NAHU Webinar Recap

[Yagents]

Thanks for the stroke......purrrrr

 

[somarco]

Agents WILL be able to use their own websites, to gain access to the broker portal on the FFE exchange

Will agents still be required to submit websites to HHS for approval?

If employee portion deemed "affordable", will not be eligible for subsidies on the exchange.

Less widely known is a special penalty that applies only to companies that do offer coverage: a $3,000 penalty for each employee who qualifies for, and accepts, a federal premium subsidy for coverage purchased through the state-based exchanges. An employee is eligible for such a subsidy, and can thus trigger the penalty, if the employee's share of the health insurance premium is "unaffordable" – which is defined as more than 9.5% of the employee's family income, if the employee's family income is also between 138% and 400% of the federal poverty level (FPL). The intent appears to be to discourage employers from "dumping" their lower-income employees onto the taxpayers by setting high employee premium share – although it
might just as well discourage employers from hiring people from low-income families.

When informed of this provision, employers naturally ask, "How are we supposed to know our employee's family income?"

The IRS Employer Mandate Loophole - Forbes

Carriers can ONLY offer plans outside the exchange.

This is new info. I have been under the impression carriers can only sell major med outside the xchng if they also offer product on the xchng.

 

[Yagents]

Will agents still be required to submit websites to HHS for approval?



Less widely known is a special penalty that applies only to companies that do offer coverage: a $3,000 penalty for each employee who qualifies for, and accepts, a federal premium subsidy for coverage purchased through the state-based exchanges. An employee is eligible for such a subsidy, and can thus trigger the penalty, if the employee's share of the health insurance premium is "unaffordable" – which is defined as more than 9.5% of the employee's family income, if the employee's family income is also between 138% and 400% of the federal poverty level (FPL). The intent appears to be to discourage employers from "dumping" their lower-income employees onto the taxpayers by setting high employee premium share – although it
might just as well discourage employers from hiring people from low-income families.

When informed of this provision, employers naturally ask, "How are we supposed to know our employee's family income?"

The IRS Employer Mandate Loophole - Forbes



This is new info. I have been under the impression carriers can only sell major med outside the xchng if they also offer product on the xchng.

Don't know about HHS approval for websites.....doubt it as they don't have the staff to police the wild wild west.

Recent guidance is leaning towards allowing employers to base the "affordability" on the EE's income only, not the family income.

I asked that specific question. "Can carriers ONLY offer plans off the exchange", the answer was a plain "yes", which also surprised me as I was under the same impression as you. But all plans would still have to adhere to EHB's and OOP's.

 

[taterpeeler]

This is new info. I have been under the impression carriers can only sell major med outside the xchng if they also offer product on the xchng.

I think you are referring to the last statement in sir, king, dear leader bills post.... if so im confused too but I think it was referring to long term care ins??????

 

[HealthGuy]

Bob has the million dollar question...will there be allowed non exchange plans as is today ?!? Who really knows? anyone wanna take a stab at this one ?

 

[leevena]

Don't know about HHS approval for websites.....doubt it as they don't have the staff to police the wild wild west.

Recent guidance is leaning towards allowing employers to base the "affordability" on the EE's income only, not the family income.

I asked that specific question. "Can carriers ONLY offer plans off the exchange", the answer was a plain "yes", which also surprised me as I was under the same impression as you. But all plans would still have to adhere to EHB's and OOP's.

Just a note of clarification, Self-funded plans are currently not subject to EHB's. This is true regardless of of the size.

 

[Yagents]

Nahu may have misunderstood my question re off exchange

 

[somarco]

Don't know about HHS approval for websites.....doubt it as they don't have the staff to police the wild wild west.

That hasn't stopped them before.

Agents with MAPD sites are supposed to get CMS approval. Can't find it now, but there was something a few months back about HHS approval for agent sites. I believe I even posted it here.

As for non-xchg plans, supplemental (cancer, accident, etc) are not covered under Obamacare so I see no reason why they can't be sold in 2014. But every carrier meeting has indicated they must sell MM plans on the xchg to sell outside the xchg.

Off xchg plans will be different, with higher ded, OOP and broader networks.

At least that is today's story . . .

 

[Ann H]

Just like Somarco, I also was under the impression that carriers were required to sell at least one exchange plan in order to be allowed to sell any MM plans off the exchange.
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Yes, YAgents, you are a wealth of information! Thank-you. Albeit, I must admit to feelings of inadequacy and jealousy since you've unseated me as a resident "expert" of sorts in regards to PPACA. I crave the approval, and therefore find myself addicted to this forum...... LOL. Really, thanks Bill for all the valuable information you share on a regular basis!

 

[bluediamond]

Agents: will be part of the FFE's unless the state excludes agents, which NONE have done yet. Agents WILL be able to use their own websites, to gain access to the broker portal on the FFE exchange, and assist with subsidies (Yooohoo!!), but must offer all plans/carriers for fair representation. States will still handle licensing, but HHS will control agent participation parameters. NAHU is offering a PPACA online certification class.

Read more: NAHU Webinar Recap

Ok, so I being licensed in Florida will have to show all plans for the state of Florida and therefore be appointed with all companies doing business in Florida to put someone in the exchange? Am I correct?