Health Care Reform
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IRS Releases Final Rules on Health Care Reform Costs
The affordability test applies to employer-sponsored health plans. An employee is eligible to receive a federal subsidy to purchase insurance through an exchange if his or her employer's plan premium contribution exceeds 9.5 percent of his or her household income, according to IRS guidelines.
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Employers' Deadline to Inform Employees of Health Exchanges and Cost-Sharing Plans Extended
The March 1 deadline for businesses to notify employees of their benefits cost-sharing plans and government-run health insurance exchanges has been postponed. A new deadline is expected by fall.
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HHS Gives $1.5 Billion in Grants to 11 States to Set Up Health Exchanges
The U.S. Department of Health and Human Services said it is giving $1.5 billion in grants to 11 states to launch or further develop health insurance exchanges. Those states are California, Delaware, Iowa, Kentucky, Massachusetts, Michigan, Minnesota, New York, North Carolina, Oregon and Vermont.
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HHS Proposes Rules to Verify Health Care Premium Subsidy Eligibility
Under the proposed rule, administrators of state and federal insurance exchanges must verify whether applicants seeking tax credits to buy health care coverage through an exchange are enrolled or eligible for qualifying coverage in an employer-sponsored health care plan.
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Certifications Aid Navigation of the Affordable Care Act Maze
Finding a qualified partner in the employee benefits industry can help companies adjust to the ACA regulatory landscape. Accreditations are enhancing their knowledge.
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Tobacco Cessation Report Lights Up Coverage Gaps, Confusing Language
Researchers found 'significant variation in how private health insurance coverage works for tobacco cessation treatment' when analyzing 39 insurance contracts in six states.
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Higher Financial Penalties Proposed for Uninsured Massachusetts Residents
In 2012, the maximum penalty for non-compliance was $105 a month, or $1,260 a year. The maximum penalty this year for those with incomes that exceed 300 percent of the federal poverty level will be $106 for each month that an individual is not covered by health insurance, or $1,272 a year.
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Certifications Aid Navigation of the Affordable Care Act Maze
Finding a qualified partner in the employee benefits industry can help companies adjust to the ACA regulatory landscape. Accreditations are enhancing their knowledge.
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Massachusetts Bill Would End Employer Penalty for Not Offering Health Plan
Under the governor's plan, the current annual assessment—known as the Fair Share contribution—of $295 per employee on employers not offering coverage would end on June 30.
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IRS Rules Ease Compliance With Health Reform Law Employer Mandate
The massive $2,000-per-full-time-employee penalty will not apply so long as employers offer coverage to at least 95 percent of their full-time employees and their dependents up to age 26, the IRS said.
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Minnesota, Rhode Island Get OK to Launch Health Insurance Exchanges
The U.S. Department of Health and Human Services has given tentative approval to applications filed by Minnesota and Rhode Island to launch health insurance exchanges in 2014.
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Domino's Pizza Founder Wants Exemption From Contraceptive Mandate
The U.S. Department of Health and Human Services law requires most employers to provide cost-free coverage for birth control prescriptions, sterilization, preventative screenings and other forms of women's preventative care.
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HHS Approves Health Insurance Exchanges for Two More States, D.C.
Kentucky and New York join the District of Columbia in receiving the latest approvals. In all, exchange applications filed by eight states, plus the District of Columbia, have received tentative regulatory approval.
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Pennsylvania Will Not Set Up Health Insurance Exchange
Pennsylvania is the latest state to declare it will not set up a state health exchange. States have until Dec. 14 to inform federal regulators whether they intend to establish exchanges.
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2013: A Time for Re-imagining How Work Gets Done
How work gets done, who does it and the tools they use to accomplish the task are all shifting as the new year approaches.
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2013 Employment Forecast: A Fiscal Cliffhanger
How well the job market recovers in the next 12 months could depend on what Congress decides in the next few weeks.
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HHS Gives Tentative Approval to Six State Health Insurance Exchanges
Those six states are Colorado, Connecticut, Maryland, Massachusetts, Oregon and Washington.
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HHS Details Fees to Be Paid, Provides Guidance for Transitional Reinsurance Program
Much of the $25 billion in assessments—to be paid annually over a three-year period—will be used to partially reimburse commercial insurers writing policies for individuals with high health care costs.
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The Last Word: Spending the Holidays With Obamacare
There is a large contingent of HR and benefits managers who face implementation now, during the holiday season no less.
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HHS Proposes Rules on Employee Wellness, Essential Health Benefits
Officials said the proposed rules on wellness programs are designed to give employers greater flexibility to design programs that will positively affect their employees' overall health while providing individuals with enhanced protections against discriminatory practices.
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Health Care Reform Timeline
Implementation of the Patient Protection and Affordable Care Act has been slow since its passage in March 2010. That will change starting in January when more regulations and requirements begin kicking in. Here is a list:
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Obamacare Health Exchanges Could Take a Big Bite Out of Broker Commissions
State-run health care exchanges could offer one-stop shopping experiences for small businesses, which usually pay more for insurance because they lack the buying power of bigger companies.
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Obama Re-election to Accelerate Release of Health Care Reform Law Guidance
Some health care reform law issues may be discussed during the remaining weeks of the current legislative session as lawmakers look for ways to reduce the federal budget deficit.
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Obama Win Seen as Victory for Health Care Reform
President Barack Obama's victory serves as a vindication for the Patient Protection and Affordable Care Act, industry experts said soon after the president won re-election Nov. 6.
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With Election Near, Romney, Obama Take Very Different Stances on Health Care Reform Law
Republican challenger Mitt Romney said numerous times during the campaign that one of his first acts, if elected, would be to seek repeal of the Patient Protection and Affordable Care Act.
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Most Employers to Continue Offering Health Benefits: Survey
Out of 111 Midwestern employers surveyed in August, only 8 percent said they intend to drop health care coverage for active employees in 2018, when the last of the federal health care reform act's provisions are expected to take effect, according to the Chicago-based business group's report.
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Guidance on Health Reform Law's Transitional Reinsurance Program Requested
Many questions remain unanswered about the Transitional Reinsurance Program, the Washington-based benefits lobbying group noted in a letter sent this month to the U.S. Department of Health and Human Services, which will enforce the program.
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Medicare Heats Up Biden-Ryan Debate
The Medicare segment of the debate included some of the most frequent interruptions by both Vice President Joe Biden and Republican vice presidential candidate Rep. Paul Ryan (R-Wisconsin) in a testy debate as each took turns bashing the other side's impacts on the program.
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Illinois Politicians Back Health Insurance Co-Op Applicant
Gov. Pat Quinn, fellow Democrat Richard Durbin and Republican Mark Kirk have written letters of support on behalf of SimpleHx, a co-op proposed by a group of people who met last year while pursuing their MBAs at Northwestern University.
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Rising Health Care Costs to Pinch Employees
The average cost to insure an employee is projected to jump to $11,283 in 2013, from $10,616 this year, according to the report by the unit of London-based Aon Corp.
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Lack of Health Care Reform Guidance Hampers State Lawmakers: Letter
For employers, final regulatory guidance has yet to come in a number of areas, including whether employers will be assessed a penalty of $2,000 per full-time employee if they do not offer coverage to all full-time employees, and how much they will have to pay to fund a three-year health care reform...
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Romney Reform Repeal Would Mean More Uninsured: Commonwealth Fund
Under Romney's plan, 30 percent or more of the under-65 population in nine states—Arkansas, California, Florida, Louisiana, Mississippi, Nevada, New Mexico, South Carolina and Texas—would be left uninsured by 2022, which the report says would increase the number of uninsured in every...
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South Dakota Declines to Set Up Health Insurance Exchange
South Dakota joins several other states, including Texas, whose governors said they will not set up the exchanges.
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Employees Will Need to Be Educated About Benefits Eligibility
Fortunately, most payroll and human resource information system vendors either already have a robust time and attendance system or are building one to meet the new employer record-keeping requirements mandated by the Patient Protection and Affordable Care Act.
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IRS Notice Gives Employers Clarity on Definition of 'Full Time'
Under the notice, which will remain in effect at least through 2014, employers can use a retrospective measurement period lasting between three and 12 months to determine whether an employee's hours meet the definition of “full time” under the Patient Protection and Affordable Care Act.
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Oklahoma Attorney General Refiles Suit to Block Health Reform Provisions
The amended lawsuit argues that the IRS' regulation directly contradicts the Patient Protection and Affordable Care Act's original language regarding the exchanges and—more specifically—the premium subsidies, which carry significant financial penalties for certain employers that do not...
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Certain Health Care Reform Provisions Should Be Kept: Romney
Mitt Romney says that while he would seek to repeal the health care reform law if he were elected, he could keep the provision that bans health care plans from denying coverage of pre-existing medical conditions and perhaps even expand a provision that requires health care plans to provide coverage...
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Obama Sees Election as Referendum on Reform
President Barack Obama accepted his party's nomination for another term by framing the election as a choice over whether voters value his signature healthcare law, among other policies.
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Employers Should Ignore the Rhetoric and Focus on the Reality of Health Care Reform, Experts Say
With the presidency and 33 Senate seats up for grabs in 2012, how the battle over health care reform will play out is anyone's guess, but employers are watching the tussle closer than most.
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Clinton Defends Reform Law in DNC Speech
Clinton directly answered many of Republicans' leading criticisms of the law, including the projection that the Patient Protection and Affordable Care Act will cut $716 billion from Medicare.
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Health Care Reform a 'Badge of Honor' for Democrats: HHS Secretary
During her speech, Kathleen Sebelius detailed what she said are some of the achievements of the Patient Protection and Affordable Care Act.
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Health Care to Take Center Stage at DNC
The night of September 4 will feature some of the highest-profile defenders of the law, including first lady Michelle Obama and HHS Secretary Kathleen Sebelius.
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The Last Word: 'Papa John,' Can You Spare a Dime for Health Care?
Politics apparently has joined the menu—at least through November—alongside pepperoni and pineapple as a new pizza topping.
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Repeal and Replace Health Care Reform Law: Romney
Republican presidential candidate Mitt Romney called for a repeal of the Patient Protection and Affordable Care Act during his speech at the Republican National Convention August 30.
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Reform Law is Biggest Threat to Medicare: Paul Ryan
As chairman of the House Budget Committee, Ryan drafted budgets for fiscal years 2012 and 2013 that include plans to overhaul the nation's federal healthcare entitlement programs through a premium-support model for Medicare and block grant payments to states for Medicaid.
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Health Care: A Real Fixer-Upper
Employers are helping to rebuild the health care system with a do-it-yourself approach that takes picking the right tool. The new options include value-based design, workplace clinics and direct primary care.
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Rochester Business Alliance Fosters the Links for Health Care
The Rochester Business Alliance Health Care Initiative brings together business and community leaders to find ways to improve the health care system and patient outcomes.
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GOP Platform Includes Repeal of Health Care Reform Law
As expected, the Republican Party promises massive changes to the Medicare and Medicaid programs if former Massachusetts Gov. Mitt Romney and Rep. Paul Ryan (R-Wisconsin) are elected president and vice president.
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No Penalties for Employers Not Offering Dependent Coverage: Employer Group
Under the Patient Protection and Affordable Care Act, employers are to be assessed $2,000 per full-time employee if they do not offer coverage to employees in 2014. Regulators have yet to issue definitive guidance on the penalty.
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Self-Funded Employers Will Pay Billions for High-Cost Coverage
The first-year assessment paid by very large employers—those with at least 100,000 employees—will run into millions of dollars, for which employers will receive no direct benefit.
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Most Employers to Continue Offering Health Care Plans in 2014: Survey
Eighty-eight percent of employers surveyed by Towers Watson & Co. said they have no plans to terminate coverage in 2014 or after for full-time employees, while 11 percent were not sure. Just 1 percent said they planned to terminate coverage for some employees.
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Mid-Market Companies Face Health Benefits Enrollment Challenges
One challenge for middle-market companies is the U.S. Department of Labor has yet to finalize the regulations implementing the mandate in Section 1511 of the Patient Protection and Affordable Care Act.
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Willis Makes Additions to Health Care Reform Impact Analysis Calculator
The proprietary tool allows companies to examine health plan possibilities within the Patient Protection and Affordable Care Act of 2010.
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Papa John's CEO Says Health Care Reform Law Will Increase Price of Pizza
In its most recent annual report, Papa John's International Inc. warned of higher costs due to the health care reform law.
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Retailers and Hospitality Industry Employers Face Big Health Care Reform Law Related Cost Increases in 2014
Forty-six percent of employers in the retail and hospitality industries and 40 percent of employers in the health care services industry expect health care cost increases of at least 3 percent due to health care reform law requirements.
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Large Employers Expect Group Health Care Plan Costs to Rise 7% in 2013
Amid rising costs, employers say adopting consumer-driven health plans is the most effective step they have or plan to take to combat rising costs.
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Benefits Group Asks for Exemption of Retiree Health Plans From Health Reform Law Fee
Subjecting retiree health care plans to the fee 'may lead employers to cease offering this very valuable benefit, particularly since such coverage would likely become more expensive by virtue of the application of' the fee, the American Benefits Council stated recently.
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Supreme Court Medicaid Ruling to Leave 36 Million Uninsured in 2016: CBO
A smaller reduction in the number of uninsured could negatively affect employers as the amount of uncompensated care—a cost that health care providers now try to shift in the form of higher charges to patients with health insurance—will not decline as much as providers had initially...
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Most Employers to Offer Health Plans to Employees in Near Future
The findings are similar to those last month from the International Foundation of Employee Benefit Plans, which found that 85 percent of respondents said they definitely would or were very likely to continue coverage.
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Employers Are Caught Up in the Five Stages of Health Care Reform Ruling
While many employers have achieved acceptance, a new survey shows they do not have a strategy for complying with the law's 2014 provisions. One 'sleeper' issue: Medicaid expansion.
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Multistate Attempt to Block Health Care Reform Contraception Provisions Rejected
Nebraska U.S. District Judge Warren Urbom dismissed the lawsuit, declaring that none of the plaintiffs' arguments had sufficiently demonstrated the level of plausible direct impact needed to establish standing to challenge the requirement.
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Kentucky Establishes Health Benefit Exchange
Kentucky Gov. Steve Beshear has issued an executive order to establish the Kentucky Health Benefit Exchange as required by the federal Patient Protection and Affordable Care Act, the governor's office announced July 17.
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House of Representatives Votes to Repeal Health Care Reform Law
With Democrats controlling the Senate, the bill is unlikely to advance further. In addition, if a repeal measure cleared Congress, President Barack Obama would veto it, the White House said this week.
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Lawyers Say Health Care Law Will Spur Employees to Sue Over Technical Issues
At least four federal agencies (the IRS, the Department of Labor, the Department of Health and Human Services and even the Department of Housing and Urban Development) are writing hundreds of pages of regulations that will apply as health care reform is implemented over the next six years.
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House to Vote on Bill to Repeal Health Care Reform Law
The Senate did not take up the repeal bill and it is unlikely that the Senate, where Democrats are in the majority, would do so this time.
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HR Leaders Scrambling After Supreme Court's Health Care Reform Ruling
From the individual mandate provision to 'pay or play' rule, companies find it's time to deal with the bottom line.
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The Last Word: Health Care Reform's Hurry-Up Is Just Beginning
To say health care reform is landmark, game-changing legislation that alters the way HR departments implement benefits is an understatement.
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Lack of Supreme Court Ruling on Health Care Reform Keeps Experts Guessing
Speakers at overflow sessions of the Society for Human Resource Management's 64th annual conference detail the likely scenarios that could occur when the justices rule late this week.
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Supreme Court Will Rule on Health Care Reform Law on June 28
If the entire law is struck down, the result—at least in the short run—will be mass uncertainty, benefit experts say.
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Consultancies and Companies Say They're Ready for Health Care Reform
With tools such as webinars and training videos, companies say they've taken the time to put internal battle plans in place.
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U.S. Awaits Supreme Court's Ruling on Health Care Reform Law
Three months after the justices heard oral arguments on a challenge to the Patient Protection and Affordable Care Act by 26 Republican state attorneys general, the high court will rule sometime next week as its 2011-2012 term comes to a close.
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3.1 Million Young Adults Gained Coverage Through Health Care Reform: HHS
The increase is directly attributable to the young adult coverage provision in the health care reform law, federal researchers say.
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U.S. Health Care Spending Sees Modest Increases
The recent modest increases contrast sharply with the explosive growth in health care expenditures of just a few years ago. From 2001 through 2003, increases in health care spending averaged nearly 9 percent. And as recently as 2007, costs leaped 6.2 percent.
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Most Employers Plan to Continue Offering Health Care Coverage
Just over 9 percent cited retention of tax advantages as a reason for keeping coverage and just over 7 percent said a top reason for keeping coverage was to avoid tax penalties.
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House OKs Changes to Flexible Spending Account Use It or Lose It Rule
Employers could amend their FSAs to allow employees to withdraw as taxable cash up to $500 in unused balances remaining at the end of the plan year or at the end of an FSA grace period, if an employer has that feature.
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Benefit Execs Say Supreme Court Will Strike Down Individual Mandate
Some 66 percent of the respondents' predictions about the fate of the mandate reflect what they heard the justices say during oral arguments, says one expert.
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Obama to Veto FSA, HSA Legislation
Under the measure headed for a vote this week on the House floor, employers could amend their FSAs to allow employees to withdraw as taxable cash up to $500 in unused balances remaining at the end of the plan year or at the end of an FSA grace period, if an employer has that feature.
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House Panel OKs Bill to Ease FSA ‘Use-It-or-Lose-It' Rule
The bill approved by the House panel would eliminate over-the-counter restrictions in the health care reform law.
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IRS Relaxes Health Reform Law $2,500 Limit for Noncalendar-Year FSAs
Employer benefits lobbying groups complained that the limit would effectively force noncalendar-year plans to comply with the rule before the statutory effective date.
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Congressional Panel to Vote on Bill to Overturn Health Care Reform Law Provision
The bill, H.R. 5842, to be considered by the House Ways and Means Committee, would eliminate the OTC restrictions in the Patient Protection and Affordable Care Act of 2010.
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Health Care Reform Law Ruling Likely Complicated: WorldatWork Executive
If the high court were to strike down the individual mandate that requires most U.S.
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Regulators Provide Guidance on Summary of Benefits Rules
Officials said they did not 'intend' to impose penalties during the first year the requirement is in effect so long as employers are working in 'good faith' to comply.
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Study: Couple Retiring in 2012 Needs $240K to Cover Medical Expenses
Of the $240,000 needed to cover a retired couple's health care expenses, Fidelity estimates 32 percent will go toward paying Medicare Part B and Part D premiums; 45 percent will be consumed by expenses not covered by Medicare; and 23 percent will be spent on out-of-pocket prescription drug expenses.
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Health Insurers to Return $1.3B to Policyholders Under Health Reform Rules: Kaiser
The refunds are the result of provisions of the Patient Protection and Affordable Care Act that took effect in 2011 which limit medical loss ratios, the amount of premium dollars health insurers can reserve for profit and administrative costs.
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Employers on Non-Calendar Fiscal Years Seek FSA Mandate Relief
Under a provision in the Patient Protection and Affordable Care Act, which goes into effect on Jan. 1, 2013, the maximum annual contribution employees can make to their FSAs is $2,500.
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IRS Proposed Rule Details How Health Care Reform Law Plan Fees Are Calculated
Many questions have been raised about the fees and to which type of health plans they would apply.
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Little Change for HR in Wake of Health Reform Hearings
Tough questioning of attorneys representing the Obama administration have led some to predict that the U.S. Supreme Court will repeal the mandate, though others say don't read too much into the March 26-28 oral arguments.
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Individual Mandate Rejection Seen as Worst Legal Outcome
According to one expert, if PPACA is allowed to stand without the individual mandate 'the whole thing goes south very quickly.'
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Supreme Court Divided if Health Care Law Can Survive Without Mandate
At issue in the final day of oral arguments on health care reform was whether the individual mandate, which requires most U.S.
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Dropping Health Care Coverage No Easy Decision for Employers
Because employer and employee health care benefit contributions are made on a pretax basis, it wil cost employers considerably more than the $2,000-per-employee fee for dropping coverage, if the law survives legal challenges being heard by the Supreme Court.
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Justices Ask Tough Questions on Individual Mandate
The Obama administration, which is defending the Patient Protection and Affordable Care Act, said Congress had such authority due to its constitutional power to regulate interstate commerce.
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Survey: Health Care Reform Splits Employers
Forty percent of employers want the high court, which is hearing oral arguments this week on the constitutionality of the Patient Protection and Affordable Care Act, to strike down the 2010 law. Still, employers are far from being united in favor of repealing it.
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Health Care Reform on Trial: Read the Supreme Court Oral Arguments
In addition to our web news and analysis coverage, we've posted transcripts of the arguments from all three days.
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Employers Get More Flexibility, No Extension in Health Care Plan Communications Rule
Benefit experts had hoped the administration would provide another extension, but none was provided in a batch of frequently asked questions issued March 19 by the departments of Health and Human Services, Labor and Treasury.
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Will New Claims and Appeals Procedures Change Case Law?
Health care reform regulations that took effect for the 2011 plan year require non-grandfathered self-insured and insured group health plans to make changes to their internal appeal procedures and offer external reviews of denied claims.
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Administration Lays Out Annual Dollar Limits on Student Health Care Plans
Centers for Medicare and Medicaid Services said student health insurance policies must provide annual coverage limits for essential benefits of at least $500,000 for policy years beginning on or after Sept. 23, 2012, but before Jan. 1, 2014.
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Early Retiree Health Care Plan Sponsors Have to Dec. 31, 2014, to Use ERRP Funds
Under the ERRP, early retiree health care sponsors are reimbursed for 80 percent of claims—up to $90,000—after a participant incurs $15,000 in expenses.
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Health Reform Law to Slightly Lower Number of Employer Plan Enrollees: CBO
The health care reform law will have only a modest impact on the number of people covered in employer plans, but it will significantly reduce the number of uninsured, according to a congressional analysis.
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Health Exchanges Must Notify Employers About Employees Eligible for Subsidies: HHS
Among other things, exchanges will have to provide a notice to employers that identifies by name the employees who have applied for and have been determined by exchange administrators as eligible for premium subsidies.
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Consumerism Coming to Companies' Health Care Plans
Large employers at the annual National Business Group on Health conference held last week grappled with uncertainty around health care, but one thing was clear: Employees will be asked to do more to keep costs down by staying healthy and becoming savvier consumers.
