One of the many ongoing battles over the Patient Protection and Affordable Care Act (PPACA) involves the federal minimum medical loss ratio (MLR) standards for private insurers. Under this provision, health insurance plans in the small group market are required to spend at least 80 percent of premiums on medical costs and no more than 20 percent on administrative costs (15 percent for the large group market). If a plan fails to meet the minimum MLR standard, the insurer is required to pay rebates to enrollees and policyholders.

Tags: PPACA update, aca update, ACA broker fee proposals

Tags: health care reform, health reform update, affordable care act, ACA changes

As an employer, you face tough questions from employees every day – particularly now as you both navigate the changing landscape of health care reform. If the “age 26” question hasn’t come up yet, you’ll likely encounter it soon. To help you be prepared, we’ve prepared the hypothetical scenario below.

Tags: cobra blog, COBRA eligibility at age 26, COBRA questions, age 26 rule

If you were hoping to save money on healthcare costs by sending your employees to the exchanges and helping them with premiums through tax-free contributions, think again. Thanks to recent IRS guidance on an IRS ruling made last year, you’ll have to come up with a Plan B.

Tags: healthcare reform, employer mandate, Affordable Care Act update

Tags: cobra administration, cobra conundrums, cobra, marketplace payment collection

As everyone knows by now, the Affordable Care Act (ACA) is doing away with preexisting condition exclusions under group health plans, applicable for plan years beginning on or after January 1, 2014. There’s an important change in the reporting requirements too.

Tags: certificates of creditable coverage, changes to certificates of creditable coverage, ACA changes to certificates of creditable coverage, COBRA early termination notices

For consumers, the end of open enrollment is no big news. We saw it coming, and its meaning is simple: Anyone who doesn’t yet have insurance will just have to wait till the next enrollment period to get coverage (unless they qualify for special enrollment, Medicaid or CHIP).

Tags: aca update, affordable care act, health insurance marketplace, state marketplaces

This past Friday afternoon, the Centers for Medicare and Medicaid Services (part of HHS) issued a bulletin to deal with Special Enrollment Periods (SEPs).

Tags: cobra, COBRA participants, cobra continuation coverage, cobra continuation coverage election notices, cobra enrollment window, cobra special enrollment

Tags: ppaca, cobra administration, cobra continuation coverage, cobra coordination, cobra and aca eligibility

Tags: cobra administration, same-sex guidance for employer-sponsored retiremen, COBRA benefits for same-sex spouses