Defining Affordable . . .

[Yagents]

I agree NAHU can be a waste of time and money. But for right now given our situation, more information......the better. I have found the $33/mo in NAHU to be of great value for PPACA updates only, and they do have the strongest voice (our only voice) at the table trying to save the agent role. I don't mind contributing to that cause financially. Many of you have benefited from my membership (articles I post, etc)

We all bring something to the table. Some of us have carrier rep contacts, or higher up contacts in whatever org, or subscriptions to articles/pubs, business experience, or NAHU.

TOGETHER, we can share info and triangulate this bad boy, and be best positioned no matter which way the wind blows......and this does blow. This is why I share things, and don't hold things close to the vest. I hope you all return "in kind".

For those of you out there in the bushes, and only read posts, and don't share what you're reading/hearing re PPACA.......shame on you.

 

[VolAgent]

Based on what has been posted. It seems a family would be better off if an employer did not offer coverage versus if the employer did the bare minimum to avoid a penalty.

 

[somarco]

It seems a family would be better off if an employer did not offer coverage versus if the employer did the bare minimum to avoid a penalty.

Good chance of that happening for smaller groups (under 50) and eveb sine larger employers that figure a way to game the system by reducing hours and other tricks.

 

[Yagents]

Based on what has been posted. It seems a family would be better off if an employer did not offer coverage versus if the employer did the bare minimum to avoid a penalty.

I completely agree. Once the ER does an analysis, they will drop the headache of offering a group plan. Especially:

1. Those under 50 employees
2. Those over 50 employees with a majority of low/middle income EE's

Otherwise, the EE's family could be screwed. Better to ship them ALL off to the exchange, and pay the applicable penalty of $2k. At 9.5%, that's equivalent to a $20,000 salary, so anything above that salary amount would actually be a savings to the ER, and the EE getting massive subsidies on the exchange.

 

[bluemarlin08]

I completely agree. Once the ER does an analysis, they will drop the headache of offering a group plan. Especially:

1. Those under 50 employees
2. Those over 50 employees with a majority of low/middle income EE's

Otherwise, the EE's family could be screwed. Better to ship them ALL off to the exchange, and pay the applicable penalty of $2k. At 9.5%, that's equivalent to a $20,000 salary, so anything above that salary amount would actually be a savings to the ER, and the EE getting massive subsidies on the exchange.
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This is what I have assumed all along. I am getting more calls than ever and I am trying not to stress. The entire change , however, is an interesting subject to talk with prospects about and build rapport. Several cases recently gave me new opportunities to quote other insurance.

Read more: Defining Affordable . . . - Page 5

 

[Ann H]

I completely agree. Once the ER does an analysis, they will drop the headache of offering a group plan. Especially:

1. Those under 50 employees
2. Those over 50 employees with a majority of low/middle income EE's

Otherwise, the EE's family could be screwed. Better to ship them ALL off to the exchange, and pay the applicable penalty of $2k. At 9.5%, that's equivalent to a $20,000 salary, so anything above that salary amount would actually be a savings to the ER, and the EE getting massive subsidies on the exchange.

I think you're right, Bill. Those people will most likely drop the group plan. Add a #3 to your list. It's not really "dropping" the group plan, but it's similar.

3. Some employers with over 50 EEs will move lower paid employees to part-time, keep the group plan for those who wouldn't get a subsidy, and thereby avoid the $2,000 penalty for not having a group plan.

 

[Yagents]

This speaks of individuals, but not about spouses or children.

Individuals or employers will have to fill out a form to verify group plan accessibility.

And the delays begin (cluster f*&k):

Exchanges have to give consumers a single "one-stop shopping" response on their eligibility for exchange subsidies, Medicaid or other programs like CHIP, but in the proposed rule CMS admits that it is not going to happen right away. Instead this requirement will take effect in the beginning of 2015. And no, the rule does not make it clear what kind of determination notices consumers will get when the exchange open enrollment begins on October 1, so we anticipate that consumers could get multiple and confusing notices. For example, a high-income consumer could get multiple rejection notices for Medicaid and cost-sharing assistance but an approval for the premium tax subsidy.

PROPOSED RULE FOR STRENGTHENING MEDICAID, THE CHILDREN'S HEALTH INSURANCE PROGRAM AND THE NEW HEALTH INSURANCE MARKETPLACE

Verification of Employer-sponsored Coverage. Individuals who are enrolled in employer-sponsored coverage or eligible for employer-sponsored coverage that meets affordability and minimum value standards are ineligible to receive advance payments of the premium tax credit or cost-sharing reductions through the Exchange. This proposed rule includes detail on the procedures for the Exchange to verify access to employer-sponsored coverage. It also proposes that an Exchange may opt to fulfill the employer-sponsored coverage verification process by relying on HHS.

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Find out how Rahm Emmanuel plans to get the city of Chicago out of debt........dump gov't retirees on to the exchange for all of us in the other 56 states to pay for them.
http://www.chicagotribune.com/news/local/ct-met-emanuel-retiree-health-care-20130115,0,1910971.story

 

[somarco]

or eligible for employer-sponsored coverage that meets affordability and minimum value standards are ineligible to receive advance payments of the premium tax credit or cost-sharing reductions through the Exchange.

Seems to me a spouse and/or child(ren) that are ELIGIBLE to participate in working spouse/dad plan won't qualify for subsidies.

I believe I said that earlier in this (or possibly another) thread.

 

[AllenChicago]

I was listening to some insurance experts on the Fox Business xm-radio network today. They were saying that even in the medium to larger group market, health insurance providers are predicting an 80% to 120% increase in premium on 1/1/2014. Roughly 50% of corporations are planning on dropping their group coverage and paying the substantially less costly $2,000 per employee penalty.

1. Is it likely that Group policies are going to increase in price this dramatically? I thought that Qualified Health Plans for the individual market are being designed to mimic group policies, because group policies (for the most part) already are compliant with the Affordable Care Act.

2. Since the IRS isn't going to actively enforce the tax/penalty, will corporations voluntarily send hundreds of thousands of dollars to the treasury department... just for compliance sake?

-ac

 

[Yagents]

I still believe (and per nahu), that spouses may be eligible for subsidies.

I just don't see how a family of 4, with one breadmaker making 50k a year, will have to pay up to $4500 for their own policy, and then another $5000 or more for the family to be added on. That's over 20% of their income (at least).