Insurance News

  • DOL Releases Updated Model Employer CHIP Notice August 7, 2018
    The U.S. Department of Labor (DOL) has updated its model notice for employers to provide information on eligibility for premium assistance under Medicaid or the Children's Health Insurance Program (CHIP). This notice is generally updated twice a year.
  • New Expiration Date for Certain Model FMLA Notices is Aug. 31 August 2, 2018
    The U.S. Department of Labor's Wage and Hour Division (WHD) has extended the effective date for some of its model FMLA notices through August 31, 2018.
  • Protect Your Business Against Spear-Phishing Emails July 26, 2018
    Cyberattacks and resulting data breaches often begin with a spear-phishing email. Spear phishing differs from regular email phishing in its use of extensive research to target a specific audience, which allows the spear phisher to pose as a familiar and trusted entity in its email to a mark. Read this newsfeed update to learn tops to protect your business ag […]
  • South Carolina Updates Employment Discrimination Poster July 24, 2018
    South Carolina has updated its employment discrimination poster to include required language regarding pregnancy accommodations.
  • Delaware Adjusts Minimum Wage Increase Effective Date July 19, 2018
    Delaware has adjusted its minimum wage increase to $8.75 per hour to take effect on January 1, 2019.
  • Summary Annual Reports Due Sept. 30 July 18, 2018
    Health plans with 100 or more plan participants at the beginning of a plan year are generally required to furnish a Summary Annual Report (SAR) to each health plan participant within 9 months after the end of a plan year. As a result, the deadline for most calendar year plans to satisfy the SAR requirement for plan year 2017 is September 30, 2018.
  • Delaware Raises Minimum Wage July 16, 2018
    Under a new law, Delaware’s minimum wage will increase to:
  • Oklahoma Passes Medical Marijuana Law July 12, 2018
    Effective July 26, 2018, Oklahoma law will generally prohibit employers from discriminating against a medical marijuana patient in hiring, termination, or any term or condition of employment.
  • Court Strikes Down Parts of CA Immigration Law July 11, 2018
    As a result of a recent federal district court ruling, California employers are no longer prohibited from:
  • New Expiration Date for Certain FMLA Notices is July 31, 2018 July 9, 2018
    The U.S. Department of Labor's Wage and Hour Division (WHD) has extended the effective date of several model FMLA notices through July 31, 2018.

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In 2014 it’s the law that with few exceptions everyone must maintain insurance that meets minimum essential coverage. While for the most part insurance rates have not come down the good news is there are significant subsidies available that both help with paying for coverage and for helping to meet up front and out of pocket expenses.

Who is eligible for the premium tax credit?
An individual is eligible for the premium tax credit if he or she meets all of the following requirements:

  • Purchases coverage through the Marketplace.
  • Has household income that falls within a certain range.
  • Is not able to get affordable coverage through an eligible employer plan that provides minimum value.
  • Is not eligible for coverage through a government program, like Medicaid, Medicare, CHIP or TRICARE.
  • Files a joint return, if married.
  • Cannot be claimed as a dependent by another person.

Glandon Insurance has their FFM Certification and can help you purchase coverage through the exchange.

To find out if you may be eligible to receive either premium or cost sharing subsidies: Subsidy Calculator

 

Who is subject to the individual shared responsibility provision?
The provision applies to individuals of all ages, including children. The adult or married couple who can claim a child or another individual as a dependent for federal income tax purposes is responsible for making the payment if the dependent does not have coverage or an exemption.

When does the individual shared responsibility provision go into effect?
The provision is effective as of January 1, 2014 and applies to each month in the calendar year.

In order to provide transition relief during the first year the penalty tax applies to individuals, an employee (or an individual having a relationship to the employee) who is eligible to enroll in a non-calendar year eligible employer-sponsored plan with a plan year beginning in 2013 and ending in 2014 will not be liable for the penalty tax for certain months in 2014. The transition relief begins in January 2014 and continues through the month in which the 2013–2014 plan year ends.

What counts as minimum essential coverage?
Minimum essential coverage includes employer-sponsored coverage (including self-insured plans, COBRA coverage and retiree coverage), coverage purchased in the individual market, Medicare Part A coverage and Medicare Advantage, Children’s Health Insurance Program (CHIP) coverage, and certain other types of coverage.

Calculating the Payment
The penalty in 2014 is calculated one of 2 ways. In general, individuals will pay whichever of the following amounts is higher:

  • 1% of the individual’s yearly household income above his or her applicable filing threshold (the amount of gross income that triggers the requirement to file a federal income tax return). The maximum penalty is the national average yearly premium for a bronze plan.
  • $95 per person for the year ($47.50 per child under 18). The maximum penalty per family using this method is $285.

The fee increases every year. In 2015, it increases to 2% of income or $325 per person. In 2016 and later years, the fee is 2.5% of income or $695 per person. After that it is adjusted for inflation.

If an individual is uninsured for just part of the year, 1/12 of the yearly penalty applies to each month the individual is uninsured. (If an individual is uninsured for less than 3 months, the individual does not have to make a payment.)