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Making a Good Faith Effort: ACA Reporting in 2015

Nov 6, 2015 7:32:04 AM / by Deborah Hyde posted in ACA, 2015 ACA, ACA Reporting, Front Page Post, 2015 Affordable Care Act, Affordable Care Act, Deborah Hyde

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As employers begin the final countdown to the 2015 Affordable Care Act (ACA) reporting deadlines, an important consideration to keep in mind is the IRS’s assurance that employers who make a good faith effort to comply with the requirements will not be met with filing penalties this first year.  This penalty relief should provide some comfort, but employers may be left wondering exactly what a “good faith effort” entails.  Generally, a good faith effort is one made with honest, sincere intention.  In the context of ACA reporting, how will an employer be able to demonstrate an honest, sincere intention to comply?

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MLR Rebates Require Careful Consideration

Oct 9, 2015 8:46:44 AM / by Deborah Hyde posted in ACA, 2015 ACA, MLR, Front Page Post, Affordable Care Act, Deborah Hyde, ERISA, medical loss ratio, MLR Rebates

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Under the Affordable Care Act, insurance carriers are required to spend a minimum percentage of premium dollars on medical care and health care quality improvement. This minimum percentage is referred to as “medical loss ratio” (MLR) and is set at 85% for large group market issuers, 80% for issuers in the small group and individual markets. Any issuer that does not meet the MLR standard for a year must provide a rebate to its policyholders. MLR rebates for 2014 were due to policyholders by September 30, 2015.

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Open Enrollment and Special Enrollment Periods

May 12, 2014 12:37:10 PM / by Kelley Jensen posted in Obamacare, 2015 ACA, Kelley Jensen, SEP, special enrollment period, the Affordable Care Act, Affordable Care Act, open enrollment

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One VERY significant change to the individual health insurance market made by The Affordable Care Act (ACA, Obamacare) is the implementation of open enrollment and special enrollment periods. Prior to the ACA, an individual could purchase health insurance from an insurance carrier anytime, but the insurance carrier could reject an application, based on a pre-existing condition of the applicant.

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