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Individual Mandate Deadline Extension – March 27, 2014

The Obama administration has announced an extension for those who have tried to apply for health insurance – as required by the Affordable Care Act’s individual mandate – but have been unable to do so because of technical difficulties with the federal health exchange website. Consumers who do not finish their application by Monday, March 31, will be able to request an extension.

New York State officials say the deadline to enroll in coverage through the state-based marketplace NY State of HealthTM remains March 31, but they are developing a process to help individuals who are locked out of the system because of technical difficulties.

New York State of Health intends to issue written guidance in the near future. CDPHP will bring you that information as soon as it becomes available. In the meantime, we continue to encourage those without coverage to complete their application by March 31, 2014.

The individual mandate requires most U.S. citizens to obtain health care coverage by March 31, 2014 or pay a penalty. If you miss this deadline and don’t meet the exception requirements, you will be required to pay a penalty.

In 2014, the penalty is $95 per adult and $47.50 per child (up to $285 for a family) or 1% of family income, whichever is greater. The penalty is scheduled to increase in future years. 


Administration Issues New ACA Guidelines – March 6, 2014

The Obama Administration has announced a change to the Affordable Care Act that gives a two-year reprieve for consumers whose health plans were slated to be cancelled in 2015. Under the new policy, some customers would be able to renew plans during the next two years that do not meet the law’s requirements.

While this change is optional for state exchanges, CDPHP is awaiting further guidance from New York state before determining the impact to our members. Please be aware that upon the initial delay announced by the federal government in November 2013, New York chose to require non-ACA compliant plans to be discontinued upon renewal. 


Individual Mandate Deadline Approaching – March 19, 2014

Time is running out to purchase coverage from a qualifying health plan or pay a penalty under a provision of the Affordable Care Act. The individual mandate requires most U.S. citizens to obtain health care coverage by March 31, 2014. If you miss this deadline and don’t meet the exception requirements, you will be required to pay a penalty.

In 2014, the penalty is $95 per adult and $47.50 per child (up to $285 for a family) or 1% of family income, whichever is greater. The penalty is scheduled to increase in future years.

If you do choose a plan between now and March 31, 2014, the effective date of coverage will be May 1, 2014.

Individuals who experience a life-changing event can enroll after March 31 upon submitting an application within 60 days of the event.


Administration Issues New ACA Guidelines – March 6, 2014

The Obama Administration has announced a change to the Affordable Care Act that gives a two-year reprieve for consumers whose health plans were slated to be cancelled in 2015. Under the new policy, some customers would be able to renew plans during the next two years that do not meet the law’s requirements.

While this change is optional for state exchanges, CDPHP is awaiting further guidance from New York state before determining the impact to our members. Please be aware that upon the initial delay announced by the federal government in November 2013, New York chose to require non-ACA compliant plans to be discontinued upon renewal. 


Employer Mandate Delayed Again – February 26, 2014

The Obama administration has announced another delay in a provision of the Affordable Care Act that requires business owners to provide health coverage to their employees or pay a penalty.

The Employer Shared Responsibility mandate, which was set to take effect in 2015, has been delayed for employers with 50 to 99 employees until 2016. These employers will, however, be required to report on how many workers are covered in 2015.

Employers with 100 or more workers will still be required to provide health insurance to their full-time employees in 2015. However, the new rules will only require them to cover 70 percent of workers in 2015, and 95 percent in 2016.

As before, companies with fewer than 50 employees will not be required to provide health coverage.


NY State of Health Marketplace Enrollment Deadline for Individuals and Families – February 26, 2014
The NY State of Health marketplace open enrollment period ends on March 31, 2014. To purchase coverage after this date, you must be eligible for a special enrollment period due to a qualifying life event, such as moving to a new state, certain changes in income, and changes in your family size (e.g., marriage, divorce, and birth or adoption of a child). 

If you don’t enroll in a health plan by the March 31 deadline, you may have to pay a penalty


Payment Deadline Approaching – January 6, 2014
If you signed up for individual coverage (on or off the NY State of Health marketplace), you have until Friday (1/10) to make a payment for coverage effective January 1. In the weeks leading up to the New Year, we saw several deadline extensions granted by the federal and state governments. One of those extensions gave consumers, who completed their application by December 24, until January 10 to make their first premium payment. If you signed up for coverage through CDPHP and want to check the status of your application/payment, please call (518) 641-3050 or 1-855-236-7113.


Small Business Marketplace Open Enrollment Extension – December 2, 2013
The open enrollment period for the Small Business Marketplace has been extended to Tuesday, December 3, 2013. The enrollment period was supposed to close on November 29. However, some small business employees encountered technical difficulties in selecting a plan. If you have any questions about your plan selection, please contact your broker or a CDPHP representative.


Federal Online Enrollment Delay for Small Businesses – November 27, 2013
On Wednesday, Nov. 27, 2013, the Obama Administration announced a one-year delay of online enrollment in the federal health insurance exchange for small businesses.

We are aware of this federal delay.

While we believe this is for the federal exchanges only, we will await further guidance from New York state as to any impact on the NY State of Health.

We will provide updates on this development as soon as they are available.



NY Announces Decision on Discontinuance Plans – November 21, 2013
President Barack Obama recently announced a plan to allow insurers to continue to offer health plans that are slated to be discontinued due to changes required by the Affordable Care Act. In his announcement, the president said it is up to the states to decide whether or not these plans would be allowed.

On Monday, Gov. Andrew Cuomo said New York will NOT offer the discontinued plans because the state’s marketplace has not experienced the same problems as the federal exchange. Because of that, Gov. Cuomo said he sees no reason for changing the current course.

As a result, CDPHP will continue to move forward with the discontinuance of plans that will not be ACA-compliant after Jan. 1, 2014. Rest assured, CDPHP has an array of plans to meet your needs, and we will work with you to help you find the best fit and make the transition as easy as possible.


ACA Announcement: New "Transitional Policy" for Discontinued Plans – November 15, 2013
Yesterday, President Obama announced a “transitional policy” regarding discontinued policies due to the Affordable Care Act. Additionally, CMS has issued a letter to state Insurance Commissioners outlining the new policy and encouraging them to adopt the same transitional policy.  We are awaiting guidance and direction from the New York State Department of Financial Services on this issue and will provide you with our plan and process as soon as possible.


Individual Mandate Penalty Deadline Extended – November 8, 2013
The U.S. Department of Health and Human Services (HHS) is extending the deadline for the individual shared responsibility payment, or Individual Mandate, for those who sign up for health insurance coverage through the marketplace by the open enrollment deadline of March 31, 2014. This delay is being implemented due to the lag time in processing applications.

HHS has determined it is unfair to require individuals to pay the penalty even though they have signed up for coverage within the appropriate timeframe.

The Shared Responsibility Provision Question and Answer memo provides a detailed explanation.



Broker Certification Process - September 12, 2013

NY State of Health has released a three step process for brokers and agents who plan to sell, solicit, or negotiate health insurance in the Marketplace. The information, which includes details on the certification and registration process, can be found on the NY State of Health website.


New Name of New York Health Benefit Exchange – August 20, 2013
The New York Health Benefit Exchange has a new name! State officials held a webinar today to announce that the marketplace will officially be called ‘NY State of Health’

NY State of Health executive director, Donna Frescatore, was joined by a representative from DDB New York, the advertising agency that has been hired to promote the Marketplace. The pair introduced a TV ad which will begin airing soon across the state. You can watch the video here.

The state also rolled out a new logo and website for NY State of Health, and announced the site will include a new tax credit calculator, where people can determine their eligibility for subsidies on the exchange. For more information, visit the NY State of Health website


Marketplace Rates Released – July 17, 2013
The New York State Department of Financial Services today released rates for health care coverage both on and off the NY State of Health marketplace.

Chief Strategy Officer, Bob Hinckley, explains on the CDPHP Health Care Reform blog.


Assuring Your Premiums Go For Care  – July 8, 2013
CDPHP has once again exceeded the state and federal requirements for Medical Loss Ratio, or MLR. This means that more of your premium dollars are going toward paying medical claims and improving the quality of care you receive. For more about MLR, visit our Frequently Asked Questions.


Obama Administration Delays Large Employer Mandate  – July 2, 2013
The Obama Administration announced a delay in the implementation of the mandatory employer and insurer reporting requirements under the Affordable Care Act (ACA) until 2015, according to the U.S. Department of Treasury statement.

The mandate requires businesses with 50 or more employees to offer affordable coverage to their workers or pay a penalty. The mandate was to take effect by 2014. This decision to delay the mandate was based on feedback the Administration received from businesses across the country, according to the Treasury. While this decision affects the “pay or play” reporting and penalties, our current interpretation indicates that this does not impact large group product changes that were required as part of the ACA.

The Administration expects to provide formal guidance within the next week to assist employers with the transition, with proposed rules on the mandate to be published this summer. When the rules are issued, the Administration plans to work with employers, insurers, and other reporting entities to encourage them to voluntarily implement the reporting in 2014 in preparation for the provisions in 2015.

There are still issues that the Treasury will need to clarify. CDPHP will keep you updated on the latest developments in health care reform, including changes to the employer mandate as they are announced. We will share the guidance and other information as soon as we get it.




Health Insurance at a Crossroads: Helping You Prepare for Health Care Reform  – June 26, 2013
In case you missed the recent CDPHP health care reform employer webinar, Health Insurance at a Crossroads: Helping You Prepare for Health Care Reform, we’d like to share it with you.
View the recorded webinar
.


U.S. Department of Labor issues guidance on Notice to Employees of Coverage Options under Fair Labor Standards Act – May 8, 2013
The Affordable Care Act added a requirement to the Fair Labor Standards Act stating that employers must notify employees of coverage options available through the Exchange. The U.S. Department of Labor (DOL) recently made model notices available to distribute to employees. Employers must issue this notice to current employees by October 1, 2013 and to new employees within 14 days of their start date. CDPHP will send a reminder about this notice to employers in August. More information about the regulation, as well as the model notices, is available on the DOL website


CDPHP® Files For New York Health Benefit Exchange – April 15, 2013
Continuing our commitment to provide greater access to affordable health care, CDPHP® today submitted its application for participation in the New York Health Benefit Exchange. 


Feds Announce Exchange Notification Postponement – January 29, 2013
On Jan. 24, 2013, federal regulators postponed the “notice of exchange” requirement for employers indefinitely. The law, which is part of The Affordable Care Act, originally required employers to give written notice to employees about the availability of public health insurance exchanges by March 1, 2013.

The Department of Labor (DOL) expects that the timing for distribution of notices will be the late summer or fall of 2013, which will coordinate with the open enrollment period for exchanges. The DOL is considering providing model, generic language that could be used to satisfy the notice requirement.

The Departments of Health and Human Services, Treasury and Labor jointly issued FAQ regarding the delay of this notification requirement.