Insurance News

  • HHS Increases Civil Penalties for HIPAA Violations January 21, 2020
    Privacy and Security Rule Violations Impacted by Rule On Jan. 17, 2020, the Department of Health and Human Services (HHS) published a final rule increasing the civil monetary penalties for violations of the HIPAA Privacy and Security Rules. HHS is
  • DOL Increases Penalties for Group Health Plan Violations January 15, 2020
    2020 DOL Penalty Amounts for ERISA Violations Issued The U.S. Department of Labor (DOL) has increased the penalties employers face under ERISA for group health plan reporting and disclosure failures. These new amounts apply to penalties assessed after Jan. 15,
  • DOL Adopts New Joint Employer Determination Test January 14, 2020
    On Jan. 12, 2020, the U.S. Department of Labor (DOL) announced a new four factor balancing test to determine whether two or more organizations should be considered “joint employers” under the Fair Labor Standards Act (FLSA). The final rule establishing
  • DOL Publishes Guidance on Lump Sum Bonuses and Per-Project Payments January 10, 2020
    Opinion Letters Provide an Insight on How the DOL applies the Law to Specific Facts On Jan. 7, 2020 the U.S. Department of Labor (DOL) issued two opinion letters that clarify how the Fair Labor Standards Act (FLSA) applies in
  • New York Eliminates Tipped Employee Minimum Wage in Miscellaneous Industries January 10, 2020
    New Rate will Phase in Beginning June 30 On Dec. 31, 2019, New York amended its wage order for miscellaneous industries to eliminate the subminimum wage for tipped employees. Please note that the current tipped employee minimum wage rates still
  • Temporary Injunction on California AB 5 for Trucking Industry January 7, 2020
    Temporary Injunction Applies Only to the Trucking Industry A district court in San Diego has issued a temporary injunction to prevent enforcement of California’s recent AB 5 law for the trucking industry. This injunction does not affect other industries and
  • IRS Announces 2020 Standard Mileage Rates December 31, 2019
    On Dec. 31. 2019, the Internal Revenue Service (IRS) issued the 2020 optional standard mileage rates, which are used to calculate the deductible costs of operating an automobile for business, charitable, medical or moving purposes.
  • Washington Increases Threshold for Overtime Exemptions December 17, 2019
    New Law Becomes Effective July 1, 2020 On Dec. 11, 2019, Washington amended its wage and hour laws to increase the salary threshold white collar employees must satisfy to qualify for the state’s overtime exemption. The amendments also update some
  • Pennsylvania Extends E-Verify Requirement to Construction Industry December 17, 2019
    New Law Takes Effect Oct. 7, 2020 A new law in Pennsylvania law will require employers in the construction industry to use the federal E Verify system to confirm the employment eligibility of new hires. E Verify is a federal
  • DOL Issues 2020 Form W-4 December 13, 2019
    Employers Must Begin Using the New Form Jan. 1 On Dec. 5, 2019, the Internal Revenue Service released an updated version of its W 4 form, also known as the “Employee’s Withholding Certificate.”  Employers use IRS

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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.)