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Innovative Healthcare Compliance and Solutions

The Total Health Care Solution
The law has brought about many changes. Individuals started to see changes in 2010 when preventive services became covered at 100% and there was no longer any a pre-existing conditions clause for kids under 19. Other changes under the Affordable Care Act required plans and issuers that offer coverage to children on their parents' plan to make the coverage available until the adult child reaches the age of 26. In addition, there was no longer a lifetime limit on benefits and restrictive annual limits were prohibited. Businesses benefited too when the Small Business Tax credit was instituted.

Employee and Individual Insurance
Employers will decide whether or not to offer coverage to their employees. Most employers will continue to offer coverage because group coverage is best for their employees and a valuable benefit to their employees. Continued coverage will vary by industry and by salary levels of their employees. Employees that work for Employers that continue to offer health insurance coverage will not be eligible to go to the public exchange called the “Marketplace” and receive a federal tax credit and cost sharing subsidies if the employer’s coverage is considered “affordable” and provides minimum value.

Employees that are not offered coverage through their employer as well as individuals will now have access to health care coverage through both the private and public exchange. Individuals with incomes between 100% and 400% of the poverty level who purchase insurance through a public exchange are eligible for a tax credit to reduce the cost of coverage, making the plans affordable for millions of Americans.

And the best news is that insurance offered through employer group coverage or individual insurance coverage cannot be denied to anyone based on medical conditions. It’s called guaranteed issue and everyone can receive coverage. But the good news did come with a stipulation; everyone must get coverage or pay a penalty. In 2014, it is a $95 penalty or 1% of income whichever is greater. In 2015 it’s 2% of income or $325 per person. In 2016 and later years it’s 2.5% of income or $695 per person. After that it's adjusted for inflation.

Large Employers Must Now Offer Coverage
Are you going to be considered a large employer effective 2015?

On February 12, 2014, the IRS issued the final 4980H regulations which implement the employer shared responsibility provisions of the ACA, which requires employers with 50 or more employees to offer "affordable," minimum-value health coverage to their "full-time employees" (generally employees working on average at least 30 hours per week along with those deemed full time equivalents) or pay a penalty, triggered when at least one full-time employee receives a federal premium tax subsidy or credit to purchase coverage through a health insurance exchange.

Previously, in Notice 2013-45 the administration had deferred the assessment of 4980H penalties to 2015 since the reporting requirements under the ACA had not been finalized. Under the regulations, the 4980H requirements will apply only to employers with 100 or more employees beginning in 2015 and with 50 or more employees in 2016, if the employer provides an appropriate certification described in the rules. Moreover, large employers who are required to offer coverage are only required to offer coverage to 70% of their full time employees in 2015.

Innovative Benefit Group is a Full Service Health Insurance Agency
Providing Benefits to Employer Groups and Individuals

There are a lot of decisions to make regarding offering Employer Group coverage or choosing Individual Health Insurance, whether you are a large employer, small employer or an individual. We will help you analyze each situation to determine the best solution for an employer, employee or individual. There is not a one size fits all.

Employer Groups and Individuals should work with an agency such as Innovative Benefit Group that has completed the NAHU PPACA Certification Course for Health Care Reform. We have spent many tireless hours dedicated to understanding the impact of healthcare reform and to helping our clients.

Employers that are Large Employers need to determine their strategy for 2015 now. By simply providing us a few pieces of information, we can determine what the benefit vs the cost of providing coverage to your employees and then shop carriers and plans for you. We are appointed with all the major health insurance carriers.

For Individuals, the Marketplace open enrollment period for 2015 coverage runs from November 15, 2014 to February 15, 2015. The earliest an individual would obtain coverage is January 1, 2015. Innovative Benefit Group will assist you in comparing Marketplace plans and prices. If eligible, we will also assist you in navigating through Healthcare.gov where you will receive “On Exchange” plans. “On Exchange” plans are where you can receive a federal tax credit and cost sharing subsidies. The Federal Government is going to help pay the insurance bill for anyone between 138% and 400% of the poverty level, making the plans affordable for millions of Americans.

It is so easy, just call our office at 800-909-8098.


Innovative Employer Solutions © 2017 • 635 93rd Ave. North, Saint Petersburg, Florida 33702
(800) 909-9098 • Phone (727) 217-0022 • Fax (727) 217-0033