With all best wishes for a happy and peaceful holiday season and a successful, healthy and happy New Year!
Eric Walters PEO/Insurance Services
December 20, 2017
On Dec. 20, Congress passed the Tax Cuts and Jobs Act, which makes significant changes to individual and corporate provisions of the U.S. tax code, including a reduction in the corporate tax rate to 21%, down from 35%, beginning in 2018.
The bill includes permanent effective repeal of the Affordable Care Act (ACA) individual mandate, requiring individuals to purchase and maintain health coverage, by zeroing out the penalty beginning in 2019.
For 2018, most individuals are still required to maintain coverage or pay a penalty when they file their 2018 federal income tax return.
The bill was negotiated by a conference committee comprised of representatives from both the Senate and House after each chamber passed their own versions of tax reform. The final bill was passed 51-48 by the Senate and 224-201 by the House before being sent to the President. President Trump is expected to sign the bill into law soon.
The bill also changes how certain tax thresholds will be indexed for inflation. Affected provisions, including the ACA “Cadillac” Tax (scheduled to take effect in 2020), will now be indexed to the Chained Consumer Price Index (CPI) instead of the regular CPI (the previous metric). That change makes it likely that more employer-sponsored plans would trigger the Cadillac tax sooner.
Phoenix Tops US in Population Growth
Los Angeles added 27,173, San Antonio 24,473 and New York 21,171 persons during the same time frame, according to the Census data. The population data is for cities and not metro areas.
That is good news for the real estate industry, home and apartment builders and business recruiters. It also shows the Phoenix market is getting back to pre-recession norms after the last real estate and economic crash.
Population growth stalled during and right after the recession.
The Phoenix metro area and Arizona as a whole have long depended on population growth to fuel construction, retail and restaurants and business services. A larger population also means Phoenix is in line for more federal funding for transportation, infrastructure and security dollars for programs based on population.
The city of Phoenix is expanding its Metro light rail system and also wants to bring more residents to its downtown core. A growing population can help convince developers and builders to do that.
The city of Phoenix’s population now totals more than 1.6 million persons. That ranks fifth among U.S. cities and ahead of Philadelphia (1.57 million).
New York is the largest U.S. city at 8.5 million followed by Los Angeles at 3.98 million and Chicago with 2.7 million.
The Phoenix metro area has 4.66 million persons. That ranks 12th nationally.
Maricopa County also topped the list of U.S. counties for population growth during the same time frame.
Lee McPheters, an economist with Arizona State University’s W.P. Carey School of Business, is projecting 2 percent population growth for the Phoenix metro this year. That comes after 2.1 percent growth in 2016 and 2 percent in 2015. A growing population certainly shows economic attractiveness and strength and appeals to employers looking for workers, home and apartment builders as well as real estate investors.
The Valley’s large labor pool is attractive to back-office and call centers and distribution hubs.
JPMorgan Chase & Co. (NYSE: JPM), Amazon.com Inc. (Nasdaq: AMZN), Bank of America (NYSE: BAC) and Wal-Mart Stores (NYSE: WMT) all have large operational footprints in the Phoenix market.
The West Valley city of Buckeye also ranks as one of the fastest growing U.S. cities posting 4.8 percent growth between July 2015 and July 2016. Buckeye has 64,629 residents, according to the Census Bureau.
That growth ranks Buckeye seventh nationally. Conroe, Texas near Houston had the highest growth at 7.8 percent. Frisco, Texas near Dallas was second with 6.2 percent population growth.
Overall most of the population growth in the U.S. is in the South and West.
“Overall, cities in the South continue to grow at a faster rate than any other U.S region,” said Amel Toukabri, a demographer with the Census Bureau. “Since the 2010 Census, the population in large southern cities grew by an average of 9.4 percent. In comparison, cities in the West grew 7.3 percent, while cities in the Northeast and Midwest had much lower growth rates at 1.8 percent and 3 percent respectively.”
Under current Arizona law, patients do not have any type of support to fight insurance companies that refuse to pay for procedures or services a patient received from out-of-network physicians.
SB 1441, authored by Sen. Debbie Lesko (R-Peoria), would allow patients to ask the Arizona Department of Insurance to intervene in cases where patients feel they are being unfairly charged, according to the report.
State intervention, however, would only be available in cases where patients could not check prior to the procedure whether a physician was in or out-of-network.
Arbitration will be available if a healthcare provider does not disclose upfront whether it is considered in-network, charges more than the estimated total cost and does not give the patient a chance to waive their rights to dispute the bill, according to the report.
Sen. Lesko said under SB 1441, patients would only be responsible for the normal co-pay amount and the deductible, in most situations. If the patient agrees ahead of time to a specific out-of-network cost, the legislation will not be applicable, according to the report. However, if the medical bill ends up being more than the agreed upon amount, the patient will have access to the procedure outlined in the legislation.
The Department of Insurance will have until 2019 to create the procedure for the review process if the legislation passes.
Scottsdale, Az 85260
The major differences between the 2 health plans before the Senate has reviewed the Trump proposals.
Individual Mandate: (X Repeal)
Obamacare: All Americans are required to have health insurance or pay a tax penalty.
Republican plan: The mandate is repealed, but individuals who forgo health insurance for more than 63 days must pay a 30% surcharge on their insurance premiums for a year.
Employer mandate (X Repeal)
Obamacare: Companies with more than 50 employees are required to offer health insurance or pay a penalty.
Republican plan: This mandate is repealed.
Taxes (X Repeal)
Obamacare: Raised Medicare taxes on the wealthy and imposed new taxes on medical devices, health insurers, drug companies, investment income, tanning salons and high-end health insurance plans.
Republican plan: Repeals most Obamacare taxes and delays implementation of the tax on high-end health insurance plans to 2026.
Insurance for dependents ( √ Keep)
Obamacare: Requires insurers to allow children under age 26 to be covered by their parents’ policies
Republican plan: Maintains this requirement.
Essential health benefits (… Change)
Obamacare: Requires all insurance plans to cover certain health conditions and services, such as emergency room visits, cancer treatment, annual physical exams, prescription drug costs and mental health counselling.
Republican plan: Allows states to define what benefits are mandated or opt out of the requirement entirely.
Pre-existing condition coverage ( … Change)
Obamacare: Prohibits insurers from denying coverage or charging more to individuals who have pre-existing medical conditions.
Republican plan: States can let insurers charge as much as they like to sick people. Allocates $8bn to help subsidise those patients.
Medicaid (… Change)
Obamacare: Expanded Medicaid health insurance for the poor to cover more low-income individuals.
Republican plan: Phases out Medicaid expansion to reduce federal funding on the programme by $880bn over the next decade, and gives states greater flexibility in administering the programme in exchange for fixed federal spending.
Women’s healthcare (… Change)
Obamacare: Insurance companies prohibited from charging women more than men for the same health plan and must provide core services including maternity care and contraceptives.
Republican plan: Insurance companies still banned from charging women more, but states could allow insurers to drop maternity care and contraceptives from basic benefits. Also bans women from using federal tax credits to buy a plan that covers abortion.
Older Americans (… Change)
Obamacare: Insurers can charge older Americans no more than three times the cost for younger Americans
Republican plan: Insurers can charge older Americans five times as much as younger Americans. States would also be able to set their own ratio.
Subsidies (… Change)
Obamacare: Provided refundable tax credits for low-income individuals who purchased their insurance on government-run marketplaces and support for some out-of-pocket medical expenses.
Republican plan: Alters formula for tax credits, which will expand the benefit to more middle-class Americans but probably raise the costs for some elderly and less-affluent individuals.
All types of individual and group (employee benefits) health plans available including alternative coverage with new innovative plans with and without employer contribution!
The Centers for Medicare & Medicaid Services (CMS), the agency that put out the packet of regulations, also has made a final decision to:
NOTE: These changes are before any GOP changes/repeal of Obamacre.
ACA Blog: www.azhealthinsuranceblog.com
Read more: Health Savings Account Overview
When businesses offer an HSA in combination with an HRA, they give employees more choices and more control over their own health benefits. The combo appeals to businesses, too, as it allows them to control costs by fixing them through an HSA contribution and setting up an HRA in place of other small business health insurance options.
Health savings accounts (HSAs) have become a popular option for people who wish to have comprehensive individual health insurance while building up tax-free savings they can roll over from year to year. According to research firm Devenir, more than 16 million people had an HSA in 2015.
An HSA allows individuals to use tax-free funds to pay for medical expenses, doctors’ visits, prescriptions, and other qualified health expenses. In many cases, employers also contribute matching dollars.
Before you can contribute to your HSA, however, you must first be enrolled in a high-deductible health plan (HDHP). As the name indicates, HDHPs have a higher deductible than traditional insurance plans.
When Is an HDHP HSA Qualified?
Just because you have an HDHP, however, does not mean it qualifies for an HSA. In 2016, for example, just 19 percent of the HDHPs available on the federal exchange were HSA eligible.
High deductibles are not the only requirement for an HDHP to be HSA eligible. As defined by the IRS, HSA qualified HDHPs have:
The IRS publishes minimum deductible and maximum medical expense limits annually. The chart below lists the annual HSA contribution limits and the HDHP minimum required deductibles for 2016 and 2017.
|Contributions and out-of-pocket limits for HSAs and HDHPs|
|For 2016||For 2017|
|HSA contribution limit (employer + employee)||Self only: $3,350Family: $6,750||Self only: $3,400Family: $6,750|
|HSA catch-up contributions (age 55 or older)*||$1,000||$1,000|
|HDHP minimum deductibles||Self only: $1,300Family: $2,600||Self only: $1,300Family: $2,600|
|HDHP maximum out-of-pocket amounts
(deductibles, copayments, and other amounts besides premiums)
|Self only: $6,550Family: $13,100||Self only: $6,550Family: $13,100|
* Catch-up contributions can be made at any time in the year the participant turns 55.
How to Tell If Your Plan Is HSA Eligible
If you’re new to HDHPs and HSAs, sorting through the various requirements can feel a bit like trying to read a bowl of alphabet soup.
If you’re overwhelmed, keep in mind that insurance carriers will label their plans as HSA eligible.
Other HSA Requirements
In addition to having an HSA-qualified insurance policy, there are several other requirements to contribute to your HSA in a given year:
HSAs are an increasingly popular choice for people looking to manage the rising cost of individual health insurance. Because HSAs offer triple tax advantages, more and more people are likely to participate in the future.
Eric Walters – Insurance Services.
ACA Blog: www.azhealthinsuranceblog.com
As of spring 2016, more than 11 million people had enrolled in individual health insurance through the Affordable Care Act (ACA) Marketplace, and similar numbers are expected in 2017. With numbers that high, some of these people are bound to feel confused, overwhelmed, and frustrated when shopping for health coverage. The good news is you don’t have to do it alone. Many people don’t realize there are free resources available to them.
Selecting an Individual Health Insurance Plan
Choosing an individual health insurance policy can be a complicated journey. Multiple factors go into the price of a plan—including the size of the provider network, how much the insurance company will cover, and the deductible amount. In an effort to simplify the process, the ACA divided their policies into four different tiers.
The lowest tier (Bronze) comes with the lowest premiums, but the highest out-of-pocket expense share at 40 percent. Silver is the next step up, then Gold. The highest tier is Platinum, which has the highest premiums, but enrollees can expect to pay only 10 percent of the cost of medical care.
Each family’s needs are different, but generally speaking, people who expect to seek little medical attention would be suited for the Bronze tier. If you are treating a chronic illness or require multiple prescriptions, a higher tier may be more suited to you. In addition, if network size is important to you, you may want to look into a PPO plan as opposed to an HMO.
What Does a Broker Do?
Brokers are there to help you make a more informed decision—usually at no charge to you. They can get individual health insurance quotes, compare plans, and help you understand what your options are. They should be able to answer most of your questions, and if not, they’ll have access to people who can.
There are multiple ways to find a broker. If you go to Healthcare.gov and look for individual health insurance quotes, brokers may call you to offer their assistance. You are welcome to use their services by phone or email—and no, you will not be charged.
Another way to find a healthcare broker is to call a company like Stride Health. They provide many free resources on their website, which means you can do some research ahead of time and ask more informed questions over the phone.
Word to the Wise
You may be wondering, if brokers provide free services, how do they get paid? Brokers are often paid a commission by the insurance company when they sign someone up for a policy. This means that companies offering better incentives to brokers may end up with more enrollees—and the individual health insurance option they recommend may take into account more than just the best option for you and your family.
As always, it is best to do your research and make sure that you understand all of the parameters of your plan before signing up for the year. Don’t be afraid to ask plenty of questions, including “Why are you recommending this plan for my family?
Office: Tel: 480-657-8595
November 20, 2016
In Notice 2016-70, IRS extends the 2017 deadline from January 31 to March 2 for employers and insurers to furnish individual statements on 2016 health coverage and full-time employee status (Forms 1095-B and 1095-C). The notice also extends 2015 good-faith penalty relief to 2016 for incorrect or incomplete reports due in 2017.
In the Notice, the IRS did not extend the due date for filing the forms with the IRS February 28 (if filing by paper) or March 31 (if filing electronically).
Please remember that filers can take advantage of an automatic 30-day extension of the IRS filing deadline by submitting Form 8809 before the relevant due date.
Lastly, IRS extended the good-faith relief in Notice 2016-70 that applied to in 2015 to 2016. This relief applies to missing and inaccurate taxpayer identification numbers and dates of birth, as well as other information required on the return or statement. To show good faith efforts to qualify for this relief, filers must meet applicable deadlines. However, IRS recognizes that late filers may still be able avoid penalties by showing reasonable cause for missing the due dates.
For a copy of Notice, please click on the link below:
More information available from:
Email: email@example.com OR firstname.lastname@example.org
|Question:||What if a consumer files his or her tax return without Form 8962?|
|Answer:||Tax filers must file their tax return with the IRS Form 8962 to reconcile advance payments of the premium tax credit (APTC).|
|Question:||Does a consumer’s eligibility for Medicaid, in addition to actually being enrolled in Medicaid, disqualify a consumer from receiving advance payments of the premium tax credit (APTC)?|
|Answer:||Consumers who are determined eligible for or are enrolled in coverage through Medicaid or CHIP that qualifies as minimum essential coverage (MEC) are ineligible for APTC for themselves, and for income-based cost-sharing reductions (CSRs) to help pay for the cost of their Marketplace coverage.|
|Question:||Is loss of advance payments of the premium tax credit (APTC) or income-based cost-sharing reductions (CSR) a qualifying event for a special enrollment period (SEP) for consumers to change their Marketplace plan?|
|Answer:||A consumer may qualify for a Special Enrollment Period if he or she (or anyone in his or her household):
- Is enrolled in Marketplace coverage and report a change that makes him or her: Newly eligible for help paying for coverage; Ineligible for help paying for coverage; Eligible for a different amount of help paying for out-of-pocket costs, like copayments.
- Become newly eligible for Marketplace coverage because he or she has become a U.S. citizen, U.S. national, or lawfully present individual.
- Become newly eligible for Marketplace coverage after being released from incarceration (detention, jail, or prison).
- Gain or maintain status as a member of a federally recognized tribe or Alaska Native Claim Settlement Act (ANCSA) Corporation shareholders (he or she can change plans once per month).
- Become newly eligible for help paying for Marketplace coverage because he or she had a change in household income or moved to a different state and he or she was previously both of these: Ineligible for Medicaid coverage because he or she lived in a state that hasn’t expanded Medicaid; Ineligible for help paying for coverage because his or her household income was below 100% of the Federal Poverty Level (FPL).
|Question:||How would a consumer become enrolled in both Medicaid/Children’s Health Insurance Program (CHIP) and a Marketplace plan with advance payments of the premium tax credit (APTC) or income-based cost sharing reductions (CSR)?|
|Answer:||A consumer may experience a life change (e.g., drop in income) making him or her eligible for Medicaid or CHIP, but he or she may fail to end Marketplace coverage with APTC/CSRs after being determined eligible for Medicaid or CHIP. Similarly, consumers who are enrolled in Marketplace coverage with APTC/CSRs may apply for Medicaid or CHIP directly with the state agency and be determined eligible, but fail to end Marketplace coverage with APTC/CSRs. While the Marketplace reinforces in many places the importance of reporting changes directly to the Marketplace and ending Marketplace coverage with APTC/CSRs after being determined eligible for or enrolling in other minimum essential coverage, this notice is a reminder to these consumers who may not have been aware that they need to end their Marketplace coverage with APTC/CSRs after being determined eligible for Medicaid or CHIP.|
|Question:||Will the process for termination of advance payments of the premium tax credit (APTC) or income-based cost sharing reductions (CSR) be the same for consumers who are enrolled in Medicare?|
|Answer:||This noticing effort is the first step the Federally-facilitated Marketplace (FFM) is taking to make sure consumers take action to end their Marketplace coverage with APTC because they are receiving Minimum Essential Coverage (MEC) Medicare. The FFM does expect to turn off APTC/CSR for consumers who are found to be dually-enrolled in a Marketplace plan with financial assistance and Medicare once it is operationally feasible.|
|Question:||If consumers have recently amended their federal income tax returns, how long do they need to wait in to reapply for Marketplace coverage?|
|Answer:||The Internal Revenue Service (IRS) takes 3-10 weeks to process a tax return based on how it is filed. Consumers should update their application, or reapply for coverage, during the Open Enrollment Period which begins November 1, 2016. After tax filers have filed their tax return, they can attest on the application to having filed their taxes for all past years that they received advance payments of the premium tax credit (APTC). Consumers should update their application and select a plan by Dec 15, 2016 to have coverage effective Jan 1, 2017.|
|Question:||If a consumer received a final Medicaid/Children’s Health Insurance Program (CHIP) Periodic Data Matching (Medicaid/CHIP PDM) notice, but is not enrolled in Medicaid or CHIP, can he or she appeal the Marketplace’s decision to end advance payments of the premium tax credit (APTC) and income-based cost-sharing reductions (CSRs)?|
|Answer:||A consumer can appeal the Marketplace’s decision about his or her eligibility for health coverage, including eligibility for APTC and CSRs, within 90 days from the date of the notice. A consumer may appoint an Authorized Representative to help with his or her appeal, or may participate on his or her own. If a consumer requests an appeal, he or she may be able to maintain eligibility for coverage while the appeal is pending. Note that the outcome of an appeal could change the eligibility of other household members on the consumer’s Marketplace account, even if they do not ask for an appeal. Information regarding a consumer’s right to appeal and instructions on how to do so are included in the final notice.|
|Question:||When were failure to reconcile (FTR) notices sent to consumers?|
|Answer:||FTR warning notices were sent in May 2016 letting affected consumers and members of their households know they were at risk of losing advance payments of the premium tax credit (APTC) because Internal Revenue Service (IRS) records indicated they did not have a 2014 federal income tax return on file.|
|Question:||Does simply filing a 2014 federal income tax return automatically count as reconciling advance payments of the premium tax credit (APTC)?|
|Answer:||Tax filers must file their tax return with the Internal Revenue Service (IRS) Form 8962 to reconcile APTC.|
On Exchange healthplan?- did you get Premium Tax Credit and cost sharing reduction payments in 2016?
CMS is re-determining subsidy eligibility for all on-exchange members again this year.
The Marketplace will use the newest income data available to re-determine advance payments of the premium tax credit (APTC) and cost-sharing reductions (CSR). This applies to enrollees who do not return to the Marketplace to update their application information and select a plan by December 15, 2016.
Also in October, CMS will send a Marketplace Open Enrollment Notice (MOEN) to all on-Exchange members.
This notice will contain certain basic information, including: a description of the annual redetermination and renewal process; the requirement to report changes affecting eligibility and the ways for reporting such changes; and the last day members can choose a plan for coverage starting January 1. For enrollees who authorized the Marketplace to request updated tax return information for use in the annual redetermination process and who are receiving APTC or income-based CSRs, this notice will have information on the process the FFM will use to establish APTC and CSR eligibility for 2017 for enrollees who do not actively reenroll.
Again this year, consumers who received subsidies in 2016 but did not file a 2015 federal tax return with Form 8962 to reconcile their APTC will be placed into a federal tax return (FTR) group. This could result in a loss of APTC and CSR eligibility. These consumers will receive a special version of the MOEN from CMS in October indicating that they are at risk for losing APTC in 2017. During Open Enrollment, this group will need to actively renew and include their latest income information or their APTC will be set to $0 for 2017.