On October 12th, President Trump signed a health care executive order that requests his administration to develop policies to increase health care industry competition and consumer choice while improving quality and lowering prices. However, it could also shatter The Affordable Care Act (Obamacare) by providing a means for younger, healthier individuals to opt out from the exchanges.
The President is asking the Department of Labor to find ways to make it easier for small businesses and perhaps individuals to form nationwide associations to buy health insurance.
Trump’s Health Care Executive Order potentially could:
- allow employers in the same industry to offer group coverage across state lines.
- provide a much a wider range of policies.
- lower costs to consumers (employers and employees).
- offer consumers the ability to purchase short-term policies that do not need to comply with pre-existing condition protection.
- broaden health reimbursement arrangements (aka HRA’s) allowing employers. to give workers money to buy their own coverage.
- free the association health plans from several Obamacare regulations so that they can operate more like large corporations. These could include:
- requirement to provide comprehensive policies that cover prescription drugs, mental health and substance abuse
- deny coverage to the group
- set rates based on the medical history of those in the group
- exclude employees or develop premiums based on health conditions
- expand the use of short-term insurance plans
- exclude those with pre-existing conditions
- base rates on consumers’ health background
- offer plans with lower premiums with less benefits.
- offer less comprehensive coverage
- create plans that reduce and/or eliminate state oversight.
- pull younger and healthier customers away from Obamacare.
- increase premiums for sicker people left in the exchanges.
May take 6 months or more to implement Trump’s health care Executive Order
The order could leverage the buying power of millions of Americans to form big health care pools. However, there are many who feel it is not going to solve the problem as it only effects a tiny number of people and will not do anything for workers that are currently part of the exchanges and are not members of a franchise or trade association.
It is not known how the agencies within the Trump administration will change the current regulations at this time. Health care plans sponsored by trade organizations already exist. We will continue to watch as this new executive order begins to take shape and let you know what you need to know to keep competitive and stay ahead of the regulations. Please contact us with any questions or concerns you may have.
Our Proprietary Programs have been helping Employers achieve what Trump is proposing. HRB Solutions Inc. has been helping employers participate in large pools with economies of scale discounts for over 5 years!
Here are a few other resources that will help you understand more about this news of the day.
Wall Street Journal
Every year, employers must provide their Medicare-eligible employees covered under their group health plan a written notice regarding Medicare Part D.
This notice must be received by the employee by October 14th
This notice must contain details about coverage status of the prescription drug benefit. The notice must inform the employee if the prescription drug benefit on their group healthcare plan is as good as the standard Medicare Part D Plan.
There are two types of Medicare Part D notices that need to be sent by October 14th:
- A creditable coverage notice should be provided when the drug benefit is at least as good as the standard Medicare Part D plan.
- A non-creditable coverage notice should be provided when the drug benefit isn’t as good as the standard Part D plan.
Other times when the Medicare Part D notice needs to be sent:
- When creditable coverage status changes
- When a Medicare-eligible employee first joins the plan.
Who should receive the Medicare Part D notice:
- Any covered dependents who are eligible for Medicare,
- Employees who become eligible for Medicare due to a disability.
- COBRA beneficiaries
- Covered retirees who are eligible for Medicare
As a best practice, employers may want to provide this notice to everyone covered under their group health plan.
Please note, anyone who is eligible for Medicare but is late to enroll is subject to a late enrollment penalty unless they have suitable coverage elsewhere. This penalty is calculated at 1% of the base beneficiary premium for every month the person is without creditable coverage.
In August, 217 the Centers for Medicare and Medicaid Services (CMS) announced the average basic premium for Medicare Part D prescription drug plan was projected to decline $1.20 from the 2017 rates to a new level of $33.50. Open enrollment for Medicare begins on October 15th and ends on December 7th.
Sample notices can be found on the CMS website or contact us to discuss what documents are needed for your organization and to see if we can save you some money.
Senators Lindsey Graham (R-SC) and Bill Cassidy (R-LA) have been spearheading efforts (aka Graham-Cassidy Bill) to repeal and replace substantial parts of the Affordable Care Act (ACA). While there are many changes that the so-called “Graham-Cassidy” bill would make to the ACA, there are really three main themes that stand out:
1. Block Grants to States: The bill would end funding for Exchange subsidies and Medicaid expansion as it exists under the ACA today. Instead, states would be provided block grants from the federal government, and states would decide how those funds are used. States could opt out of certain ACA provisions, such as those that apply to pre-existing conditions and essential health benefits, but only if there was a program in place to provide adequate and affordable coverage to lower income and/or high-risk individuals.
2. The End of Mandates: The bill would make penalties under the Individual and Employer Mandates $0 retroactively to 2016. Although this is not a direct repeal of the mandates, it essentially has the same effect as a repeal.
3. Enhancements to HSAs: Contribution limits for Health Savings Accounts (HSAs) would increase and would be equal to the maximum out-of-pocket limit for an HSA-eligible health plan ($6,650/single, $13,300/family in 2018). Several other HSA enhancements were also included in the bill.
The Senate had planned to vote on the Graham-Cassidy bill this week, but that’s not going to happen anymore. This is a bill that was only going to pass if all Senate Republicans but two voted in support of it, and as of Tuesday, at least three opposed the bill. Senators John McCain (R-AZ), Rand Paul (R-KY) and Susan Collins (R-ME) all publicly indicated their opposition to the bill. This essentially puts Republican efforts to repeal and replace the ACA in a standstill.
For more information, please check out these links from these great sources or contact us to discuss the details:
The article by Katie Kuehner-Herbert linked below highlights several elements from the Large Employers’ 2018 Health Care Strategy and Plan Design Survey.
The health care industry is rapidly changing. Daily we hear of something new. We see changes in Washington, at the State levels and even some changes locally. The costs of supplying health care to employees for the average business is growing well beyond the rest of the business. To help combat this trend, we are starting to see businesses leverage new means for controlling costs and steer away from the traditional ways of the past. It is a fine line to walk down. As a business, cost containment is paramount. With employee acquisition and retention, having a quality health care plan in place is crucial. We need to find a way to keep costs and care in balance so that neither have a negative impact on the business.
Key Highlights from the 2018 Heath Care Strategy Survey include:
- Implementation of consumer-directed health plans.
- Exploring new ways to guide employees through the systems.
- Offering consumer-directed health plans.
- Raising awareness and management of pharmaceutical costs.
- Engaging telehealth services when state law allows.
- Promoting accountable care organizations.
- Supporting on/near site health centers.
- Utilizing centers of excellence for certain procedures.
This is a focused article that gets to the heart of what many businesses need to consider as we move together towards a very uncertain and potentially very costly future. For more ways to control rising health care costs, please contact us.
Welcome to HRB Solutions INC. blog. This is the first in what we hope will be one of the key platforms we engage to inform our customers and those interested in Health Care about what is happening in the Health Care insurance industry. The health care environment is sometimes very difficult to navigate. Through our brand-new website, our LinkedIn page, our Blog and other social media venues we hope to help you gain a better understanding of the insurance industry and how it impacts your role as an employer or employee.
Please check out our website in more detail. We have outlined the services that we provide, the mainstream insurance packages we can assemble for your business and our amazing proprietary offerings. What we hope that you will quickly see is that we will stand with you and help put in programs that will help set your organization apart from your competition, raise the benefits for your employees and keep your costs down. Please check out our LinkedIn page and our other social media accounts. We will engage these resources to help you stay better informed on your terms and where you spend your time. We will only post when we have something to say that we feel will directly help raise your level of understanding or be of benefit to your business or your employees.
Welcome to the NEW! HRBSolutions blog and welcome to your home for increased understanding, lower costs and better health care coverage from here forward. Thanks for taking the time to check in and we do hope you come back.
As always, contact us if you have a question, want a quote or have a specific topic you would like us to discuss. We are in this together.
There is a lot of discussion out there right now about the Affordable Care Act and the current US Congress activity to repeal and replace the existing ACA. As of this writing the ACA is still in effect and needs to be addressed and fully implemented within your organizations. The US House of Representatives has passed an update to the bill and several Executive Orders have been made to pave the way for changes or full re-write of the law but the existing law is in place until the Senate passes their version and the two houses of cCongress come together and the President signs the bill into law. You may recall this process from High School Civics or maybe School House Rock.
We wanted to provide you with a few links that may help you better understand the Law better and to keep up with the changing environment. We have also compiled a chart to summarize what is needed and offer that at the end of the list. Please check out our resources page for more details