Categorized as: Blog

Essential Health Benefits, Minimum Essential Coverage, Minimum Value Coverage – What’s the Difference?

The Patient Protection and Affordable Care Act (PPACA) uses terms that sound alike for three very different things. Here’s a closer look at these terms, and when they’re used. Essential Health Benefits Significantly affects individuals and small employers with a fully insured plan. Has a limited impact on self-funded and large insured plans. Beginning in 2014, policies in the individual and small group markets* will be required to provide coverage for each of the 10 “essential health benefits” regardless whether the policy is purchased through or outside the exchange. Self-funded plans (regardless of size), large group plans, and grandfathered plans…

New PPACA Details: Eligibility Waiting Periods, Employee Notices, & Claims Appeals

The Department of Health and Human Services (HHS), the Department of Labor (DOL) and the Internal Revenue Service (IRS) continue to issue details on the Patient Protection and Affordable Care Act (PPACA).  The past 10 days has brought several changes of interest to employers: Eligibility Waiting Periods Affects all plans, whether fully insured, self-funded or grandfathered.  Applies to all sizes of employers, as of the start of the 2014 plan year The agencies have issued proposed regulations that state that an eligibility waiting period cannot be more than 90 days.  This literally is 90 calendar days — a plan that…

Firms Find New Solutions in Voluntary Options

As rising health care costs take their toll on traditional benefits offerings, voluntary options are emerging as a “win-win” situation for employers and employees alike. While voluntary benefits, in which employers pay little or nothing toward the cost of coverage, may seem like a downgrade compared with traditional employer-paid benefits, experts say many employees prefer having more choices through voluntary options and appreciate employers’ help in securing the best choices. Employers are beginning to view voluntary benefits as a key component to their efforts to build a happier and more loyal workforce. Higher deductibles and increased cost sharing are starting…

Radio Interview on Healthcare Reform

On Wednesday, March 27th at 1:40 pm, Aida Visakay will be Bert Baron’s guest on “New Jersey TODAY”. Tune in to find out what employers need to know for 2014, when Health Care Reform will require that nearly all American Citizens and residents to purchase qualified health insurance. This interview can be heard live on WCTC 1450 AM Talk Radio – The Voice of Central Jersey. If you are not able to access the station, tune in and listen live over the internet: http://www.wctcam.com/listen/.

Labor Department Releases New FMLA Model Forms & Notice Poster

The U.S. Department of Labor has released revised model Family and Medical Leave Act (“FMLA”) forms to administer federal FMLA leave and a notice poster. The updated forms should be used by employers immediately, although they include no substantive revisions despite recent rulemaking on the FMLA military caregiver leave provisions (see our article DOL Publishes Final Regulations Addressing Military Family Leave Provisions). The new forms expire on February 28, 2015. Following are links to the revised model forms: WH-380-E Certification of Health Care Provider for Employee’s Serious Health Condition WH-380-F Certification of Health Care Provider for Family Member’s Serious Health…

Regulation Roundup: The Hits Keep on Coming

An annual survey by the Center for Professional Excellence notes that the perceived professionalism of entry-level workers by their managers has slipped during the past five years with about 45% of those polled saying their employees’ work ethic has worsened. Respondents cited a “too-casual” view of work, workers not being self-starters, and a “lack of ownership in one’s work”. The survey reflects an emerging trend that poses a tough challenge to HR professionals: how to encourage “milennials” to adapt and succeed within a company’s business culture. The federal government in the past few weeks has kept up the fast pace…

What is my State doing under PPACA?

WHAT IS MY STATE DOING WITH EXCHANGES, MEDICAID UNDER PPACA?   States have two major decisions to make with respect to the Patient Protection and Affordable Care Act (PPACA) — whether they will run the health exchange themselves, and whether they will expand Medicaid to cover most individuals whose income is below 133 percent of the federal poverty level. Exchange Election Beginning in 2014, all states will have a health exchange.  If a state chooses not to run an exchange, the federal government will run the exchange for the state. An exchange run by the federal government for a state…

Significant Changes in Final HIPAA Privacy Regulations

The Office for Civil Rights (“OCR”) of the U.S. Department of Health and Human Services published its long-awaited final privacy and security regulations (“Final Rule”) under the Health Insurance Portability and Accountability Act (“HIPAA”) on January 25, 2013. The Final Rule becomes effective March 26, 2013, and, in general, covered entities and business associates are required to comply by September 23, 2013. The Final Rule addresses four key areas: (i) changes made by the Health Information for Economic and Clinical Health Act (“HITECH Act”); (ii) the HIPAA enforcement rule; (iii) updates to the data breach notification regulations; and (iv) changes made by…

The New Age of EAPs

In the new issue of Employee Benefit Advisor, Aida Visakay was a contributor to the article, The New Age of EAPs. To read the full article, here is a direct link. Feel free to read the article and browse through the rest of the magazine by following the link.