PPACA Updates and Deadlines

Please take two minutes to scan the content in this email newsletter.

Updates to the Patient Protection and Affordable Care Act (PPACA) and other new legislation mean this month's newsletter is full of content. This information is critically important to your business, and we have broken down the topics below in detail to ensure you are up-to-date. We are passionate about helping our clients stay current and hope this month's newsletter accomplishes that goal. Thank you for reading!


Kind regards,

Laurie Rood, CEO
Update to Master the Maze of Health Care Reform Part 4 
Legislation updates mean new information for you! 

There have been several changes to the Patient Protection and Affordable Care Act (PPACA) since our June 27th webinar, the most significant being the delay of mandatory coverage until January 1, 2015, which means some of the information in that presentation is no longer applicable. We have updated our presentation to include the latest changes to the legislation and what they mean for you and your business and would love to share this information with you. The slides are available as a PDF file; if you would like a copy, please call or email your request.

Notice to All Employees Regarding Covered California  
All employees must receive this notice by October 1, 2013

The United States Department of Labor has released a notice that must be given to ALL employees regarding the availability of health coverage through their employer. This notice explains what the health insurance exchange is and how employees can qualify for a subsidy through Covered California. It also spells out in detail the criteria for obtaining a subsidy.

It is your responsibility to ensure EVERY employee receives this notice by October 1, 2013. You can download the notice on the Department of Labor's website here. Please note that page 3 of the notice is OPTIONAL, and we do NOT recommend including this page with the notice.

Please email us by September 1, 2013 to confirm you have received this message and are aware of your obligation to send this notice to ALL employees. Please also call or email if you have any questions or concerns; we are here to help you!

Early Renewal of your Group Medical Plan Prior to January 2014 
Renew before January 1, 2014 to avoid rate increases

Depending on the average age of your group, rating factor, and renewal cycle, it may be financially beneficial to change your renewal date.  This particularly applies if you have a January 1, 2014 effective date. Most of the carriers have agreed to an early renewal and have become flexible with the date changes but they all have very specific rules. 


Kaiser's deadline is almost upon us, so if you are considering changing your renewal date, we need to submit the change request before the end of August.


We are contacting all of our groups personally to discuss this option. Your team at Benefits Done Right is working quickly however, as always, we welcome your calls and questions.


Interpretation of 60-Day Wait for Benefits  
New law will affect both small and large groups

A new California law, effective January 1, 2014, prohibits insured plans from imposing waiting periods in excess of 60 days on covered employees and their dependents. Note that this provision is narrower than the federal requirement prohibiting waiting periods in excess of 90 days.


The California law was originally thought to apply only to small, non-grandfathered plans; however, recent guidance has clarified that all insured plans (regardless of size or grandfathered status) are subject to this provision. The law means an insured plan in California cannot have more than a 60-day waiting period; the first of the month following 60 days will not work. It is unclear whether it can be phased in with plan year renewals or will require an across-the-board change on January 1, 2014.


Who Does the Law Apply To?

The law is written to apply to any insured plan that provides benefits to residents in California regardless of the status of the contract or the policyholder. It is important to note that if an employer has an insured plan written outside of California that covers California employees, the plan may not be able to impose a waiting period over 60 days.


The law does not apply to self-insured plans; however, self-insured plans remain subject to the federal prohibition on waiting periods in excess of 90 days beginning with plan years in 2014. The law also does not apply to dental or vision coverage when provided under a separate insurance contract; however, plans may prefer to align waiting periods for administrative ease.


Are Your Vaccinations Covered?   
Check with your carrier for details

Has your primary care doctor directed you to your pharmacy to obtain vaccinations ?


Be sure to check with your insurance carrier requirements prior to obtaining vaccinations at your local pharmacy. Many insurance carriers require that members be referred to another doctor or obtain a pre-authorization before obtaining vaccinations from their pharmacy or other medical professional.

Benefits Done Right Insurance Agency, Inc.
601 University Avenue, Suite 250 | Sacramento, CA  95825
Toll-Free: (800) 482-1817 | Direct: (916) 568-2345 | Fax: (916) 564-9228
www.benefitsdoneright.com |info@benefitsdoneright.com | Company Directory

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