Category Archives: Health Care Reform

How do I stay on top of all of this?

This is a pretty common question – I probably get asked it a couple of times a month.  In addition to at least two hours of reading each week (minimum) and paying attention to current events, in 2016, I had more than 100 hours of formal training (online, webconference or in person) in these areas:  (8 hours)

Specific Carrier and Plan Training (25 hours)

Regulations and changes (24 hours)

Retirement Plans and Investments (24 hours)

General Knowledge (21 hours)

Employers That Hire Holiday Help: Understand the ACA Rules Around Seasonal Workers

holiday help seasonal workers

“If you have at least 50 full-time employees, including full-time equivalent employees, on average during the prior year, your organization is an ALE…. If your workforce exceeds 50 full-time employees for 120 days or fewer during a calendar year, and the employees in excess of 50 during that period were seasonal workers, your organization is not considered an ALE. For this purpose, a seasonal worker is an employee who performs labor or services on a seasonal basis.”
Internal Revenue Service [IRS]

Major Changes to NY Empire and Oxford plans for 2017

logos for blue cross and oxford

Empire Blue Cross Network Changes-

  1. EPO/PPO (i.e. “BlueCard”) –this is Empire’s best-in-class legacy BlueCard network
  2. Blue Priority – full BlueCard hospital network with a narrowed practitioner (doctor) network when in Empire’s 28-county service area. Plans are non-gated with National BlueCard access for folks living and traveling outside of NY.  Most of Northwell doctors now are non-participating in the Blue Priority Network.  Doctors were just notified in November. The change does not impact BlueCard and/or Pathway networks – Northwell doctors and hospitals still participate in both of those.
  3. Pathway – narrowed hospital and practitioner network limited to Empire’s 28-county service area (though this network has grown to be fairly comprehensive, missing really only Memorial Sloan Kettering & SUNY Stonybrook)

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IRS delays 1095 reporting requirements for next year.

irs logo
On Friday, the IRS issued Notice 2016-70, which delays the deadlines for employers and health insurers to distribute Forms 1095-C and 1095-B to applicable employees.
With the delay, employee statements must be distributed by March 2, 2017 (previously January 31).  The deadlines for IRS transmittals (Forms 1094-C and 1094-B) were not delayed. Forms 1094-C and 1094-B must be submitted to the IRS by February 28 if in hardcopy and March 31 if in electronic format via AIR. As with last year’s reporting, copies of all 1095-Cs and 1095-Bs distributed to employees are included with the IRS submissions.

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What information do I need to see if I can get a subsidy?

image of questionnaire

Only a small amount of information is required in order for us to help you determine (a)  if you qualify for a subsidy, (b) what plans are available in your area, and (c) what would be best for you.

Simply email us the name, date of birth and smoking status of each person to be covered.  Include your zip code, and (to determine subsidy) your adjusted gross income for this year.  Be sure to include a phone number so we can get back to you!

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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. - SIPC - Brokercheck