The Effect of the ACA on Self-Funded Plans & Free Market Medical Providers

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By Maria Robles Meyers, Esq.

[Free Market Medical Association]

Obama Care
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4 Responses

  1. CMS Mulling Rules To Prevent Providers from Steering Patients into ACA Plans

    A U.S. government health agency just said that it was considering new rules to prevent healthcare providers or related groups from steering patients into Obamacare individual insurance plans instead of Medicare or Medicaid in order to receive higher payments for medical services.

    The Centers for Medicare & Medicaid Services on Thursday said it is seeking public comment and considering rules including prohibiting or limiting premium payments or cost-sharing for the individual marketplace plans, monetary penalties and limits on such payments.

    Source: Caroline Humer, Reuters [8/18/16]


  2. UnitedHealth Group’s earnings swell as ACA offerings shrink

    The health insurer’s year-on-year revenue increased almost 12 percent to $46.3 billion as its Medicare, Medicaid, employer and consulting lines of business all posted robust growth in the third quarter. UnitedHealth executives raised net earnings for the year as they reduce the insurer’s offerings on the Affordable Care Act marketplaces (Modern Healthcare).



  3. 2017 Marketplace Enrollment May Reach 11.6 Million

    S&P Global Market Intelligence recently released a forecast of 2017 ACA marketplace enrollment. Here are some key findings from the report:

    • 2017 marketplace enrollment is projected to range between 10.2 and 11.6 million.
    • 85% of enrollees will be hedged against the full impact of premium increases.
    • 2.5 million may be eligible for a subsidy if they switch to the marketplace.
    • 9 million of the uninsured may be eligible for a tax subsidy.
    • 1.5 million or 15% of the marketplace enrollees didn’t receive a subsidy in 2016.
    • 15% of enrollees are projected to drop-off after open enrollment.

    Source: S&P Global Market Intelligence, October 13, 2016


  4. 7 Reasons Why Self-Funded Plans Are Gaining Popularity for Small Businesses

    1. Savings of up to 20 percent for some groups
    2. Opportunity for credit refund at end of plan year
    3. Predictable monthly payments
    4. A choice of plans
    5. Stop-loss reinsurance
    6. Professional service for claims and payments
    7. Broad provider network

    Source: Employee Benefit Research Institute


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