The employment-based health benefits system is the most common type of coverage in the U.S., and is also at the center of one the most hotly debated issues in American politics. Whether you support Medicare for all, single-payer or some other plan, the fact is you’re most likely to be affected by changes in regulation that impact employment-based coverage.
In an example of what NOT to do to as a tactic to manage group health costs, Dave & Busters was recently ordered to pay $7.4 million to workers in the proposed settlement of a class action lawsuit alleging the company reduced employees’ hours to render them ineligible for company health coverage.
As we kick off 2019, it probably comes as no surprise that the debate over healthcare continues to rage on, but there have been recent developments that might affect both individual and employer-sponsored health coverage in the coming year.
Under New York law and the Patient Protection and Affordable Care Act (ACA), the definition of "small group," as it relates to health plan eligibility, was established to be 1-100 employees, as of January 1, 2016.
How Does it Work? Self-insured may sound like a contradiction in terms—after all, isn’t the point of insurance to have the financial backing of a major carrier to cover medical expenses? But in reality, self-insured plans can provide all the protection of a fully insured plan while delivering cost efficiencies to employers that those plans cannot.
Last summer, several versions of a healthcare bill were attempted in Congress, but none were successful and the debate still carries on. Regardless of your political affiliation, healthcare is a hot button issue for every American and the policy outlook remains complex.
How Self-Insured Health Plans Can Help You Avoid State Mandate Penalties New Jersey is the second state to re-impose an individual mandate following the Congressional repeal under the passage of the Tax Cuts and Jobs Act. The individual mandate has been a key pillar of the Affordable Care Act (ACA) since its inception. The mandate requires individuals to maintain health benefits that meet the definition of minimum essential coverage (MEC) or pay a tax penalty of either 2.5 percent of adjusted household income or $695 per adult and $347.50 per child under 18 (capped at $2,085), whichever is greater.