As an insurance agent working with employers, it is important that I keep myself and my clients up to date on the Affordable Care Act each year.
Hopefully you are up to date with the following:
- Employee Handbooks: are you providing current information on the benefits offered? An audit by either the IRS or Dept. of Labor could request a copy of your handbook for examination.
- All large employers (50 or more full-time employees) MUST provide health coverage to their employees working 30+ hours a week. Failure could result in penalties if an employee applies and receives a tax subsidy on the Marketplace.
- Document those employees who WAIVE coverage: If employees waive coverage an employer needs to protect themselves with documentation. If an employee applies for a Marketplace plan the employer must provide a reason why the employee was not eligible and support their case with documentation.
- Don’t discount FTE (full time equivalent employees): although they might not be full time, those employees who work 30+ hours (interns, part-timers, temps, etc…) may need to have their hours included and may fall in the eligibility definition.
- Include a legal waiting period for healthcare in employee handbook: 90 calendar days is the longest allowable for a waiting period. Make sure your handbook and your benefits do not have a waiting period longer than first of the month following 60 days.
- Provide SBC ( Summary of Benefits Coverage): education about the coverage offered is just as important as offering the coverage. Make sure SBCs are provided at least on an annual basis.
- Calculate eligible employees correctly: or hire someone that can. Don’t guess it could cost you more than you think.
Make sure you and your agent are talking about these points. If not, call me and we can discuss them.
A little more about us:
The Business Warrior group has some of the industry’s top experts in all the areas your business needs to be successful. Amongst the contributors is Janis VanAhn, owner of Health Insurance Advisor, LLC. For 19 years Janis has worked in and around the health insurance industry initially providing service to agents and employers related to employee benefits, individual healthcare and Medicare, while more recently becoming appointed as an individual agent with various quality carriers to provide this service to individuals through her own business.
Four years ago Janis was ‘blessed’ with being let go from her job at an insurance ageny. Staying within insurance was her path…but in what capacity. 2010 was the year Janis began her career as an independent insurance agent specializing in health insurance. Finding quality, cost-effective healthcare for individuals and families under age 65 as well as working with those who are Medicare eligible truly was her passion. She has made this a true specialty and positioned herself as someone to work with whether it is a financial professional or property & casualty agent with a client that needs assistance, to a group of seniors turning 65 and they keep receiving Medicare information and are confused about what to do.
Janis enjoys the one on one contact with clients as well as looking forward to speaking to groups about healthcare. Her excitement for this industry is what drives her to stay in tune with Healthcare Reform and what is currently happening and what will happen with coverage from now to past 2014.
‘Educating individual and Medicare consumers to make informed choices’ is her mission because if people are educated and understand, they will make informed choices that they are comfortable with.
Footnote: https://freedomcarebenefits.com/forgotten-details-of-aca-compliance/?utm_source=June+2… Dated June 30, 2016 as source for this article.