Those of us that work in the employee benefit world have come to expect change.
Whether it is the removal of certain parts of the ACA or it is the deferral of other aspects of the ACA, we live in a world of constant change.
As we enter into the fourth quarter there are a number of factors that are affecting our practices. For those working in the individual marketplace the rate increases that are being approved through the various Exchanges underscore the fact that many people who previously did not have insurance have taken advantage of the new program. The success of the Exchanges has a downside in the significant increase in claims being paid by the carriers that participate. In my own state of Idaho, rate increases that have been approved range anywhere from 9% to 24%. We are unlike numerous other marketplaces that are seeing double digit increases. The small group arena is also under the same rate increase pressure. Fall renewals are in the 16% to 25% rate increase category and groups that are grandfathered, grandmothered, or utilizing ACA mandated products are all experiencing some form of rate increase.
The fourth quarter also will be critical to those employers that must now comply with the Pay or Play rules and the reporting requirements. Although the draft form from the IRS were issued in August, there is still significant confusion as to how and what data needs to be compiled by the employers that are subject to this provision of the code.
While all of this is going on, there are a number of pieces of Legislation that have been proposed and the question remains as to whether or not they will be able to be passed through this Congress. A brief summary of the Legislation is listed here.
Medical Loss Ratio (MLR)
Legislation to remove the agent/broker compensation from the Medical Loss Ratio (MLR) Requirement in the individual and small group markets.
- R. 815 – Reps. Billy Long (R-MO) and Kurt Schrader (D-OR)
- 1661 – Sens. Johnny Isakson (R-GA) and Chris Coons (D-DE)
Small Group Expansion
Legislation to amend the PPACA to provide States with flexibility in determining the size of employers in the small group market. The bills are known as the Protecting Affordable Coverage for Employers (PACE) Act.
H.R. 1624 – Reps. Brett Guthrie (R-KY) and Tony Cardenas (D-CA)
- 1099 – Sens. Tim Scott (R-SC) and Jeanne Shaheen (D-NH)
Cadillac/Excise Tax Repeal
Legislation to repeal the “Cadillac Tax” on middle class Americans’ health plans.
The foundation of his work philosophy is reflected in the following:
“My company is dedicated to providing prompt service and assistance in the areas of employee benefit design, consultation, implementation, related business insurance needs and estate planning for business owners and key executives.”
Hyatt is a graduate of Carroll College in Helena, Mt., earning a Bachelor’s Degree in general business. Hyatt and his wife, Belen, have four children. His activities in the insurance industry include having served as President for both the local and state Insurance and Financial Advisors Association. He is a past board member of the National Association of Health Insurance Advisors, and currently chairs a national committee for the Insurance and Financial Advisors Association. Currently, Hyatt is the Chairman of the Board of the Idaho Small Employer Reinsurance and Individual High Risk Reinsurance Pool for the State of Idaho. He also serves as a board member of the Idaho Exchange “Your Health Idaho” These activities, coupled with Hyatt’s commitment to serving his clientele in the ever-changing benefits arena, have made him an invaluable resource.
Through a consummate desire to provide exemplary service and a reputation for integrity, Hyatt has been recognized by his peers with the receipt of The Presidents Achievement Award, The Glennon Award, The Rankin Award and Isern Award.
Hyatt would welcome the opportunity to work with your organization.
Latest posts by Hyatt Erstad (see all)
- Elimination of Commission Payments in Health Markets - April 22, 2016
- As ACA Co-Ops Go Under, Advisors Are Left in the Lurch - January 21, 2016
- Employee Benefits Change or Not? - October 26, 2015