Issue link: http://www.insightdigital.biz/i/201303
• aximum deductible: Individual M $2,000, family $4,000. • odified community rating M (rating classes limited to age, tobacco use, family size and geographic area) applies. • uaranteed issue applies. G • uaranteed renewal (with some G limitations) applies. Employers must also meet these ACA requirements for 2014: » PCORI (Patient-Centered Outcome Research Institute) fee: There was a July 31 deadline for reporting and payment of fees for plans that ended Oct. 1, 2012 to Dec. 31, 2012. Employers sponsoring certain group health plans must pay a fee of $1 per covered life per year. » MLR (medical loss ratio) rebates: Timely distribution of any MLR rebates the plan may receive. » Summary of Benefits & Coverage (SBC): Must be provided as part of open enrollment. » DOL notice distribution: Department of Labor notice regarding exchange should have been distributed by Oct. 1, 2013. » W-2 reporting: Must report health care costs on W-2 (with exemption for employers that issued fewer than 250 W-2s in the prior year or that contribute to a multiple employer plan continues for 2013 W-2). » Transitional reinsurance fee: Due in January 2015. Employers will not need to meet the following requirements until Jan. 1, 2015: » Offer minimum essential coverage to 95 percent of full-time employees. » Offer minimum value (60 percent) coverage to full-time employees. » Offer affordable (less than 9.5 percent of income) coverage to fulltime employees. » Consider employees who average 30 or more hours per week full-time for health plan purposes. » Count employee hours to w w w. i n s i g h t o n b u s i n e s s . c o m determine whether they average 30 or more hours work per week. Still confused? Wondering where to go from here? One recommendation is don't do this alone. Get some expert help, either from an attorney, consultant or your insurance broker. Understanding 20,000 pages of regulations – and how you need to comply with the law – is cause for anyone to be confused. Manage your confusion by relying on the experts. Mary Felton, founder and president of HR Business Partners, has more than 25 years of experience. She partners with companies of all sizes to help with their human resource needs, such as legal compliance, handbooks, recruiting and employee relations. Mary's previous experience included vice president of HR for TIDI Products and Miller Electric. Contact Mary Felton at mfelton@hrbusinesspartnersllc. com, (920) 419-2014, or visit www. hrbusinesspartnersllc.com. Health Insurance from Health Experts Coordinated care is your answer to reduced company health plan costs. Developed by Prevea Health right here in Wisconsin, Prevea360 Health Plan connects a strong network of providers, innovative hospitals, one medical record system and comprehensive insurance coverage to make the highest quality care highly affordable. Contact your agent, or call us at 877.230.7615 to get a custom quote. You'll see that you don't have to compromise on quality, access, or your budget to provide excellent health coverage to your team. prevea360.com Underwritten by Dean Health Plan, Inc. Corporate health & wellness at its best Check out prevea.com/gamechanger and see how our LeadWell Health & Wellness program is making a real difference in the lives, and workplaces, of six local people. N o v e m b e r 2 013 • Insight | 35