Insurance News

  • EEOC Issues Opinion Letter on ICHRAs and the ADEA January 14, 2021
    A Jan. 7, 2021 opinion letter from the U.S. Equal Employment Opportunity Commission (EEOC) addresses employer contributions to Individual Coverage Health Reimbursement Arrangements (ICHRAs) and compliance with the Age Discrimination in Employment Act of 1967 (ADEA).
  • Proposed Rules Would Amend Wellness Program Incentive Rules January 12, 2021
    On Jan. 7, 2021, the Equal Employment Opportunity Commission issued two proposed rules on wellness programs under the Americans with Disabilities Act and the Genetic Information Non-Discrimination Act.
  • HHS Issues Proposed Changes to the HIPAA Privacy Rule January 12, 2021
    The Department of Health and Human Services (HHS) issued a proposed rule that would make certain changes to the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule.
  • Massachusetts Issues Emergency PFML Regulations January 11, 2021
    The Massachusetts Department of Family and Medical Leave (DFML) has issued emergency regulations for the paid family and medical leave (PFML) program. The emergency regulations add personal care attendants and family care providers to the program’s definition of “covered individual.”
  • DOL Issues New Q&As About FFCRA Leave Requirements January 6, 2021
    The U.S. Dept. of Labor (DOL) has issued two additional Q&As about employee leave under the Families First Coronavirus Response Act.
  • CO Employers Must Provide 80 Hours’ Emergency Leave on Jan. 1 December 30, 2020
    On Jan. 1, 2021, Colorado employers will have to provide workers with up to 80 hours of paid public health emergency leave under the state’s Healthy Families and Workplaces Act, passed in July 2020. The requirement was clarified in guidance and temporary emergency rules issued by the state’s Department of Labor and Employment on Dec. 23, 2020.
  • DOL to Accept Telemedicine as In-person Visit for FMLA Purposes December 30, 2020
    New Directive Aligns Enforcement Practices with COVID 19 Guidance On Dec. 29, 2020, the U.S. Department of Labor (DOL) published Field Assistance Bulletin 2020 8 to provide enforcement guidance regarding the use of telemedicine when establishing a serious health condition
  • DOL Issues Guidance on Electronic Posting of Certain Labor Law Notices December 30, 2020
    On Dec. 29, 2020, the U.S. Department of Labor (DOL) issued Field Assistance Bulletin 2020-7, which addresses when the DOL will consider electronic posting by employers (by email, or an internet or intranet website) sufficient to provide employees with required notice of their statutory rights under a variety of federal labor laws.
  • IRS Announces 2021 Standard Mileage Rates December 28, 2020
    On Dec. 22, 2020, the Internal Revenue Service (IRS) issued the 2021 optional standard mileage rates, which are used to calculate the deductible costs of operating an automobile for business, charitable, medical or moving purposes.
  • Stimulus Bill With Temporary Special Rules for FSAs Signed Into Law December 28, 2020
    On Dec. 27, 2020, President Trump signed the Consolidated Appropriations Act of 2021 into law. The Act provides temporary special rules for health and dependent care flexible spending accounts (FSAs) that give employees additional time to use these funds.

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.