bernardini & donovan insurance services

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.

July 1, 2013September 8, 2016

How to Determine if you are Considered Large Group

As a business employer, there are several parts of the Affordable Care Act (ACA) that may affect your business and your group plan. Beginning in 2014, business owners with 50 full-time workers or full-time equivalents (FTEs), are considered a large group employer. As a business owner, the act requires you to offer affordable health insurance coverage to all of your full-time workers, as well as their dependent children, or be subject to penalties.

Am I a ‘large group’ or ‘small group’ employer?
If you are a business that employs at least 50 full-time employees or 50 full-time equivalents during the prior calendar year, you are subject to the play or pay penalties and the employer-shared responsibility provisions.

There is a one-time special six-month transition rule, which applies only for 2014, which allows you to use any consecutive six -month period in 2013 rather than using the full previous twelve months to determine whether you are a large employer.

What is a full-time employee or equivalent?
A common law employee who averages at least 30 hours per week or 130 hours in a calendar month is considered a full-time employee. You must calculate your hourly worker’s service hours based on hours worked and hours of earned paid leave.

If you are a California business in the Redlands or Inland Empire, and have questions about health reform legislation, and how it will affect your large group plan, contact the experts at Bernardini & Donovan Insurance Services.

June 26, 2013September 8, 2016

Covered California Health Insurance Exchange: Applying for Coverage

Starting October 1, 2013, Covered California will become the primary marketplace for individual health insurance coverage. The market will feature tools which will allow insurance consumers to compare policies that offer affordability to low-income individuals and families. Services include free health insurance or significantly reduced health insurance for qualifying individuals and families.

For those who wish to apply for coverage, Covered California can be initiated by phone, online, or through a licensed agent. Applicants should expect to talk with a Covered California call center representative who will screen the applicant for qualification. If qualified, the call is transferred to a county representative for completion.

Income verification if through the IRS and the exchange will use the applicants last filed IRS return to verify income as an estimation of income. Applicants can prove income by showing documentation of major changes in income levels for the current year.

Covered California is part of the health insurance exchange for California residents and helps to ensure that all Californians are covered with health insurance.

Bernardini & Donovan Insurance Services provides insurance policies to the people of San Bernardino County, the City of Redlands, CA and the State of California. If you have questions about insurance or the Covered California program, please contact Bernardini & Donovan Insurance Services.

June 21, 2013September 8, 2016

Covered California Health Insurance Exchange: What Kind of Coverage Will you be Getting?

If you want or need to get insured, Covered California has options for health insurance. The exchange has been created to comply with the health insurance changes that are taking effect in 2014. Under the exchange, people will get individual health insurance coverage, there will be 13 commercial health plans, and more than 80% of practicing physicians and acute care hospitals will be participating. The plans provided cover doctor visits, hospital stays, prescriptions, and more. They also avoid many of the gimmicks of same plans that were seen in the past.

The out-of-pocket cost is capped at a maximum of $6,350, which will reduce the risk of people going bankrupt because of large medical bills. Without the proper insurance, this possibility is still very real. The list of current insurers is only for individual health insurance coverage, but options will also be available for small businesses to work with the health insurance exchange in order to cover their employees in the near future.

For more information on the health insurance coverage provided by Covered California in the Redlands, CA area and throughout CA, please contact Bernardini & Donovan Insurance Services today.

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