Insurance News

  • Virginia Legalizes Marijuana and Expands Employer Restrictions February 23, 2021
    The New Law Affects Background Checks for Job Applicants On Feb. 5, 2021, Virginia passed a new law (House Bill 2312) that legalizes recreational marijuana for adults ages 21 and older in the state. The new law also expands an
  • DOL Proposes New Effective Date for Independent Contractor Rule February 23, 2021
    The Delay Would Allow the Biden Administration Time to Evaluate the Rule Before It Becomes Effective On Friday, Feb. 5, 2021, the U.S. Department of Labor’s (DOL) Wage and Hour Division (WHD) proposed delaying the effective date for the Independent
  • CDC Provides Guidance on Consent and Disclosures for Workplace COVID-19 Testing February 23, 2021
    Informed Consent Requires Disclosure, Understanding and Free Choice The Centers for Disease Control and Prevention (CDC) has issued guidance on the elements of consent and disclosures necessary to support employee decision making when employers incorporate workplace COVID 19 testing.
  • Outbreak Period Expiration Approaching February 22, 2021
    Last year, federal agencies issued relief postponing various employee benefit plan deadlines during a defined “Outbreak Period” to help plans, participants and service providers impacted by the COVID-19 pandemic.
  • 9th Cir.: FMLA Leave Includes “Off” Time in Rotating Schedules February 19, 2021
    An employee working a “one week on, one week off” schedule who takes 12 workweeks of continuous federal Family and Medical Leave Act (FMLA) leave may be required to return to work 12 weeks later, a federal appeals court has held.
  • Additional COVID-19 Relief and Clarifying Guidance for Cafeteria Plans February 18, 2021
    On Feb. 18, 2021, the IRS released Notice 2021-15, which provides additional mid-year election change relief for Section 125 cafeteria plans for plan years ending in 2021.
  • Employers May Have to Provide Paid Military Leave, Court Says February 17, 2021
    Employees who take off work for military duty may be entitled to paid leave from their employers, according to a Feb. 3, 2021, federal appeals court decision.
  • DOL Issues Updated Model Employer CHIP Notice February 9, 2021
    The Department of Labor (DOL) has released a new model Employer CHIP Notice with information current as of Jan. 31, 2021.
  • New York Issues New Guidance on COVID-19 Leave February 3, 2021
    Employers who prohibit employees not in quarantine or isolation from coming to work for COVID-19 exposure reasons must pay them their regular rate, according to new guidance issued by the New York Department of Labor. The Jan. 20, 2021, guidance also states that employees may take leave for three periods of quarantine or isolation, among other points.
  • IRS Updates FAQs on Employer Tax Credits for FFCRA Leave February 2, 2021
    On Jan. 29, 2021, the IRS updated its frequently asked questions on tax credits available to employers for providing paid employee leave under the Families First Coronavirus Response Act.

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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.)