Employers that offer partially self-funded medical plans are subject to the Transitional Reinsurance fee established by the Patient Protection and Affordable Care Act (PPACA). 

This fee was imposed over a three year period, with 2016 being the third and final year. The fee in 2016 is $27 per average covered life (both employees and dependents) covered on the health plan in 2016.  

Partially self-funded plans need to take action soon by reporting their average number of covered lives for the first 9 months of 2016 to The Department of Health and Human Services (HHS) by the deadline of November 15th, 2016.

On January 1, 2017, new wellness program rules from the Equal Employment Opportunity Commission (EEOC) go into effect. These rules differ a bit from those under HIPAA and the ACA, so we recommend every employer review and revise their wellness program to ensure compliance, including new rules around incentives, new limitations on the types of info gathered in Health Risk Assessments on family members, and newly required notices you must provide to employees.

Amendment 69: Know Before you Vote

By now you’ve most likely heard of Amendment 69, but maybe don’t know much about it.  Amendment 69 will be the first option on the November ballot, so now’s the time to educate yourself and your employees about this important healthcare bill!

The Amendment proposes that Colorado implement the first single-payer healthcare system in the nation, called ColoradoCare.  This universal healthcare system would cover all Colorado residents and provide the same benefit level to everyone, regardless of taxpayer or citizenship status.  To finance the plan, a new 10% payroll tax would be created, with employers paying 6.7% and employees paying 3.3%.  Self-employed persons would pay

Employers spend approximately 18-20% of their healthcare costs on prescription drugs, and the rapidly increasing cost of specialty drugs is causing this to inch ever up.  To offset these cost hikes, we’re always keeping our eyes on expensive drugs that are coming off patent and facing cost-slashing competitors soon. There are eight blockbuster drugs (those with a billion dollars or more in sales) coming off patent in 2016.  

The Medicare Modernization Act (MMA) requires Employers with prescription drug coverage to complete two items each year regarding Medicare Part D.  The first deadline is October 15th annually, and the other is 60 days from the beginning of each new plan year.  
The only employers exempt from this requirement are those that are small enough to be certain that their plan does not cover anyone eligible for Medicare such as employees or spouses over 65, anyone in end stage renal failure, or any disabled individuals. If you’re not positive – we recommend you comply to be safe.