Affordable Care Act HIEs at Launch

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Some Important Launching Information for Doctors and Business Owners

By Bobby Whirley CPA

[Whirley & Associates LLC – Alpharetta, GA]

Dear ME-P Readers,

The ACA (Affordable Care Act) requires employers to provide their workers with a notice about the state health insurance exchanges.

Today October 1st is the deadline for providing these notices.

These exchanges will sell insurance to individuals who don’t get coverage through their employers. The exchanges are also available to medical practices and small businesses, which may or may not currently offer heath care coverage.

The Fines?

Some doctors or business owners are concerned about paying a fine of up to $100 per day under the general non-compliance penalty provisions.

The recent notice of the Affordable Health Care Act states that there will be no penalty.  Please refer to http://www.dol.gov/ebsa/faqs/faq-noticeofcoverageoptions.html

If your medical practice, clinic or company is covered by the Fair Labor Standards Act (you have one or more employees, sales of over $500,000, and deal in interstate commerce), you must provide a written notice to your employees about the Health Insurance Marketplace by Oct 1, 2013.

Model Notices

The U.S. Department of Labor has two model notices to help employers comply. There is one model for employers who do not offer a health plan and another model for employers who offer a health plan or some or all employees.

More:

The model notices are also available in Spanish and MS Word format at http://www.dol.gov/ebsa/healthreform/

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Health-Information-Exchange

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Assessment

Employers may use one of these models, as applicable, or a modified version. More compliance assistance information is available in a Technical Release issued by the US Department of Labor.

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21 Responses

  1. More on HIEs

    State Insurance Exchange Blind Spots

    http://thehealthcareblog.com/blog/2013/09/23/state-insurance-exchange-blind-spots-unknown-risks-and-unintended-consequences/

    Unknown Risks and Unintended Consequences

    Thanks Bob.

    Dr. Bitterman

    Like

  2. CMS Releases Final Rule on Health Exchanges

    On August 28, 2013, the Centers for Medicare and Medicaid Services and the U.S. Department of Health and Human Services updated policies regarding the Health Insurance Marketplaces or Affordable Insurance Exchanges (Exchanges), from the proposed rules published on January 22, 2013 and June 19, 2013.

    This final rule updates provisions from the Patient Protection and Affordable Care Act (ACA) and proposed rule regarding various standards affecting the Exchanges and the state Small Business Health Options Program (SHOP).

    Click to access EXCHANGES.pdf

    The release of the final regulations is timely, preceding the implementation of the Exchanges slated for October 1, 2013 … that’s today!

    Robert James Cimasi MHA AVA CMP™
    http://www.HealthCapital.com
    via Ann Miller RN MHA

    Like

  3. 10 Ways to Get Ready for The Health Insurance Marketplace

    1. Find the Marketplace in your state and get your options & info.

    2. Sign up for email or text updates about the Marketplace and connect with us on social media.

    3. Gather basic information about your household income to see if you qualify for lower costs on Marketplace coverage. Use this checklist to get started.

    4. Set your budget and estimate your costs and savings in the Marketplace.

    5. Make sure you understand how coverage works, including things like premiums, deductibles, out-of-pocket maximums, copayments, and coinsurance.

    6. Learn about the different types of health coverage.

    7. Explore your current options. You may be able to get coverage that starts before January 1, 2014 through existing programs.

    8. Ask your employer if it plans to offer health insurance in 2014. If you don’t have coverage, you may have to pay a fee.

    9. Learn how to get help with your Marketplace application. Visit LocalHelp.HealthCare.gov to find help in your area.

    10. Get help with a Marketplace question. You can call 1-800-318-2596 24 hours a day, 7 days a week. TTY users should call 1-855-889-4325 Online chat is also available 24/7.

    Source: HealthCare.gov

    Like

  4. Obamacare Website Gets Too Many Visitors – Crashes

    Millions of Americans visited new online health insurance exchanges as enrollment opened on Tuesday, suggesting a broad national appetite for the affordable coverage that President Obama has promised with his health care law.

    But, many people quickly encountered technological problems that prevented them from getting rates, comparing health plans or signing up.

    Barbara

    Like

  5. Health Care Sign-Ups
    [This Is What Transparency Looks Like]

    How many people have enrolled in health plans using the new federal exchange?

    http://www.propublica.org/article/health-care-sign-ups-this-is-what-transparency-looks-like

    Er-Ah, according to this article, nobody seems to have a clue.

    Cooper

    Like

  6. Enrollment Numbers at State Exchanges That Have Released Them

    1. New York – 40,000
    2. Washington – 24,949
    3. Maryland – 16,712
    4. California – 16,300
    5. Kentucky – 10,990

    Source: The Atlantic

    Like

  7. Healthcare.gov’s Users Speak Out

    Health and Human Services asked for comments about its website. It got them by the hundreds.

    http://www.propublica.org/article/healthcare.govs-users-speak-out-clean-this-mess-up

    Consumers and insurance agents say they were stymied, and one applicant said he and his wife were wrongly listed as incarcerated – then denied.

    So, ‘Clean This Mess Up’ already.

    Donna

    Like

  8. Round One of the Obamacare Exchange Hearings

    http://thehealthcareblog.com/blog/2013/10/24/great-quotes-from-round-one-of-the-obamacare-exchange-hearings-angry-republicans-6-contractors-0/

    Angry Republicans 6 – Contractors 0; in this essay by Charles Ornstein.

    Ann Miller RN MHA

    Like

  9. Extension Confirmation

    The Obama administration just granted a six-week extension until March 31st, 2014 for Americans to sign up for coverage next year and avoid new tax penalties under the president’s health care overhaul law.

    Hedrick

    Like

  10. White House knew millions could not keep their health insurance

    The president told Americans they’d be able to keep their plans under the Affordable Care Act.

    http://investigations.nbcnews.com/_news/2013/10/29/21222195-obama-administration-knew-millions-could-not-keep-their-health-insurance?lite

    But, millions are getting cancellation letters & it’s not a surprise.

    Charles

    Like

  11. HealthCare.gov

    The government as brought in Jeff Zients [Advisory Board Company] who promised front and back-end website functionality by November 30th.

    Moreover, the administration has extended the deadline for enrollment without penalty by six weeks, from February 15th to March 31st.

    Any thoughts?

    Hope Rachel Hetico RN MHA CMP™
    http://www.CertifiedMedicalPlanner.org

    Like

  12. HIE Georgia

    The system is down at the moment.

    We are experiencing technical difficulties and hope to have them resolved soon. Please try again later.

    In a hurry? You might be able to apply faster at our Marketplace call center. Call 1-800-318-2596 to talk with one of our trained representatives about applying over the phone.

    Dr. David Edward Marcinko MBA
    [Georgia]

    Like

  13. My rate increase

    I just received notice that my health insurance premium increased 13%.

    Darrell
    [Texas]

    Like

  14. Increasing Challenges for Health Exchange Enrollment

    As of third quarter 2013, a Gallup poll estimated that 18% of Americans were uninsured, most in the under-26 year old age bracket. The goal of the Obama administration is to provide coverage to at least 7 million beneficiaries during the initial enrollment period.

    Click to access EXCHANGES.pdf

    However, when the State and Federal Health Exchanges opened for enrollment on October 1st, 2013, the federal healthcare.gov site and several state enrollment sites were plagued by technical bugs and difficulties due to the high volume of visitors.

    Robert James Cimasi MSHA AVA CMP™

    Like

  15. How Low Will Health Care Enrollments Be?
    [Here’s What to Watch For]

    Just a fraction of the 500,000 people expected to enroll in Obamacare via the new health exchanges have done so, according to media reports anticipating the official numbers.

    http://www.propublica.org/article/how-low-will-health-care-enrollments-be-heres-what-to-watch-for?utm_source=et&utm_medium=email&utm_campaign=dailynewsletter

    But, there’s more to the story.

    Greta

    Like

  16. From Uwe – On Healthcare Price Transparency

    [T]he often advanced idea that American patients should have:

    “more skin in the game” through higher cost sharing, inducing them to shop around for cost-effective health care, so far has been about as sensible as blindfolding shoppers entering a department store in the hope that inside they can and will then shop smartly for the merchandise they seek. So far the application of this idea in practice has been as silly as it has been cruel. […]

    In their almost united opposition to government, US physicians and health care organizations have always paid lip service to the virtue of market, possibly without fully understanding what market actually means outside a safe fortress that keeps prices and quality of services opaque from potential buyers. Reference pricing for health care coupled with full transparency of those prices is one manifestation of raw market forces at work.”

    http://jama.jamanetwork.com/article.aspx?articleid=1769895

    -Uwe Reinhardt PhD
    [JAMA]
    via Hope R. Hetico RN MHA

    Like

  17. UnitedHealth Drops Thousands of Docs

    UnitedHealth Group, the nation’s largest provider of privately managed Medicare Advantage plans, has dropped thousands of doctors from its networks in recent weeks-spurring protest from lawmakers and physician groups and leaving many elderly patients unsure about whether they need to switch plans to keep seeing their doctors.

    http://online.wsj.com/news/articles/SB10001424052702303559504579200190614501838?utm_source=11.18.13&utm_campaign=11713&utm_medium=email

    Hope R. Hetico RN MHA

    Like

  18. A Cheat Sheet For The Obamacare Hearings

    For well over a month – 10 hearings have plumbed the problems with HealthCare.gov.

    http://www.propublica.org/article/a-cheat-sheet-for-the-obamacare-hearings?utm_source=et&utm_medium=email&utm_campaign=dailynewsletter

    Any thoughts?

    Dr. Armstrong

    Like

  19. Feds delay small biz access to HealthCare.gov

    Well, there’s another delay for people wanting to use the federal government’s troubled health insurance website. This time, small businesses will have to wait a year to use HealthCare.gov.

    Why? The Small Business Health Options Program (SHOP) won’t be available for a full year, according to the Centers for Medicare and Medicaid Services [CMS] which runs the online exchange and just announced to little fanfare.

    Tony

    Like

  20. The Two Million Scenario:

    What if the Affordable Care Act enrolls a lot fewer people in the Exchanges than predicted?

    http://thehealthcareblog.com/blog/2013/11/30/the-two-million-scenario-what-if-the-affordable-care-act-enrolls-a-lot-fewer-people-in-the-exchanges-than-predicted/

    An interesting essay by Seth Chandler.

    Dr. Peabody

    Like

  21. What is Exchange or Marketplace Notice?
    [Axiom Benefit Consultants via YouTube]

    Did you know that every Business Owner is REQUIRED to distribute notices to all employees about the new health insurance marketplace.

    http://www.healthsharetv.com/content/what-exchange-or-marketplace-notice

    Learn what is it, where to get the forms and how to distribute them here!

    Ann Miller RN MHA

    Like

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