Upcoming Reinsurance Assessment Fee Webinars

The Centers for Medicare and Medicaid Services will host three free webinars in September explaining how to complete and submit the 2015 ACA Transitional Reinsurance Program Annual Enrollment and Contributions Submission Form and providing information about how to pay the fee. The form is expected to be made available at pay.gov/public/home on Oct. 1, 2015.

Staff who are completing the form for employers with self-insured group plans may want to consider attending one of the training sessions.

The free webinars are scheduled for:

  • Sept. 23, 2015 from 1pm to 2:30pm Eastern
  • Sept. 28, 2015 from 1pm to 2:30pm Eastern
  • Sept. 30, 2015 from 1pm to 2:30pm Eastern

Log on to www.REGTAP.info for registration and additional information on the webinars.

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Filed under Healthcare reform

MLR Rebate Checks Being Mailed to Employers

In accordance with the Patient Protection and Affordable Care Act (PPACA) regulations, the week of September 7, 2015, Trustmark will mail Medical Loss Ratio (MLR) rebate checks with letters to eligible groups as shown below. The size of the group is based on eligible employees.

Small group (based on state definitions, but generally groups with 50 or fewer employees): AR, AZ, GA, IL, IN, KS, MO, MT, NE, NV, OH, TN, TX, UT, VA, WV, WY

Large group (based on state definitions, but generally groups with 51+ employees): AZ, IL, IN, MO, TX, WY

Sample cover letter

Sample letter

Regulations under the Patient Protection and Affordable Care Act require health insurers to spend at least 80 percent of their premiums on medical expenses for small groups, and at least 85 percent for large groups, or rebate the difference to customers.  A lower Medical Loss Ratio (MLR) percentage means a higher potential rebate to the employer. This requirement does not apply to self-funded plans.

Click here to view the MLR rebates Q&A.

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Filed under Medical Loss Ratio

New FAQ Available to Help Answer 6055 and 6056 Questions

A new frequently asked questions document about 6055 and 6056 reporting requirements is available for brokers in the Healthcare Reform toolkit. The flyer answers some of the most common questions about the Affordable Care Act, the reporting process, and how Starmark is helping. It also includes additional resources for more information.

And don’t forget, the 6055 and 6056 presentations are available in the videos section of the toolkit for more in-depth information.

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Filed under 6055/6056 Reporting, FAQs

New Presentations Available about 6055 and 6056 Reporting Requirements

Two new presentations are available in the Healthcare Reform toolkit to help explain the 6055 and 6056 reporting requirements. The presentations explain the requirements, who must comply, details of what the reports must contain, reporting deadlines, and more.

View the 6055 Reporting presentation here.

View the 6056 Reporting presentation here.

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Same-Sex Marriage Ruling

Prior to the June 26, 2015, Supreme Court ruling legalizing same-sex marriage, Starmark processed same-sex marriage as a qualifying event in states which recognized same-sex marriage. In light of the recent ruling, Starmark will continue to process special enrollees in all states.

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Filed under Enrollment, Healthcare reform

Letters Being Sent to Employers Regarding Social Security Numbers

Starting this week, letters will be mailed to Starmark® employers with a self-funded plan design providing information on the status of dependent social security numbers (SSNs). This will help with their 2016 ACA 6055/6056 filing requirements by letting them know if we are missing SSNs for any covered dependents. The broker of record will receive a copy of their group(s) letter.

If the employer has any covered dependents in 2015 with missing SSNs, or adds a dependent later with a missing SSN, they can log in to the Starmark website and update the information under Manage My Group > Dependent SSN Update. The initiative by the employer to obtain and update all missing information will help to ensure that the January 2016 report available in the Document Center will be as complete as possible.

It is the employers’ responsibility to collect the pertinent information and file the appropriate documents with the IRS for all employees. Employers should consult a professional benefit adviser or legal counsel regarding how the law may impact their business and specific self-funded benefit plan.

View the letters below:
Social security numbers missing
Add-on information

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Filed under 6055/6056 Reporting, Healthcare reform

Supreme Court Rules on Federal Tax Subsidies

In a widely anticipated ruling, the U.S. Supreme Court issued a decision upholding the payment of subsidies to consumers who obtain health insurance coverage through the federal marketplace or exchange..

On June 25, 2015, the Court ruled that federal tax subsidies should be provided to millions of lower- and middle-income Americans who purchased individual health insurance in approximately three dozen states through the federal marketplace or exchange..

The Obama administration had contended that the Patient Protection and Affordable Care Act (PPACA) extends the subsidies to Americans who purchase health insurance through the federal marketplace and through exchanges established by states. However, challengers maintained the law limits the subsidies to individuals who purchased health insurance only through a state exchange.

The Court’s Opinion is available at: http://www.supremecourt.gov/opinions/14pdf/14-114_qol1.pdf

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Filed under Exchanges, Healthcare reform