Our Focus Is Your Success
In This Issue
President's Message
Standout Communication
University Day 2016
LAAHU Vanguard Council
LAAHU Membership Campaign
Heard On the Net February
Quick Links
Thank You
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LAAHU's Mission

Provide members professional growth and a powerful voice at the local level by delivering valuable networking and educational opportunities.


LAAHU's Vision

LAAHU empowers our members by providing the tools to succeed in today's every-changing healthcare industry

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Succession Planning...Call For HELP!                                
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Many Hands Make Light Work!

As you may, or may not, know LAAHU operates on the dedication and time of the volunteers who are willing to jump in and lend a hand.  All of the programs you attend and the accomplishments and progress we see in Sacramento and Washington D.C. are a direct result of the time your elected Board of Directors, and YOU, our members, are willing to donate.  We are very lucky to have a Board that consists of people who truly want to see agents succeed and triumph in the ever changing world that is now ACA. 
"Succession Planning" has been a key term in the Association from the National level, to the state and local chapter levels.  As times change we are realizing that there is a serious need to re-invigorate the interest of our members to participate.  We need a larger pool of people that would be interested in helping to accomplish our common goals.
That being said, we would like to reach out to our membership and ask for your participation to be a more successful and long standing association.  If you are interested in holding a chair position on the Board of Directors PLEASE let us know by emailing:  info@laahu.org.  We would also love to have you join our committees to help further our progress; or if you know someone that might be interested please ask them to email info@laahu.org
There is an open invitation to join us at our monthly board meeting (every 2 nd Tuesday) if you are unsure about what we do or would just like to see the process.  If you need additional reasons - look at some of our members "Why" statements explaining what they find valuable.  If you have never heard of finding your "Why" you will have a better understanding after watching this:  Difference between "What" and "WHY".
There are many opportunities available and the "work" can be customized to fit your needs in regards to the amount of time you have available to dedicate.  Below is a list of possible ways you can get involved and have a voice in paving our journey.  Pick one that you would enjoy being involved in and let us know:
Legislative Committee: 
Work on Adopt-A-Legislator Program
Help set appointments in Sacramento and D.C.
Write articles and communications                                 
Communications :
Write articles
Help promote events
Make calls to colleagues
Come up with creative campaign ideas
Help decide what events and courses we provide

President's Message

No one is legally required to join their local Health Underwriters chapter. Yet hundreds of benefit professionals have joined LAAHU making us one of the largest local Health Underwriter chapters in the country. Why? Because over the years we've delivered real value to our members.

  • Representation: whether in Sacramento and Washington, LAAHU members are on the front lines of protecting our profession and our clients' best interests. And we have the successes to prove it.


  • Networking: at monthly membership meetings, Vanguard Council events or special events like University Day, LAAHU gives you the opportunity to build relationships with some of the smartest, most professional benefits specialists in the business.


  • Education:  delivering more than just CE credits, but information you can use to build your business and serve your clients whether at monthly meetings, University Day or the annual Medicare Summit. Then there's access to the powerful compliance tools in the member-only section of NAHU site.
And we're going to keep on delivering meaningful value because it's a tough world out there in our business. Every month there seems to be new competitors, new regulations, and new products to deal with. LAAHU is dedicated to helping you overcome the challenges and excel.
If you're already a member, please make use of all we offer. If you're not yet a member, please join today. You'll help yourself, your profession and your clients.

Alan Katz
LAAHU President

Standout Communication
Standout Communic ation  02/18/2016

You need to stand out from the crowd! In this one hour CE course, Alan Katz draws upon a study of 100 broker websites and decades of marketing experience to deliver key steps you can take now to stand out from the competition with powerful sales and client communications. 

University Day 2016
LAAHU Vanguard Council 
Are you a forward thinker?  Join us at the Vanguard Council Networking events to share ideas for success!

Drums + Drinks photo
Drums & Drinks coming up on February 18, 2016 - limited space if you want drum lessons!



January 1, 2016 - March 31, 2016
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If a new member joins LAAHU, and notes  you
 as the referring member, your name  will be
 entered into our  GRAND PRIZE  drawing 
on University Day, as will the member 
that joins.  The new member must complete 
the member application and still be active 
at the time of the event on April 13, 2016. 

Heard On the Net 
Heard on the Net
Complied by Bill Robinson, DCAHU Communications Chair
Note: All headlines contain embedded URL links to the full article - just click on each headline!
As the Affordable Care Act heads into its sixth year, employers are bracing for the full employer mandate and new reporting provisions, while the Obama administration prepares to go back to court. In this issue of "Road to Reform," we look ahead to see what 2016 has to hold for health care.
2016 Obamacare Outlook  
"According to early CMS data, 38% of exchange enrollees are under age 35. Is the risk pool beginning to stabilize? ... If rates increase too much in 2017, will those young people jump ship? ... Will the higher tax penalty for not having coverage prompt more young and healthy people to enroll? ... Will other carriers get out of Obamacare? ... Will provider-based plans continue to grow? ... Will the small business SHOP exchanges continue to struggle?"  (Bob Laszewski's Health Care Policy and Marketplace Review)  

"The Endangered Individual Health Insurance Market" by Alan Katz

And then there were none? The individual health insurance marketplace is endangered and policymakers need to start thinking about a fix now, before we pass the point of no return. Health plans aren't officially withdrawing from the individual and family market segment, but actual withdrawals are rare. What were witnessing, however, may be the start......

"Is This Reform a Sham or Just Naive?"  by Alan Katz

At some point during the Republican debate in New Hampshire Saturday night a candidate will call for allowing consumers to buy health insurance offered in other states. Apparently all the remaining presidential contenders support this as part of repealing and replacing the Affordable Care Act. Unless I'm missing something, however, this proposal makes no sense.
A Broker's Role Is Not About Pricing Anymore 
"There will be plenty of headaches as employers go through the first year of the Affordable Care Act reporting requirements. But there is also opportunity for employee benefit brokers. Helping clients navigate this process can increase a broker's value and secure those clients for the long-term.... Determining eligibility is one challenge ... Finding data, such as eligible employees, employer and employee contributions and the number of times a health plan was offered, is not easy."
Total reaches nearly 1.57 million as share of young customers edges higher.
About 4 million people signed up for health coverage for the first time, reports the Health and Human Services Department.
Why the 2016 Open Enrollment Stalled: How Unaffordable Obamacare Is for the Working and Middle Class 
"Most insurance companies are losing money today under Obamacare because not enough healthy people have signed up. They were hoping that the 2016 enrollment would change that. It has not. This can't continue." 
(Bob Laszewski's Health Care Policy and Marketplace Review)   
  CMS Announcement Clarifying, Eliminating and Enforcing Special Enrollment Periods  
"The action  we are taking today   announces the elimination of several unnecessary special enrollment periods, clarifies the definitions of other special enrollment periods, and provides stronger enforcement so that special enrollment periods serve the purpose for which they are intended and do not provide unintended loopholes.... While there will continue to be special enrollment periods for people who lose coverage mid-year or experience other life changes, this channel for enrollment will not be available for the vast majority of consumers."
A new report released by Covered California details how exchange enrollees are accessing health care services at hospitals in the state. For example, enrollees had 65,040 emergency department visits and underwent 10,928 cancer treatments during the exchange's first 18 months of operation. House Minority Leader Nancy Pelosi called Covered California "an enormous success."
Insurers Sounding Alarms Over Future of Exchanges   (no link)   - Health plans are worried that "churn" in Obamacare is destabilizing the insurance exchanges and spiking costs, Pro's Paul Demko reports. They're concerned that rules are too lax for special enrollment periods and that customers aren't required to provide sufficient proof that they're eligible to sign up for coverage outside of the standard open season. They also believe some exchange customers are exploiting a three-month "grace period" to continue getting insurance even though they've stopped paying their premiums. Paul writes "That makes the risk pools skew toward sicker costlier customers - especially when many healthier uninsured people are taking their chances rather than shelling out money for coverage."
Aetna estimates that 25 percent of the insurer's enrollments through HealthCare.gov last year came through special enrollment periods. UnitedHealth Group, which is threatening to drop out of the Obamacare marketplaces in 2017 because it's losing too much money, said last year that it expected 30 percent of its exchange enrollments for the year to come outside the normal sign-up window. And BCBSA says that exchange customers who sign up during special enrollment periods are 55 percent more expensive than their counterparts who enroll during the regular season. In recent comments to the Obama administration about proposed marketplace rules for 2017, Aetna wrote that "unless some fundamental flaws are corrected, we believe there is a grave risk that the federal exchange will not operate as a viable, competitive market in 2017."  from Politico Pulse - www.politico.com
Licking Wounds, Insurers Accelerate Moves To Limit Health-Law Enrollment Major changes in broker compensation are designed to discourage enrollment of the sickest, say consumer advocates.
CDHP Enrollees More Cost Conscious Than Traditional Plan Enrollees  
"Those in a CDHP or HDHP were more likely than those with traditional coverage to say that they had checked whether the plan would cover care; asked for a generic drug instead of a brand name; talked to their doctors about prescription options and costs; asked a doctor to recommend a less costly drug; talked to their doctors about other treatment options and costs; developed a budget to manage health care expenses; and used an online cost-tracking tool provided by the health plan."
Retirement Health Savings Account and Medicare: Using an HSA for Supplemental Retiree Medical Expenses  
"For any retiree that is saving for both medical expenses in retirement and also all of their other retirement goals, using a combination of an IRA (for most retirement expenses) supplemented by an HSA as a 'retirement health savings account' may be the most tax-preferenced way to save holistically for retirement.... Contributing the maximum to an HSA every year has the potential for more beneficial tax treatment than any other type of tax-preferenced account. Which makes accumulating in an HSA so desirable that it may even be preferable to pay current medical expenses out of pocket, just to preserve (and keep contributing to) the HSA account balance to be used as a future health retirement account!"
Text of IRS Publication 969: Health Savings Accounts and Other Tax-Favored Health Plans (PDF)  
21 pages, dated Jan. 13, 2016. "An HSA may receive contributions from an eligible individual or any other person, including an employer or a family member, on behalf of an eligible individual.... An Archer MSA may receive contributions from an eligible individual and his or her employer, but not both in the same year.... A health FSA may receive contributions from an eligible individual. Employers may also contribute.... An HRA must receive contributions from the employer only. Employees may not contribute."
California's largest health plans -- Anthem Blue Cross, Blue Shield of California, Health Net and Kaiser Permanente -- could owe $10 billion in back taxes and at least $1 billion annually going forward depending on the outcome of cases centering on whether they should be regulated as insurers.
Lawmakers, policymakers and California voters are poised this year to move past dismay and disussion about rising prescription drug prices. With a new law on the books in California and a petition approved for the statewide ballot, dismay may give way to action.
Three Ways to Help Employees Understand and Utilize New Benefits  
"Today's workforce spans four generations, soon to be five. So when you craft your communications, it's important to know whom you're talking to.... Many insurance plans offer perks that your employees may not be aware of, and by communicating these little extras, you can help your workforce understand the true value of their benefits ... Make your communication more enjoyable with simple videos to explain complex health care terms and insurance concepts."
Feds Targeting Three Common FMLA Mistakes  
"[1] Not recognizing workers' need for leave and disciplining those employees for absences that should've been covered by FMLA; [2] Failing to meet the notice deadlines under the FMLA regs, and [3] Failing to properly administer medical certification -- including recertification requests that are made more frequently than the law allows."
The Health and Welfare 'Wrap' Document: What It Is and Why You Want One  
"One common mistake employers make is assuming that the certificates and booklets provided by insurers contain all of the provisions necessary to satisfy the SPD requirement -- but that is rarely the case. Smaller employers often assume that there is a small employer exemption to the SPD requirement (not true); other employers believe that their health and welfare plans are not subject to ERISA (rarely true).... [M]any employers are unaware of the 5500 requirement, or believe that it applies only to 401(k) and other retirement plans (not the case).... One way to make compliance easier is through a welfare wrap document."
2015 Ends With a Flurry of ACA Activity  
"The guidance in [ Notice 2015-87 ] regarding health coverage affordability determinations for applicable large employers who maintain opt-out arrangements, flex credits, or HRAs should help employers assess how to complete line 15 of Form 1095-C and understand their potential exposure under the ESR rules. Also welcome was an indication in the Notice that the IRS will not impose penalties for ACA reporting failures, provided that the employer can show that it has made good faith efforts to comply with the information reporting requirements."
Employers Getting Pushed for 1095s Despite Deadline Extension  
"Employees are now realizing that, in order to fill out their tax returns -- and get their refunds -- they need the information from Form 1095. IRS and Treasury officials ... have posted  Q&As directed to individuals   explaining the Form 1095 delay implications and gave limited relief, under certain conditions, which would permit employees to go ahead and file their individual tax returns without the Form 1095.... Since the requirements are complicated, employers would be well advised to direct employee questions/demands concerning the Form 1095 to the IRS website or the employee's tax advisor."
Helpful Communication Tools to Explain ACA Form 1095 to Employees  
"Self-insured and fully-insured health plans must provide employees with one or both IRS 1095 Forms (1095-B and 1095-C). To help employees understand what IRS Form 1095 means for them, the authors have prepared a one-page communication that can be shared with employees."
Seven Questions Employees Will Ask About the ACA Form 1095 
"[1] What is this form I'm receiving? ... [2] Who is sending it to me, when, and how? ... [3] Why are you sending it to me? ... [4] What am I supposed to do with this form? ... [5] What if I get more than one 1095 form? ... [6] What if I did not get a Form 1095-B or a 1095-C? ... [7] I have more questions -- who do I contact?"
Completing Form 1095-C: Coding Line 14 May Not Be as Intuitive as It Appears  
"Without a doubt the most challenging parts of the Form 1095-C to complete are lines 14, 15, and 16. These lines provide critical information to the government regarding an individual's eligibility for a premium tax credit, the individual mandate, and the employer mandate. Line 14 dictates how line 15 and line 16 should be completed. Therefore, correctly completing line 14 is critical to accurately completing line 15 and line 16."
ACA Reporting Requirements for Carriers and Employers (Part 24 of 24): 5 Predictions 
"Carriers and employers, and their vendors, service providers and strategic partners, have scrambled up a steep learning curve.... This post offers some predictions about how the authors expect compliance to unfold. [1] MEC Reporting will work as advertised -- for the most part ... [2] Software solutions for applicable large employers may work and will converge ... [3] For employers, the first year will be chaos ... [4] Also for employers, there will be some unwelcome surprises ... [5] Despite items [1] through [4], there will be few train wrecks."