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News from Washington DC (copy 01)

Special Enrollment Period for Individual Market: 04/30/15 & Tax season important information!

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Special Enrollment Period for Individual Market: 04/30/15 & Tax season important information!

Blessings, I just returned from the yearly Health Underwriters Conference in Washington D.C. and I am bringing you the message of “Stand Up and Be Heard!”  As this was the agenda for this year’s health underwriting conference. From meeting with Kevin Counihan, CEO of the U.S. Department of Health and Human Services, Senator Tim Scott, representative Ami Bera M.D. and many others, we discussed the administration’s view on the future of the health insurance marketplace. The direction of Health Reform in the 114th Congress, and a House call – Bipartisan Health Reform possibilities. It is very clear that affordability is the key to our future health care costs as well as the key to the success of our healthcare reform.  It will be devastating for everyone if we are able to access coverage but unable to pay for this coverage.We really have to examine what is causing the cost of our health insurance to rise and the cost of medical care to skyrocket.  We should all get involved somehow in the lawmaking to improve access and lower the cost. The following are some suggestions: 

  • Review your personal behavior choices when we experience a medical situation. Research and get educated about the condition and make an educated decision of which route would be best for you.

  • Price transparency – check current, accurate and unbiased medical cost. You will be surprised to realize the difference in negotiation costs/fees for each facility within the same zip code.

  • Invest in your well-being, wellness, yoga and meditation for healing and feeling positive towards your emotional balance.

 As always, I send so much love and best wishes to you and your families,Naama ♥ 

Individual Market

 Special enrollment period was announced on February 23, 2015 through April 30, 2015 if you did not know or understand there would be a tax penalty for being uninsured in 2014 or learned you may face a penalty for 2015. You are eligible to apply for health coverage during this special enrollment period by attesting that you did not realize there was a tax penalty. 

Tax Season

 It’s tax season and now that the Affordable Care Act reporting requirements are taking effect, federal tax law requires everyone to prove they have health insurance, unless you’re eligible for an exemption.If you received a tax subsidy in 2014, then you must present your actual income for the year when you file your tax return. You should have received Form 1095-A by early February, which will outline the exact tax subsidy amount you received.  You will need this form to file your tax return properly. If you are covered under a private policy and everyone in your household had health insurance last year, there is very little that needs to be done. You will have to report the fact that you had minimal essential coverage as outlined by the Affordable Care Act on your tax forms. You simply need to check the appropriate box on Form 1040. No further action is required! 

Employer Compliance Corner

 Understanding Employer reporting requirements of the healthcare law is crucial. I have met with many of you during the year and again, despite the fact that each and every one of us have their personal tax adviser, we will need to provide the actual information.Reporting was voluntary for calendar year 2014. All applicable large employers are required to report health coverage information for the first time in early 2016 for calendar year 2015.To be prepared to report this information to the IRS and issue the new Form 1095-C to employees, you will need to:

  • Determine if your organization is an applicable large employer (2015 100+ equivalent full time. 2016 50+).

  • Determine the kinds of health insurance coverage you offered to full-time employees and their dependents, if any.

  • Identify who your full-time employees are for each month and track health coverage information in 2015 (started January 2015) to help complete IRS forms.

*** A full-time employee is an employee who is employed on average, per month, at least 30 hours of service per week (or at least 130 hours of service in a calendar month).*** A full-time equivalent employee is a combination of employees, each of whom individually is not a full-time employee (has fewer than 30 hours of service per week), but who, in combination, are equivalent to a full-time employee.*** An aggregated group is commonly owned or otherwise related or affiliated employers, which must combine their employees to determine their workforce size. -There are many additional rules on determining who is a full-time employee, including what counts as hours of service.For more information you can check out the employer shared responsibility final regulations and related questions and answers on www.IRS.gov-*Form 1094-C – Transmittal of Employer provided Health Insurance offer and coverage Returns.  

King v. Burwell

 This Supreme Court case is one of the most challenging and interesting cases of our time and may have a huge impact on our industry,  and marketplace. Hearing started today focuses on explaining the “stakes” regarding subsidies for, depending on the source, 7.5 million to 8.5 million people received. There is general agreement that the outcome of the case will depend on the votes of Chief Justice John Roberts and Justice Anthony Kennedy as the other justices are believed to line up in conservative and liberal blocs.USA today report “insurance coverage for millions of people is riding” on the result of the Supreme Court hearing. Chief Justice John Roberts is described as being the “pivotal vote.” The case turns on “four words – established by the state” in an argument that residents of the states that “opted against creating their own health insurance marketplaces,” should not receive subsidies to help them pay for insurance acquired through the Federal exchange healthcare.gov. Should the Court side with the plaintiffs, “more than 8.5 million people of the 11.4 million people” who have acquired insurance under the law could be affected.For more information: www.politico.com  Be the light, you are the light, thank you for allowing us to be of service to you,In light,Naama & the A+ team ♥

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