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August 19, 2013September 8, 2016

How do exchanges improve health plan quality and value?

One component to the Affordable Care Act being instituted as of January 1, 2014 is the addition of healthcare exchanges. Healthcare exchanges will be required throughout the United States and will create a marketplace through which individuals and small business owners can find affordable health care plans.

How Will Healthcare Exchanges Work?

While the details haven’t all been set in stone, a healthcare exchange will provide access to multiple types of insurance products. Individuals will be able to contact a healthcare exchange so they can compare different types of insurance policy to find the best one for them. There will be separate exchanges for individuals seeking insurance and small companies seeking insurance.

How Do Exchanges Improve My Health Plan?

A healthcare exchange requires that insurance companies compete against each other for their clients. This means that insurance companies will be forced to lower their costs and increase the benefits of their policies so they can stay competitive within the market. Healthcare exchanges will also help to assist individuals in choosing the best coverage for their situation.

For more information about individual health insurance and the new individual exchanges contact the experts at Bernardini & Donovan Insurance Services.

August 14, 2013September 8, 2016

What are an Exchange’s responsibilities?

With individual health insurance becoming a mandatory requirement in January 2014, it’s time to become aware of what is expected of you as an individual, and the responsibility of the individual exchanges. What are the responsibilities of an exchange?

The exchanges carry the burden of making sure health care providers comply with the minimum standards in providing health care. They are the “store” that carries a variety of products that will be offered for consumer selection. The exchanges will make sure all consumers are aware of pricing, quality ratings and performance and will also have the responsibility of making sure enrollees who qualify for subsidies and exemptions get the proper credit. Employers will have the advantage of having the exchanges work with them to make sure they are in compliance. By using an exchange, individuals and businesses should have smoother transitions in enrolling into health plans and complying with the law. Although making sure you are enrolled into a health plan is your obligation, using the exchange for information should make things a lot easier.

For more information on health insurance exchanges and compliance with the Affordable Care Act, contact Bernardini & Donovan Insurance Services.

August 9, 2013September 8, 2016

How Buying Insurance in an Exchange is Going to Work for Individuals

The first day for open enrollment into the California insurance exchange is drawing near, offering access to individual health insurance like never before. Individuals are going to be able to shop for a plan that suits their personal needs as well as being able to compare and contrast the available options. Covered California, the state exchange, offers the option to get information via a website, through the mail or by phone. All of these options are going to contain information that helps you, the consumer, decide on which plan is right for you.

The website will have a variety of features that allow the user to pick and choose their plan. Available information includes premiums, what benefits are offered for each plan, provider networks and availability. Other information demonstrates how much the plan spends in order to cover medical claims in relation to administrative charges. That way, the consumer can see how much money is going to the health care as opposed to office work. An online calculator is also available for figuring out the actual cost of insurance, including any premium subsidy. You, the consumer, then have the option of buying insurance in an exchange that makes the most sense for you.

For more information about health insurance in the greater Redlands area, contact Bernardini & Donovan Insurance Services today.

August 5, 2013September 8, 2016

What is an Individual Health Insurance Exchange

Now that the end of the year is approaching, California and other states are making sure they comply with provisions of the Affordable Care Act. One of the main provisions is providing Health Insurance Exchanges for individuals. What does this mean?

It means that people can purchase individual health insurance plans to cover their medical expenses. The exchanges allow individuals to compare pricing and services, making informed decisions on what will work best for them according to the four levels of coverage offered. These plans will be available for purchase in a variety of ways: mail, web, by phone or in-person. Additionally, the exchanges will have information you need in relation to premium costs and possible subsidies. It is important to understand the intricacies of selecting a provider and how the exchanges work.

Starting January 2014, everyone is required under the Affordable Care Act to carry a health insurance policy. For more information on the Affordable Care Act and the Health Insurance Exchanges, contact Bernardini & Donovan Insurance Services.

July 31, 2013September 8, 2016

Large Group Reforms Delayed till 2015

In July of 2013, the Obama Administration announced that it was delaying the large group reforms of its insurance mandate until 2015. That was a significant issue for companies that knew they would have to provide coverage for a significant number of employees. The smaller groups and individuals who are required to purchase insurance will still need to have that in place by January 1st of 2014, however, as the change does not apply to them.

For companies to fall under the mandate extension, they need to have 50 or more full-time employees. However, that’s not as simple as it sounds. These employees are what’s considered to be “full time equivalent” workers. If they have worked an average of 30 hours or more per week in a given month, they fall under that designation. Companies need to keep careful track of their workers’ hours in order to determine whether they fall under the mandate or not. With the large group reforms delayed, many companies that would otherwise have to spend a lot of money for insurance very soon will be able to wait a bit longer.

For more information on large group health insurance in the Redlands, CA area, contact Bernardini & Donovan Insurance Services today.

July 24, 2013September 8, 2016

Healthcare Reform: Employer Responsibility

As the fully implemented Healthcare Reform provisions go into effect on January 2014, employer responsibility becomes a national issue. Although there are some pieces of Healthcare Reform that have already started to change, the brunt of the law and its implications are waiting in the wings.

Large groups and their employers play a major role in the effectiveness of the law. While most large group employers do offer health insurance options, they must keep in mind that non-compliance with the law is not an option. If they do not comply, stiff penalties will result. Large group employers now carry a certain amount of employer responsibility that has never been an issue.

Additionally, employers of large groups will now have to report their health care coverage compliance to the IRS, ensure all employees are notified about health care exchanges available, and run the risk of getting into serious trouble if they completely ignore the law. Employer responsibility is no longer a choice, but a requirement that all employers of large groups must adhere to.

For more information on employer responsibility and how your large group organization must comply with the laws, contact Bernardini & Donovan Insurance Services.

July 19, 2013September 8, 2016

Controlling the “Play or Pay Penalty” Under Healthcare Reform

When preparing to comply with the new Healthcare Reform law, large employers should recognize the implications of non-compliance as it relates to the play or pay penalty. If your organization has over fifty full-time employees and they were there in the preceding year, you must offer an adequate health care insurance option to them or pay penalties. What does this mean?

It means that if you are a large corporation, your penalties will be assessed based on the recorded number of full-time employees. The pay or play penalty can be calculated in a variety of ways. If you have a number of subsidiaries, your calculations would be different than that of a company with just one major corporation and all of the full-time employees working under that entity. This penalty applies to the corporation or entity that failed to provide “affordable” coverage, which is the main stipulation of the law. If your corporation offers this coverage, then you are in compliance and will not face these penalties.

For more detailed information on the pay to play penalties and how it could affect your organization, contact Bernardini & Donovan Insurance Services.

July 15, 2013September 8, 2016

How the Play or Pay Penalty Works

One of the upcoming changes included in the healthcare reform bill is what is known as the Play or Pay penalty. It’s aimed at larger businesses with a certain amount of employees, and it is not exactly straightforward. An employer can offer health insurance , but, it must be “affordable”. The idea behind the penalty is to offset the cost of insurance for each employee that uses the public health care plans.

The specifics for the Play or Pay penalty are as follows:

An employer that has 50 full-time or full-time equivalent employees (IE 100 part-time employees) must offer what is known as “affordable” coverage to all qualifying employees.
When an employer does not offer health insurance to all employees, an annual tax of $2,000 for each full-time employee if one employee gets federally-subsidized coverage.
In the case an employer does not offer “affordable” coverage to full-time employees, and one employee gets coverage through the exchange, the employer must pay an annual tax of $3,000 per subsidized employee who gets coverage through the exchange.

For all of these rules, the first 30 full-time employees are exempt from the penalties.

If you are in the Redlands area, or throughout California, contact Bernardini & Donovan Insurance Services for more information about how the penalties can affect your company.

July 10, 2013September 8, 2016

How a Small Group is Defined for Health Insurance Policies

The Affordable Care Act has divided employers into two categories: small group and large group. The act itself has a test that small business owners use to determine which category they fall under. There is a general dividing line at 50 full-time employees or equivalents, although there are some benefits specifically aimed at businesses with 25 or less full-time employees.

A business that employs 50 or less full-time employees falls under the small group definition. However, the full-time employee doesn’t necessarily have to be one individual. A business can have as many part-time employees as it wants as long as the equivalent number does not go over 50. In other words, an employer can have four part time employees working ten hours a week for a total of 40 hours worked. These four people working a total of 40 hours is calculated as one employee. There can be any variation on this theme to qualify for the small group coverage as long as the sum total is no more than 50 full-time employees.

If you are in the Redlands, CA area, or throughout California, and are interested in more information about health insurance policies for business owners, contact Bernardini & Donovan Insurance Services.

July 5, 2013September 8, 2016

Healthcare Reform: How does it affect large groups?

The new Healthcare Reform policies will affect everyone in different ways. Large and small business owners will definitely be affected, as well as health care organizations. As a large group employer, which is an organization that have over 50 full-time employees, you may already offer an insurance option to your employees. If you don’t, you will definitely be required to as the full policy goes into effect January 2014. What does this mean?

If you do not comply with federal regulations and provide an adequate health insurance option, you will pay stiff penalties. You have to offer it to at least ninety-five percent of your employees and prove it, even if they choose to opt out of the program. Make sure to keep proper documentation. If you don’t currently offer an adequate health insurance plan for your employees, now is the time to start looking for one. It may save you a lot of time and money in the long run.

For more information on insurance options and the law, contact Bernardini & Donovan Insurance Services.

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