NMAHU Northlander Notes
September 2015
President's Message  by Raquel Paulus

It's a tedious thing to say, but really...where did the summer go?!  Is it seriously time to ship kids to school, think about inviting family for color tours and start planning for the Individual and Medicare open enrollment?  Well, NMAHU is here to help you get ready for at least one of those things.  For your kids and family, you're on your own!  Our NMAHU September meeting will be with the COBRA-man himself, Matt Isbell to talk to us about compliance (see more details in the Program section of the newsletter) and for October, we'd like to have the carriers back similar to last year to give us their individual and small group updates.  More to come when we get that one planned.
I will also take one quick moment to thank Keith Wright for the past year as President of NMAHU.  He not only kept us moving forward and organized as a chapter, he also stepped up to the state level and will now be serving on the Michigan chapter of Health Underwriters as Secretary.  Yes, that does mean he'll be President of the Michigan chapter in a few years too.  Congrats Keith and thanks for all that you do for the agent community!
As members, you are always welcome to attend our monthly board meetings held the first Wednesday of every month, 9 am at the Chamber.  Or if you have any suggestions or concerns about our Chapter, please reach out to one of the board members listed on this page.  We're here to serve you!
Thank you and I hope to see you all on the 23rd.  
Raquel Paulus
President, NMAHU  

Wednesday, September 23rd, Noon

Topic:  Passing An IRS/DOL COBRA and HIPAA Plan Audit

Speaker: Matt Isbell, COBRA Resources, Inc.

RSVP: info@nmahu.org

* The FOUR building blocks of correct compliance!
* 10 COBRA notice language requirements not included in the DOL model notices!
* Understanding there is no such thing as COBRA, just group health insurance!
* Producing the FIVE COBRA notices and updates!
* The myth of COBRA outsourcing - you are still liable!
* How HIPAA special enrollments integrate into COBRA procedures!
* The most common employer mistakes and how to correct them!

Matt Isbell, a.k.a. Cobra-man

Golf Outing
A BIG THANK YOU to all who participated in the Annual Golf Outing.  It was a huge success and we want to acknowledge all the players, volunteers and sponsors.

Professional Development and Educational materials and seminars are just one way your NMAHU membership works for you! From emails to website articles to up to the minute updates on the issues in the news. NAHU can help you become more informed and successful!

NAHU provides its members with multiple opportunities to obtain professional designations and earn continuing education credits. Utilize your member benefits to the fullest by taking advantage
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Member-only tuition discounts make your learning experiences even more worthwhile. If you're already a member - ask a friend or colleague to join! Your membership and support keeps our profession alive. Just go to www.NMAHU.org today and click


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We are amongst August Recess, a period in time in which Federal Legislators venture home from the beltway for an extended period of time to conduct various district meetings and events.
And while the cats are away, the mice will play. The U.S. Department of Treasury just recently released Notice 2015-52, which is an attempt to offer further tax guidance on a provision of the Affordable Care Act - the 40% excise tax imposed indirectly to the employer if the aggregate cost of applicable employer-sponsored coverage provided to an employee exceeds a statutory dollar limit, which is adjusted annually....  or better known as the "Cadillac Tax". As with this Notice and any others, your good friends at NAHU will voice your concerns and worries during the open comment periods. If you are interested in reading the Notice for yourself, you can find it here: http://www.irs.gov/pub/irs-drop/n-15-52.pdf.
On the lighter side, NAHU and its members were able to garner 100 co-sponsors on H.R. 815, a bill to remove agent and broker compensation from the medical loss ratio calculation. To-date, there are three U.S. Representatives in the State of Michigan whom have signed on - Tim Walberg (MI-07), Dan Benishek (M-01) and Bill Huizenga (MI-02). If your Representative's name isn't one of the three, it's time for you to make a phone call! You can find your Member of Congress' contact information here: www.house.gov.
S.1099 was put up for consideration in the U.S. Senate. This bill would allow States the flexibility in determining the size of employer groups in the small group market. If the Senate fails to move this bill along in September, it will unfortunately be too late and the 2016 definitions, as is, will therefore be enforced. Please call your U.S. Senators to share your thoughts. You may reach U.S. Senator Debbie Stabenow by calling 202.224.4822 and U.S. Senator Gary Peters at 202.225.5802.
And lastly, the Surface Transportation and Veterans Health Care Choice Improvement Act of 2015 was signed into law. This law amends the section of the PPACA that addresses the definition of an applicable large employer by excluding employees enrolled in TRICARE or veteran's coverage into the calculation in determining whether or not an employer group is an "applicable large employer".

HUPAC is a separate segregated fund (SSF) that allows for political advocacy from the connected organization, in this case being NAHU.

Who can contribute?
  • Individual's contributions through personal credit cards or bank accounts
  • NAHU members, their spouses, and NAHU staff can give up to $5,000 each year (federal law)
  • Businesses
  • State and Local Chapters
Who can accept contributions from HUPAC?
  • Political Parties ($15,000 a year)
  • Other PACS ($5,000 a year)
  • Leadership PACS ($5,000 a year)
  • Candidates & Candidate Committees
    • o   $5000 per Primary Election
    • o   $5,000 per General Election
If you would like to learn more about HUPAC or contribute and help our voices be heard in Washington please click here:

 Senior Markets


As we approach yet another Medicare   Annual Election period (Oct 15 - Dec 7) we see there will be some significant changes that affect the recipients of Medicare.
We have the normal things that agents talk about like Part B Deductible will likely be raised significantly however hospital deductible will most likely be similar to 20 15.
With regards to Part D: Part D prescription deductible is $360 with the initial coverage limit (donut hole) set at $3310. Out of pocket threshold (exceed donut hole) for 2016 is $4850 While in the donut hole, name brand drugs get a 55% discount, while generic drugs get a 42% discount. After one is out of the donut hole, the cost of drugs is typically 5%.
Two things agents will not notice:

1.  How doctors are paid including bonus/penalty based on quality of service.  This could seriously affect a doctors willingness to participate with Medicare in future years if they get a poor report card, while doctors getting a bonus will look forward to 2017.

2.   No COLA is likely for 2016, thus cost of Part B likely to affect more people with many paying $159.30/mo instead of the $104.90/mo.  Also it is projected that the Part B deductible will be up from $147 to $223 for 2016.  With no cost of living increase for 2016, seniors will be upset.  As an agent, be prepared to help them best we can.


email:  info@nmahu.org

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