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The Future Belongs to the Efficient Kilpatrick Companies

Details: And publish health reform regulatory, carrier, and compliance updates on an ongoing basis in our news blog. News and updates Read our blog to learn about latest trends and get access to a better way to manage your clients. BCBS • Tue, Mar 23, 2021. CMS Extends COVID-19 Special Enrollment Period in Individual Market to Aug 15

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Table of Important Yearly Health Insurance Maximums

Details: The table below provides a single resource for all relevant health insurance related limits, thresholds, fees, penalties, etc published by industry regulators. …

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Broker Compensation Disclosure Requirements in CAA 2021

Details: Not to be deterred, the Senate health committee saw an opportunity to bury the same bill within the massive 5,593-page CAA. Section 202 appears on page 4,475. The CAA is the fifth longest bill ever passed by Congress, a $2.3 trillion “must pass” omnibus spending bill, which funds the government for nine months and directs $900 billion in

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BCBS Launches Financial Relief Program for 51+ Insured

Details: The programs outlined below are available to most groups offering fully insured health plans with 51+ enrolled employees. They are not available to groups with payments that are 30 days past due and/or self-funded, minimum premium, community rated small group, Blue Balance Funded, student health, ADM, MEWA/PEO, association health plan

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COBRA Premium Assistance Provisions under the American

Details: AEIs receiving subsidies must notify the employer or health plan when they become eligible for another group health plan or Medicare. Intentional failure to notify will result in a penalty equal to the greater of $250 or 110% of the ineligible assistance.

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Trump and Health Care Reform 2.0 Kilpatrick Companies

Details: The ACA capped health plan cost sharing. Regulations could allow cost sharing to inflate at a faster pace. The ACA defined broad essential health benefits categories that health plans must cover. Revised regulations could simplify the headache of pediatric dental and make their inclusion consistent on and off exchange.

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2020-03.23 COVID 19 National General Benefits Solutions

Details: establish a self-funded health benefit plan for their employees. The benefit plan is established by the employer and is not an insurance product. Stop-loss insurance for the NGBS Self-Funded Program is underwritten and issued by National Health Insurance Company, Integon National Insurance Company, and Integon Indemnity Corporation.

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Enrollment Kit Checklist

Details: This standard health benefit plan may provide a more affordable health plan for you although, at the same time, it may provide you with fewer health plan benefits than those normally included as state-mandated health benefits in Texas. If you choose this standard health benefit plan, please consult with

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Cigna: Final Rules on Employer Wellness Programs Under the

Details: The rules apply to programs that include disability-related inquiries, medical examinations, and/or inquiries on family health information. Employers have been using wellness programs to promote better health among employees and help control health care costs for a number of years. The Affordable Care Act (ACA) wellness rules were finalized in

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Proposed Changes for SBCs

Details: On December 22, 2014, the Departments of Health and Human Services (HHS), Labor and Treasury issued proposed regulations for changes to the Summary of Benefits and Coverage (SBC).. The proposed regulations clarify when and how a plan administrator or insurer must provide an SBC, shorten the SBC template, add a third cost example and revise the uniform glossary.

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National General Self-Funded Enrollment Kit

Details: surance is underwritten by: Integon National Insurance Company in CO, CT, NY and VT; Integon Indemnity Corporation in FL; and National Health Insurance Company in all other states where offered. National Health Insurance Company, Integon National Insurance Company, and Integon Indemnity Corporation are rated “A-” (Excellent) by A.M. Best.

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Enforcement Delayed for Health Plan Identifier (HPID

Details: The health care reform legislation requires all health plans to obtain a ten-digit “unique identifier” from a government sponsored agency, known as the Health Plan Identifier (HPID). The HPID is intended to streamline electronic transactions between carriers, administrators, health care professionals, and financial institutions.

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Proposed Rules for Association Health Plans

Details: Health nondiscrimination protections under the proposed rule: The proposed rule applies existing nondiscrimination provisions under HIPAA and the ACA to AHP’s. Under the proposed rules, the group or association cannot restrict me3mbership based upon any health factor and cannot treat any member employers as distinct groups of similarly

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New EEOC Ruling Affects Workplace Wellness Programs

Details: Earlier health reform regulations had increased the money employers are able to use for rewards or penalties within wellness programs that encourage actions that may produce better health outcomes. Financial incentives (or penalties) may be used for either participatory or health-contingent wellness programs.

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Cigna: Final Rules on Employer Wellness Programs Under the

Details: The rules apply to programs that include disability-related inquiries, medical examinations, and/or inquiries on family health information. Employers have been using wellness programs to promote better health among employees and help control health care costs for a number of years.

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Wellness Program Proposed Rules and FAQs Issued

Details: On April 16, the U.S. Equal Employment Opportunity Commission (EEOC) issued proposed rules about wellness programs included in group health plans and the guidelines that must be followed if the program asks employees to answer disability-related questions or take a medical examination. At the same time, the Department of Health and Human Services (HHS) and other …

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Enrollment Kit Checklist

Details: A health benefit that provides pregnancy-related benefits for individuals covered under the plan shall offer and make available to each holder or sponsor of the plan coverage for services and benefits on an expense incurred, service, or prepaid basis for

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Bianchi: Can a Plan That Fails to Cover Inpatient

Details: Group health plan coverage is deemed to provide minimum value if the “percentage of the total allowed costs of benefits provided under a group health plan” is at least 60% of all plan benefits, without regard to co-pays, deductibles, co-insurance, and employee premium contributions.

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Scott & White Enrollment Kit Small Group / ACA Metal Plans

Details: This standard health benefit plan may provide a more affordable health plan for you although, at the same time, it may provide you with fewer health plan benefits than those normally included as state-mandated health benefits in Texas. If you choose this standard health benefit plan, please consult with your insurance agent to discover which

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UHC Information about Eligibility Verification Audits

Details: Email: [email protected]: Fax: 877-232-7902: Phone: 877-504-1179: Mail: UnitedHealthcare Risk Management MN017-E700 9700 Health Care Lane Minnetonka, MN 55343

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Cigna: Administration Releases New Guidance on HRAs and

Details: On Oct 23, 2018, the Departments of Treasury, Labor, and Health and Human Services (HHS) issued proposed rules that would allow employees to use the dollars in employer-funded Health Reimbursement Arrangements (HRAs, also called Health Reimbursement Accounts) to purchase individual coverage both on and off the public Marketplace (or Exchange).

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HHS Proposes that Health Insurers use Composite Rates in

Details: This proposed policy would generally apply to health insurance issuers offering non-grandfathered health insurance coverage in the small group market, through a SHOP or outside of a SHOP, for plan years beginning on or after January 1, 2015. However, we encourage issuers to voluntarily adopt this approach for plan years beginning in 2014.

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IRS Issues Request for Information on the Cadillac Tax

Details: The Cadillac Tax is a 40% excise tax scheduled to take effect in 2018 to reduce health care usage and costs by encouraging employers to offer cost-effective plans that engage employees in sharing in the cost of care. The tax impacts plans exceeding the following thresholds, which will be adjusted annually for inflation:

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Employer Reporting Requirements under the ACA

Details: This entry was posted in Industry News and tagged 1094, 1095, ACA, employer mandate, health insurance, health reform, HHS, IRS, large group, minimum essential coverage, minimum value, section 6055, section 6056, self-funded, small group. Bookmark the permalink. Follow any comments here with the RSS feed for this post

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Cigna: Final Regulations Issued on Several 2010 Provisions

Details: On November 13, the Departments of Health and Human Services (HHS), Labor and Treasury issued final regulations regarding Lifetime and Annual Limits, Grandfathered Plans, Preexisting Condition Exclusions, Rescissions (Cancellation of Coverage), Dependent Coverage, Primary Care Physicians, Emergency Care, and Appeals and Review.. These final regulations apply to individual and group health

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UHC: New EEOC Regulations Required for Wellness Incentive

Details: Apply to wellness programs (both participatory and health-contingent) that are part of a group health plan as well as those outside of the group health plan (i.e. programs offered to all employees regardless of whether they are enrolled in a group health plan).

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Contraceptive Regulations

Details: Two regulations on contraceptive coverage were issued on August 22 by the Department of Health and Human Services (HHS), the Department of Labor (DOL) and the Treasury. Proposed regulations provide initial guidance about how certain closely held for-profit organizations can exclude some or all contraceptive coverage.

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HHS News: Nearly 365,000 Americans selected plans in the

Details: Health and Human Services (HHS) Secretary Kathleen Sebelius announced today that nearly 365,000 individuals have selected plans from the state and federal Marketplaces by the end of November. November alone added more than a quarter million enrollees in …

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Q&A about Contributions for Plans with Per-Member Rates

Details: If “employee rate” is defined as the cost of the employee’s insurance based on the employee’s individual health factors, then the employer would probably be in violation of the contract. However, as previously stated, the employer is prohibited by GINA, HIPAA, the ADA and the ADEA from taking age into consideration when making its

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SMALL GROUP EMPLOYER APPLICATION

Details: mandated health benefits normally required in evidences of coverage in Texas. This standard health benefit plan may provide a more affordable health plan for you although, at the same time, it may provide you with fewer health plan benefits than those normally included as state-mandated health …

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Cigna: The American Health Care Act

Details: The next era of U.S. health care reform is underway with a focus on repeal and replace of the Affordable Care Act (ACA). Last week marked the latest milestone in this process with House Republicans introducing two different bills, collectively called the American Health Care Act (AHCA). The bills were developed by Republican leadership and are proceeding through the legislative process in …

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Prohibition of Employer Contributions to Individual Health

Details: Further, the employer cannot endorse any individual health insurance offering or advertise any special arrangement for buying coverage as being their health benefit program. In practical terms, employers who choose to drop their group health plan and increase everyone’s salary are doing just that. There is no return on investment.

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BCBS: Colorado Claims Database and Opt-out Process for ASO

Details: Applies to: ASO groups covering members in Colorado. The Colorado Department of Health Care Policy and Financing, the government agency that oversees Colorado’s All Payer Claims Database (“APCD”), is now requiring self-funded employer-sponsored group health plans covering an aggregate of 100 or more enrolled lives in Colorado to submit claims data (medical, eligibility, …

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Final 2016 Notice of Benefit and Payment Parameters

Details: Essential Health Benefit Benchmark Plans. It is confirmed that states may select new benchmark plans for 2017, based on plans available in 2014. Direct context. 2016 Cost Sharing Limits. The 2016 maximum annual out-of-pocket limits are confirmed at $6,850 for individual coverage and $13,700 for family coverage.

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BlueCross and BlueShield of TX Enrollment Kit

Details: A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association Life and Disability insurance is underwritten by Dearborn Life Insurance Company, 701 E. 22nd St. Suite 300, Lombard, IL 60148. Dearborn Life Insurance Company is an

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Memorial Hermann Enrollment Kit Small Group / Hybrid Plans

Details: We, the employer, intend to treat the health benefit plan as part of a plan or program under the federal Internal Revenue Code, 26 U.S.C. Section 106 (Concerning Contributions by Employer to Accident and Health Plans) or Section 162 (Concerning Trade or Business Expenses).

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DOL Issues Final Guidance on Association Health Plans

Details: On Thu, Jun 21, the Department of Labor published a final rule to expand the availability of Association Health Plans (AHP) to small employers and self-employed individuals. While the rule loosens the rules that define what is an eligible association, it does not loosen or modify the regulatory barriers that impede the formation of association

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Humana Will Provide ACA Forms 1094/95-B for Small Group

Details: Beginning with the 2018 tax season, Humana will start automatically filing two essential IRS forms on behalf of our Level Funded Premium (LFP) groups who average fewer than 50 eligible employees during the prior year (including full-time equivalent employees) at no additional cost to employers or employees: 1094-B: Transmittal of Health Coverage Information Returns (filed by …

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NEWS ALERT: HHS Delays Online Enrollment for Small

Details: Included in the proposed rule is a change to the enrollment dates for 2015 plans on the Health Insurance Marketplace. Originally scheduled for Oct. 15 to Dec. 7, 2014, the government has proposed beginning open enrollment on Nov. 15, 2014, and concluding on Jan. 15, 2015. It also proposes additional standards with respect to: Composite rating

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Final Rules Released on Information Reporting for

Details: On March 5, 2014, the Department of Treasury and the Internal Revenue Service (IRS) released final rules on two provisions: reporting health insurance coverage by large employers, and reporting minimum essential coverage by insurers and employers of self-insured plans. The guidance provides a streamlined process for reporting duplicate information required by both provisions – to …

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BCBS to Discontinue PPO Plans in Individual Market in 2016

Details: The retail market has evolved significantly since the opening of the Health Insurance Marketplace in 2014. These changes require BCBSTX to make adjustments that will allow us to continue offering sustainable health insurance options. There are …

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Memorial Hermann Enrollment Kit Small Group / ACA Metal …

Details: Organization health care plan that, either in whole or in part, does not provide state-mandated health benefits normally required in evidences of coverage in Texas. This standard health benefit plan may provide a more affordable health plan for you although, at the same time, it may provide you with fewer health plan benefits

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Health plans that

Details: Health Plan and the PPO from Insurance Company of Scott and White* offer access to 10,000 in-network doctors and the renowned Baylor Scott & White Health system. The HMO offers coverage within the network only, except in the case of an emergency. The PPO offers in- and out-of-network coverage, with varying benefit levels. Emergency care coverage is

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› Url: https://kilpatrickcos.com/download/individual/applications/SW-IMM-2017-Application-Kit-201610.pdf Go Now

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Cigna: Final 2019 Notice of Benefit and Payment Parameters

Details: On April 9, 2018, the Department of Health and Human Services (HHS) issued final regulations and related guidance on Affordable Care Act (ACA) provisions including Essential Health Benefits (EHBs), out-of-pocket (OOP) maximums, and Marketplace updates and reforms. These regulations, generally effective for plans and plan years beginning on and after Jan. 1, 2019, largely …

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