coverage General NoticeJason White, CBC
This document provides a model general notice of COBRA continuation coverage rights that plan administrators can use to inform individuals of their rights under the Consolidated Omnibus Budget Reconciliation Act (COBRA) when their group health plan coverage would otherwise end due to certain qualifying events. The notice explains what COBRA continuation coverage is, when it becomes available, how to elect it, how long it lasts, and how it works. It also notes that individuals may have other coverage options besides COBRA continuation coverage.
The document summarizes the provisions of the American Recovery and Reinvestment Act of 2009 relating to COBRA health insurance subsidies. It provides details on eligibility requirements, the 65% premium subsidy for qualified beneficiaries, additional notice requirements, and immediate compliance actions needed by employers. Key points include a subsidy for up to 9 months of COBRA coverage for involuntarily terminated individuals, additional notices that must be sent by March 19, 2009, and ensuring COBRA administration can properly process subsidies and payroll tax credits.
This document summarizes new provisions related to COBRA health insurance coverage included in the American Recovery and Reinvestment Act of 2009 stimulus package. It discusses that employees involuntarily terminated between September 2008 and December 2009, and their families, will only have to pay 35% of premiums for up to 9 months of continued coverage, with employers reimbursed for the remaining 65% through tax credits. It also outlines requirements for employers to provide updated notices to qualified beneficiaries about their options by April 18, 2009.
The document provides information about COBRA subsidy recipients and retiree health coverage. It reminds COBRA subsidy recipients that they must notify their plan in writing if they become eligible for other coverage like a new job or Medicare to avoid penalties. It also notes that plans must offer COBRA at retirement if the active and retiree plans differ, but not if they are the same. Dependents may get COBRA if losing retiree coverage due to an event like a retiree's death.
This webinar will covers:
• What is COBRA?
• When does it need to be provided?
• What are the triggering events?
• How long does it have to be provided?
• What are notice requirements?
• Payment requirements
Health Reform Bulletin Oct, 2015 - Amendments to the small employer definitio...CBIZ, Inc.
The latest Health Reform Bulletin is here! This bulletin is chock full of information from a new law that amends the definition of small employer, finalized ACA reporting forms 1094 and 105 and adjusted PCORI fees and much more. Check out some more in-depth information above.
Health Reform Bulletin 135 | Repeal of Individual Penalty Mandate, Review of ...CBIZ, Inc.
While there has been much energy over the past year focused on repealing, replacing, or repealing and replacing the Affordable Care Act (ACA), the bulk of the law remains in full force and effect.
This notwithstanding, Congress passed the “Tax Cuts and Jobs Act” (H.R. 1) on December 20, 2017; the President is expected to sign the bill into law. This tax reform bill repeals the individual penalty mandate. As background, beginning in 2014, all individuals residing in the United States are required to maintain a minimum level of health coverage, or be subject to a tax penalty. This tax penalty will be repealed, effective for tax years beginning January 1, 2019.
Group health plans can require qualified beneficiaries to pay for COBRA continuation coverage, although plan sponsors can choose to provide continuation coverage at reduced or no cost.
The maximum amount charged to qualified beneficiaries cannot exceed 102 percent of the plan’s total cost of coverage. The cost amount is based on the cost of coverage for similarly situated individuals who have not incurred a qualifying event. For qualified beneficiaries receiving the 11-month disability extension, the premium for those additional months may be increased to 150 percent of the plan's total cost of coverage...
The document provides a timeline of key provisions from the Affordable Care Act (ACA) being implemented between 2010-2013. Some key reforms include expanding dependent coverage up to age 26 (2010), prohibiting pre-existing condition exclusions for children (2010), requiring coverage of preventive care with no cost sharing (2010), eliminating lifetime and annual limits on coverage (2010), and establishing health insurance exchanges and individual mandates (2014).
The document summarizes new COBRA laws under the American Recovery and Reinvestment Act (ARRA) that provide subsidized health coverage through COBRA. Key provisions include a temporary 65% premium subsidy for qualified beneficiaries between September 2008 and December 2009, an extended election period, income limits for eligibility, required notices, and penalties for noncompliance. Employers must determine eligible beneficiaries, issue revised notices, and establish procedures to receive reimbursement for the subsidized premium amounts.
This document summarizes Section 45 of the Insurance Act of 1938 as amended in 2015, which governs when an insurance policy can be called into question. It states that a policy cannot be called into question for any reason after 3 years except in cases of fraud. For fraud, a policy can be questioned within 3 years. It also defines fraud and outlines the process for an insurer to repudiate a policy within the 3 year period.
The document summarizes Section 45 of the Insurance Act, 1938 regarding provisions on when a life insurance policy cannot be called into question. It lists 9 key points:
1. No policy can be questioned after 3 years on any grounds except fraud.
2. A policy can be questioned within 3 years for fraud. Fraud includes intentional misrepresentation or concealment.
3. Insurers cannot repudiate a policy if the insured can prove misrepresentation was unintentional and not meant to hide a material fact.
4. Policies can be questioned within 3 years if any statement materially affected risk expectations.
5. Premiums collected till repudiation must be paid within 90 days
Health Reform Bulletin 125 | Updated Employer Shared Responsibility Guidance,...CBIZ, Inc.
The latest HRB has been released. Get updates on the following: 1) Updated Employer Shared Responsibility Guidance; 2) ACA Implementation Guidance; 3) Gender Identity Discrimination: Preliminary Injunction Issued; 4) Final Rules - Premium Tax Credit; and 5) 2018 Benefit and Payment Parameters.
The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) requires that employers provide former employees and dependents who lose group health benefits with an opportunity to continue group health insurance coverage for a limited period of time. Compliance with the complex rules regarding COBRA coverage can be difficult and mistakes can be costly. Penalties for non-compliance can include IRS excise taxes and ERISA statutory fines.
This Legislative Brief provides practical information and tips for avoiding these penalties and other risks, such as lawsuits to compel coverage and adverse selection of COBRA coverage.
Beginning in 2014, ACA's individual mandate requires most individuals to obtain acceptable health insurance coverage or pay a penalty. A hardship exemption is available for individuals who have suffered a hardship with respect to the capability to obtain coverage under a qualified health plan.
Assignment 7, Chapter 15 NAME _______________________________
FIN 3610
1. a. Explain the various definitions of disability that are found in disability-income insurance. Not sure about the answer
The definition of total disability is stated in the policy. There are several definitions of total disability:
(1) Inability to perform all duties of the insured’s own occupation
(2) Most insurers today use amodified own occupationdefinition of total disability. Because of injury or sickness, you are unable to perform the material and substantial duties of your own occupation, and are not engaged in any other occupation.
(3) Inability to perform the duties of any occupation for which the insured is reasonably fitted by education, training, and experience
(4) Inability to perform the duties of any gainful occupation
(5) Loss-of-income test in some companies
Some individual disability income policies have a two-part definition. For some initial period of disability, such as two to five years, total disability is defined in terms of your own occupation. After the initial period of disability expires, the any occupation definition of disability is applied.
b. Briefly explain the following disability-income insurance provisions: Residual disability, Benefit period, Elimination period, Waiver of premium. Not sure about the answer
(1) Residual disability means that a pro rata disability benefit is paid to an insured whose earned income is reduced because of an accident or sickness.
(2) The benefit period is the length of time that disability benefits are payable after the elimination period is met.
(3) An elimination period is a waiting period during which time benefits are not paid. Insurers offer a range of benefit periods, such as 30, 60, 90, 180, or 365 days.
(4) Most policies include a waiver-of-premium provision. The insured must meet the definition of disability stated in the policy. If the insured is totally disabled for 90 days, future premiums will be waived as long as the insured remains disabled.
2. Identify five major provisions of the Affordable Care Act that will have an impact on individuals and families. Document your source and attach a copy of your information.
Need plz Document your source and attach a copy of your information.
Plz look for website about these info.
Provisions in the Affordable Care Act that will affect individuals and families include the following:
Individual mandate. Beginning in 2014, most citizens in the United States and legal residents must have qualifying health insurance or pay a financial penalty.
Preexisting conditions exclusions prohibited. Children under age 19 with a preexisting condition cannot be denied coverage or rated up because of a preexisting condition. Beginning in 2014, adults cannot be denied coverage or rated up because of a preexisting condition.
Retention of coverage until age 26. The new law allows young adults to remain on their parents’ policy until age 26.
Guaranteed acces ...
Texas has extended its state continuation coverage program temporarily for small groups. Eligible employees whose coverage was terminated, except for cause, can now continue coverage for up to nine months. There is also a special enrollment period for those terminated between September 2008 and February 2009. This aims to allow access to the new federal premium subsidy under ARRA. However, eligibility is limited as an individual must not have been fired for cause. Employers must notify former employees of the new provisions by August 2009.
Similar to The American Recovery And Reinvestment Act Of 2009 Cobra Impacts (20)
The American Recovery And Reinvestment Act Of 2009 Cobra Impacts
1. DA VINCI PARTNERS INC.
Escape the Average. Engage the Best
COBRA & The American
Recovery & Reinvestment
Act of 2009 (ARRA)
Impacts on Individuals, Group Health Plans and
Employers
1
DA VINCI PARTNERS INC. | PO BOX 1248, MANHASSET, NEW YORK 11030
2. Synopsis
The American Recovery and Reinvestment Act of 2009 (ARRA) provides premium
reductions and additional election opportunities for health benefits under the Consolidated
Omnibus Budget Reconciliation Act of 1985, most commonly known to many as “COBRA.”
Eligible individuals pay only 35% of their COBRA premiums and the remaining 65% is
reimbursed to the coverage provider through a payroll tax credit. The premium reduction
applies to periods of health coverage beginning on or after February 17, 2009 and lasts for
up to nine months for those eligible for COBRA during the period beginning September 1,
2008 and ending December 31, 2009 due to an involuntary termination of employment that
occurred during that period. The TAA Health Coverage Improvement Act of 2009, enacted as
part of ARRA, also made changes with regard to COBRA continuation coverage.
Legislative Background
ARRA (American Recovery and Reinvestment Act of 2009) Public Law 111-5 was enacted
on February 17, 2009. Section 3001 of ARRA relates specifically to premium assistance for
COBRA continuation of coverage. Section 3001 provides for a 65% reduction in the premium
otherwise payable by certain involuntary terminated individuals and their families who elect
COBRA continuation health coverage.
Plans Subject to Premium Reduction Provisions
The COBRA premium reduction provisions apply to:
• All group health plans sponsored by private-sector employers or employee
organizations (unions) subject to the COBRA rules under the Employee Retirement
Income Security Act of 1974 (ERISA);
• Plans sponsored by State or local governments subject to the continuation provisions
under the Public Health Service Act; and
• Plans in the Federal Employee Health Benefits Program (FEHBP)
Premium reduction provisions are also available for group health insurance that is required
by State law to provide comparable continuation coverage (such as “mini-COBRA”).
Assistance Eligibility Criteria
Based on ARRA, an individual is eligible if following criteria are met :
1. Individual is a qualified beneficiary as the result of an involuntary termination during
the period from September 1, 2008 through December 31, 2009.
2. An individual who is eligible for COBRA continuation coverage at any time during that
period; and
3. Elects coverage
Coverage Periods
Premium reduction applies to the 1st period of coverage beginning on or after 2/17/09. An
assistance eligible individual is eligible for premium reduction for up to nine months from the
first month the premium reduction provisions of ARRA apply to the individual. Premium
reduction ends:
1. If the individual becomes eligible for coverage under any other group health plan.
However, if the other group health plan provides ONLY dental, vision, counseling or
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3. referral services (or any combination of), flexible health spending arrangement or
health reimbursement arrangement of coverage for treatment furnished in an on-site
medical facility maintained by the employer and consists of mostly first aid services,
prevention and wellness care. They are still eligible for premium reduction as outlined
in the section 3001 of ARRA; or
2. Medicare Eligible
Premium reduction does not EXTEND beyond the period of COBRA continuation coverage.
An individual receiving the premium reduction who becomes eligible for coverage under any
other group health plan or Medicare is required to notify the group health plan of eligibility for
that other coverage. If the individual fails to notify the group health plan, the individual is
subject to a tax penalty of 110 percent of the premium reduction improperly received after
eligibility for the other coverage.
The “Second” Election Opportunity
Qualified beneficiaries whose qualifying event was an involuntary termination of employment
during the period from September 1, 2008 through February 16, 2009 and who did not elect
COBRA when it was first offered OR who did elect COBRA but are no longer enrolled (for
example, dropped COBRA coverage because they were unable to continue paying the
premium) have a new, second election opportunity.
Individuals eligible for the extended COBRA election period must receive a notice informing
them of this opportunity. This notice must be provided by April 18, 2009 and individuals have
60 days after the notice is provided to elect COBRA. However, this special election period
does not extend the period of COBRA continuation coverage beyond the original maximum
period (generally 18 months from the employee's involuntary termination). COBRA coverage
elected in this special election period begins with the first period of coverage beginning on or
after February 17, 2009.
Under ARRA; with respect to State continuation coverage, this special election period
opportunity is not required to be provided pursuant to State insurance law. A State can take
action, however, to provide an additional election period in its continuation coverage program
for individuals involuntarily terminated from September 1, 2008 through February 16, 2009 in
order for them to request premium assistance based upon involuntary termination occurring
during that period. For more information on rights and responsibilities regarding election
periods under State law, contact your specific State insurance commissioner’s office or CMS.
How ARRA Impacts Eligible Individuals, Group Health Plans and Employers
Group Health Plans
Group Health Plans must treat assistance eligible individuals who pay 35% of the premium
otherwise payable for COBRA continuation as having paid the full amount of premium.
An assistance eligible invidual who pays the reduced premium pursuant to ARRA must be
treated by the plan as having paid the full premium. If the plan does not treat the assistance
eligible individual as having paid the full premium, it is deemed a failure to meet the
requirements of the underlying statute. In the case of a plan subject to the COBRA
continuation coverage requirements under section 4980B, the failure to treat the assistance
eligible individual making the reduced payment as having made the full payment would be a
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4. failure to satisfy the requirements of section 4980B and may result in the imposition of the
excise tax under section 4980B(b)
Employer
The employer/multi-employer health plan or insurer is reimbursed for the 65% of the
premium that is not paid by the assistance eligible individual through a payroll tax credit.
Under ARRA, an employer may allow assistance eligible individual to elect coverage
different from the coverage under the plan in which the eligible individual was enrolled prior
to involuntary termination, and the premium reduction will apply with respect to the different
coverage. It is important to note, this provision does not change the basic tenet under
Federal COBRA that a group health plan must allow a qualified beneficiary to elect to
continue the coverage in which the individual is enrolled as of the qualifying event. If offered,
the assistance eligible individual has 90 days after receiving notice of the option to elect the
other coverage. The premium for coverage offered under this option CAN NOT exceed the
premium for the coverage the individual had prior to the involuntary termination. Moreover,
the coverage offered under this option must be coverage offered to active employee and
CAN NOT be coverage that provides only dental, vision, counseling (or some combination),
a flexible spending arrangement under section 106(c) of the Code, or coverage that provides
coverage through an on site medical facility maintained by the employer that consists
primarily of first aid, prevention and wellness care or similar care or any combination of such
care.
ARRA amends the Code to add Section 6432, which provides that “the person to whom
premiums are payable” is entitled to reimbursement for the amount of premiums not paid by
assistance eligible individuals by reason of ARRA in the form of a credit against payroll tax
liabilities. For this purpose, payroll taxes are defined as:
• Federal income tax withholding under section 3402
• The Employee share of Federal Insurance Contributions Act (FICA) Tax under
section 31-2; and
• The Employer share of FICA tax under section 3111
The credit is only claimed on the person’s/employer’s payroll tax return, in most cases Form
941 which is filed quarterly. If the amount of the credit to which the person/employer is
entitled exceeds the person’s payroll liabilities on the return, the person is entitled to a refund
of such excess as if it were a payment of payroll taxes.
Eligible Individual
As previously stated, ARRA provides an extended election period for certain individuals who
did not have an election of COBRA continuation coverage in effect on 2/17/09. The election
is available for individuals who would be assistance eligible individuals if they had a COBRA
continuation coverage election in effect (as a result of an involuntary termination on or after
9/1/08). This extended election period is for 60 days after the qualified beneficiaries are
provided notice of the extended election period. The resulting COBRA continuation coverage
could extend longer than the original maximum period (as measured with respect to the
qualifying event) and begins with the first period of coverage beginning on or after 2/17/09.
The extended election period applies to a group health plan subject to the Federal COBRA
requirements and to temporary continuation coverage under the FEHBP, but not the State
continuation coverage requirements.
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5. The amount of any premium reduction is excluded from an individual’s gross income under
new section 139C. For purposes of determining the gross income of the employer and any
welfare benefit plan of which the group health plan is part, the amount of the premium
reduction is intended to be treated as an employee contribution to the group health plan. i
If the premium reduction is provided with respect to COBRA continuation coverage for an
individual, the individual’s spouse, or the individual’s dependent, and the individual’s
modified adjust gross income (adjusted gross income plus amounts excluded under section
911, 931 or 933) exceeds $145,000 ($290,000 for married filing jointly) the amount of the
premium reduction is recaptured as an INCREASE in the individual’s Federal income tax
liability. The recapture is phased in for individuals with modified adjusted gross income in
excess of $125,000 ($250,000 if filing jointly).
An individual may elect to permanently waive the right to the premium reduction. In addition,
an individual who receives the premium reduction under ARRA for a month is disqualified
from receiving the Health Coverage Tax Credit under section 35 for that month.
i
H.R. Rep.No.111-16, at 716 (2009) (Conf. Rep)
IRS Notice 2009-27
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