Insurance News

  • NY Federal Court Partly Strikes Down FFCRA Leave Regulations August 4, 2020
    In a case brought by the New York attorney general, the U.S. District Court for the Southern District of New York has vacated portions of regulations issued by the U.S. Department of Labor under the Families First Coronavirus Response Act.
  • Virginia Adopts Safety and Health Standard for COVID-19 August 3, 2020
    The New Emergency Temporary Standard Requires Job Risk Assessments, Employee Training and Customized Control and Prevention Measures Virginia has adopted an occupational safety and health standard to protect employees within the state from COVID 19. This Emergency Temporary Standard (ETS)
  • Massachusetts Finalizes Amendments to PFML Regulations August 3, 2020
    On July 24, 2020, the Massachusetts Department of Paid Family and Medical Leave published final amendments to regulations issued under the state’s Paid Family and Medical Leave program.
  • Remote Verification of Form I-9 Documents Extended to Aug. 19 July 28, 2020
    According to the DHS This Will Be the Final Extension The U.S. Department of Homeland Security (DHS) has announced that the exemption for the physical inspection of Form I 9 documents has been extended to Aug. 19, 2020. 
  • NLRB Changes Rules for Abusive or Offensive Conduct By Employees July 22, 2020
    On July 21, 2020, the National Labor Relations Board issued a decision that eases the way for employers to discipline or discharge an employee based on abusive or offensive conduct—such as racist or profane remarks—committed while the employee was also engaged in activities that are protected under the National Labor Relations Act.
  • DOL Publishes More Q&As on Employment Laws and Coronavirus July 20, 2020
    On July 20, 2020, the U.S. Department of Labor (DOL) announced the agency’s publication of additional questions and answers about the operation of the federal Family and Medical Leave Act (FMLA), the Fair Labor Standards Act (FLSA) and the Families First Coronavirus Response Act (FFCRA) in workplace situations involving COVID-19.
  • DOL Revises FMLA Forms, Seeks Input on Regulations July 17, 2020
    The U.S. Department of Labor has issued a Request for Information about federal Family and Medical Leave Act (FMLA) regulations. The agency has also revised its FMLA notice and certification forms.
  • DOL Issues RFI on Paid Family and Medical Leave July 15, 2020
    In a Request for Information (RFI) issued July 15, 2020, the U.S. Department of Labor (DOL) announced it is seeking information about the effectiveness of current state- and employer-provided paid leave programs, and how access (or lack of access) to these programs impacts workers and their families.
  • Proposed Rule Would Allow Changes to Certain Grandfathered Plans July 10, 2020
    On July 10, 2020, the Departments of Labor (DOL), Health and Human Services (HHS) and the Treasury issued a proposed rule that would allow grandfathered group health plans to make certain changes to cost-sharing requirements without losing grandfather status.
  • IRS: W-2 Reporting Required for FFCRA Leave Pay July 9, 2020
    Employers are required to report sick and family leave wages paid to employees under the Families First Coronavirus Response Act (FFCRA) on Form W-2, according to guidance from the IRS and the U.S. Treasury Department.

INDIVIDUAL INSURANCE FAQ’s

Is a qualifying event required to enroll on an individual plan outside of open enrollment? Yes, individuals cannot enroll outside of open enrollment without a qualifying event. Proof of the qualifying event is required with the application; the applicant cannot be enrolled without this.

How do I know if my client has a qualifying event? Here are some common examples of qualifying events. This is not an all-inclusive list so please refer to healthcare.gov for more information.

  • Marriage
  • Having a baby
  • Losing job-based coverage for any reason, including resigning, getting laid off, or getting fired
  • Expiration of COBRA coverage
  • Losing coverage under your parents’ plan at age 26
  • Getting divorced or legally separated (resulting in loss of coverage)
  • Losing eligibility for Medicaid or the Children’s Health Insurance Program (CHIP)
  • Permanently moving outside your plan’s coverage area

How long does my client have to apply after their qualifying event? Typically, up to 60 days after the event. If the client does not apply within the 60-day time frame they may have to wait until the next open enrollment period to get coverage.

How is an on-exchange individual policy canceled? On-exchange policies must be canceled directly with healthcare.gov, either over the phone or online. Off-exchange policies are canceled directly with the carrier.

Do I have to be certified to sell on-exchange plans? Yes! In order to sell on-exchange plans, brokers must certify annually via CMS. If you are not certified you cannot sell or receive a commission for on-exchange plans. You must re-certify each year.