Author Archives: Reeve Conover

2016 COLA for Retirement Plans Released

Elective Deferral Limit 402(g)(1)

$ 18,000.00
Catch-Up Limits for 401(k) Plans (Age 50+)

$ 6,000.00
Defined Contribution Dollar Limit 415(c)(1)(A)*

$ 53,000.00
Maximum Compensation Limit 401(a)(17)

$ 265,000.00
Highly Compensated Employee Definition 414(q)(1)(B)**

$ 120,000.00
2016 Social Security Taxable Wage Base

 $ 118,500.00

PACE Act changes small group definition back to 50 or less, except in NY

While almost every state in the country has opted to continue with the current rules – small group is 2-50 employees – New York’s Governor still refused to sign off on legislation.  This means that – for the employer with 51-99 employees, you will be considered a large group at renewal time.  This could work in your favor, or be to your detriment, depending on alot of factors.  Group census, claims experience, and current rates all will play into decisions this coming year.

Medicare Premiums to rise, but no cost of living increase this year!

New Medicare Beneficiaries, and high earners, are going to get hit with substantially higher premiums.  Those currently on Medicare that are not high-earners will continue to pay $104.90 this coming year.  New Medicare Beneficiaries will pay $159 in 2016.

From the Wall Street Journal

“The rise in premiums seems increasingly likely because the Social Security Administration is expected to announce Thursday that low inflation means Social Security beneficiaries won’t get a cost-of-living increase for 2016.

About 3.1 million more participants would be subject to the rise because of their incomes. The Medicare trustees projected that single individuals earning between $85,001 and $107,000—and couples earning $170,001 to $214,000—would see monthly premiums rise from $146.90 a person this year to $223 in 2016.”

For the full article, click here.

From the New York Times:

“A quirk in the laws governing Medicare and Social Security will expose millions of Americans to a staggering 50 percent increase in their premiums for the part of Medicare that covers doctors’ bills, known as Medicare Part B. It is imperative that Congress pass legislation to protect low- and middle-income people who cannot pay that much.

The problem is that Social Security recipients will not get a cost-of-living increase in 2016, but Part B premiums are projected to rise. The roughly 70 percent of beneficiaries who are “held harmless” will pay the same premium as last year. That means the increased cost will have to be made up by the other 30 percent, because of the rule that premiums must cover one-quarter of Part B costs. This group includes 2.8 million new enrollees, 1.6 million people who don’t collect Social Security benefits and 3.1 million higher-income beneficiaries.”

For the full article, click here

 

More CO-OPs continue to fail across the country

With the collapse of Oregon and Colorado’s CO-OPs,  a third of all the ObamaCare-created plans have gone under.  This represents just shy of a Billion dollars in taxpayer money lost.  ObamaCare legislation was supposed to provide $3 billion in funding to the CO-OP’s – but can only pay 12.5% of that.  The question, “HOw are we going to pay for this law” contiues to rear its ugly head.  With the total for subsidies not yet released, I fear much bigger problems to come.

EMBLEMHEALTH ADDS STONY BROOK UNIVERSITY HOSPITAL TO ITS SELECT CARE PROVIDER NETWORK

New York, NY – EmblemHealth and Stony Brook University Hospital, Suffolk County’s only academic medical center, announced today that they have entered into an agreement, effective November 1, 2015, for Stony Brook University Hospital to provide covered medical services to Suffolk County members in EmblemHealth’s Select Care plans that service individuals and small groups both on and off the NY State of Health Marketplace.

 

In addition to the Hospital, this contract also includes University Physicians at Stony Brook – over 800 physicians and other health care providers offering a comprehensive range of high-quality medical services, from primary care to advanced subspecialty care.

 

EmblemHealth’s tailored Select Care network is a subset of EmblemHealth’s existing HMO network of physicians, hospitals, community health centers and ancillary services. The primary and specialty care providers in the Select Care network are carefully chosen based on quality, effectiveness and cost in order to keep members in better health at prices they can afford.

 

“EmblemHealth believes in providing members with quality hospitals and physicians to meet their health care needs,” said Carl Lund, Vice President, Facility Contracting, EmblemHealth.  “Since entering the NY State of Health Marketplace, our primary goal has been to provide the correct mix of physicians and hospitals to meet the needs of our increasingly diverse membership. This contract represents a large expansion of EmblemHealth’s Select Care network in Suffolk County. With the addition of Stony Brook University Hospital and University Physicians at Stony Brook, we have strengthened our provider network by offering EmblemHealth members greater choice and access to quality health care.”

 

“We are pleased to have been able to amend our existing agreement with EmblemHealth, which will allow thousands of Long Islanders who are enrolled in its Select Care network to access Stony Brook University Hospital and its physicians on an in-network basis,” said L. Reuven Pasternak, MD, Chief Executive Officer, Stony Brook University Hospital, and Vice President for Health Systems, Stony Brook Medicine. “It supports New York State’s mission to offer affordable care to our patients in a manner that is consistent with Stony Brook’s core mission as the safety net provider for the area and source of specialized and unique care for populations at risk.”

 

About EmblemHealth
EmblemHealth, Inc., through its companies Group Health Incorporated (GHI) and HIP Health Plan of New York (HIP), provides quality health care coverage and administrative services to approximately 3.1 million people. Groups and individuals can choose from a variety of PPO, EPO and HMO plans, as well as coverage for prescription drugs and dental and vision care. EmblemHealth offers a choice of networks, including quality doctors and other health care professionals throughout the region, leading acute care hospitals across the tristate area, and physicians and hospitals across all 50 states. For more information, visit www.emblemhealth.com.

Reeve Conover is a Registered Representative. Securities offered through Cambridge Investment Research, Inc., a Broker/dealer member FINRA/SPIC. Cambridge and Conover Consulting are not affiliated. Licensed in SC, NC, NY, CT, NJ, and CA.
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