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In This Issue

 

 

February is a Short Month When Determining Effective Date For Group Members

 

 Premera and MultiCare Health System Extend Collaboration

 

IRS Releases 2015 Employers Tax Guide to Fringe Benefits

 

 Individual Penalties For The Uninsured

 

Proposed Regulations on 2016 Benefit and Payment Parameters

 

 No Means No In Regards to Employer Funding of Individual Plans 

 

Secrets of People Who Don't Get Sick

 

 

 

Question of the Week

Must Our Health Plan Cover the Pregnancy Expenses of Employees' Children?

 

 Our company's major medical plan covers the pregnancy-related expenses of employees and their spouses. Is our plan also required to cover pregnancy-related expenses of employees' children who are enrolled as dependents?

 

Answer 

 

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INSURANCE SPOTLIGHT

January 15, 2015

Carrier News

 

February is a Short Month When Determining Effective Date For Group Members

This is a reminder that the probationary period for new hires, calculated in number of days, begins on their date of hire. Coverage becomes effective the first of the month following satisfaction of any probationary periods required by the employer. Because February is a short month, any probationary period satisfied during this time may result in an effective date that's different from the one you expected.

 

For example: If an employee's first day is Feb. 1 and the group has a 30-day probationary period, the employee is eligible for enrollment on April 1. The 30-day probationary period ends March 2, and the effective date is the first day of the following month-April 1. Read more

 

Premera and MultiCare Health System Extend Collaboration 

nurses.jpg Premera is pleased to announce their two cost saving, value-based networks, Heritage Signature (Individual and Small Group) and Heritage Prime (Large Group), have both expanded again to include another leading health system in our area. MultiCare has a comprehensive network of services throughout Pierce, South King, Thurston, and Kitsap counties. The expanded value-based network is effective January 1, 2015 and will include:

The partnership also includes MultiCare's numerous outpatient specialty centers and primary and urgent care clinics.

 

Federal & State News

IRS Releases 2015 Employer's Tax Guide to Fringe Benefits

The IRS LogoIRS has released the 2015 version of  Publication 15-B (Employer's Tax Guide to Fringe Benefits), with information for employers on the employment tax treatment of various fringe benefits, including accident and health coverage, adoption assistance, company cars (and other employer-provided vehicles), dependent care assistance, educational assistance, employee discount programs, group term life insurance, moving expense reimbursements, HSAs, and transportation (commuting) benefits. 
 

The 2015 guidelines are substantially similar to the 2014 version but with updated benefit limits and definitions. Read more 


Individual Penalties For The Uninsured

With the passage of the Affordable Care Act, most people are required to have health insurance or they may have to pay a penalty. Even though this information has been highly publicized, many people remain confused by the sign-up process and may not realize penalties incurred in 2014 until they start completing their 2014 tax returns.

With the deadline to enroll just weeks away, this Premera article sheds light on the real cost of not having a health plan. It includes a tax penalty calculator to estimate the cost of future penalties. 


Proposed Regulations on 2016 Benefit and Payment Parameters

2016 Reinsurance Fee Contribution Amount

The Reinsurance Fee applies to insured and self-funded group health plans for calendar years 2014 through 2016. The 2015 fee amount of $44 was announced previously. The proposed fee for 2016 is $27 per covered individual.

 

Insured expatriate plans do not have to pay the Reinsurance Fee. The regulations propose that self-insured expatriate plans will not be required to pay the Reinsurance Fee for 2015 and 2016.


 
Cost-Sharing Limits

The proposed plan year cost-sharing maximums for 2016 are $6,850 for self-only coverage and $13,700 for family coverage. Insurers are permitted, but not required, to count out-of-network costs toward the annual cost-sharing limits.

Fact Sheet

 

No Means No In Regards to Employer Funding of Individual Plans

The Obama Administration released two new key pieces of health reform regulatory guidance, including a series of FAQs that even further clarify the Administration's preexisting position that if an employer creates some type of premium reimbursement arrangement to pay for health coverage, then that arrangement is subject to all federal health law market reform requirements, even if the reimbursement is for individual insurance coverage premiums.

 

The Administration's guidance clarifies that such arrangements are subject to the group market reform provisions of the Affordable Care and that such employer healthcare arrangements will not violate these market reform provisions when integrated with a group health plan that complies with such provisions. However, an employer healthcare arrangement cannot be integrated with individual market policies to satisfy the market reforms. Consequently, such an arrangement may be subject to penalties, including excise taxes under section 4980D of the Internal Revenue Code.

 

Attached are highlights of the FAQs.

Health & Wellness

Secrets of People Who Don't Get Sick

It's tempting to dismiss it as luck: Some people might catch a slight cold or suffer an occasional ache or pain now and then, but they never seem to suffer from flus, fevers and illnesses that send the rest of us diving under the covers for days. Despite centuries of scientific advances, doctors still can't tell us definitively how to stay well. So why not look for solutions from the people for whom the common cold is, well, uncommon? Here are 10 surprising habits of those people who never get sick and how you can adapt them to your own soon-to-be healthier life.
If you have any questions about the articles contained in this newsletter, please give us a call or e-mail us: