Filed under: Combs & Company, Health Insurance, Insurance 101 | Tags: Combs & Company Vlog, Contributory, Insurance 101, Noncontributory
Check out our quick video on what contributory means!
More videos where this came from… Check out the Combs & Co YouTube channel for more!
Filed under: Combs & Company, Health Insurance, Insurance 101, Uncategorized | Tags: Covered Medical Expenses, Insurance 101
Check out our quick video on what are covered medical expenses!
More videos where this came from… Check out the Combs & Co YouTube channel for more!
Filed under: Health Insurance, Insurance 101 | Tags: Combs & Company Vlog, Conversion, Insuance 101
Check out our quick video on What a Conversion is!
More videos where this came from… Check out the Combs & Co YouTube channel for more!
Filed under: Combs & Company, Health Insurance, Insurance 101 | Tags: Combs & Company, Insurance 101, Major Medical
Check out our quick video on What Comprehensive Major Medical is!
More videos where this came from… Check out the Combs & Co YouTube channel for more!
Filed under: Combs & Company, Combs & Company Blog, Health Insurance, Vlog
Check out our quick video on What Benefits Are!
More videos where this came from… Check out the Combs & Co YouTube channel for more!
Filed under: Co-Ops, Combs & Company, Combs & Company Blog, Health Insurance, Innovative Broker Lab, Susan L Combs | Tags: Combs & Company, Farewll to the Co-Ops, Innovative Broker Lab, Susan L Combs
Talk about a cluster! If you are in Arizona, Colorado, Iowa, Kentucky, Louisiana, Michigan, Nebraska, New York, Nevada, Oregon, Tennessee or (insert state that has probably been added in the past hour) I am feeling your pain over the co-op shutdown.
In New York, we were under the impression we had until 1/1 to secure coverage for our clients, only to get an email around 4pm on Friday, October 30th that Health Republic of New York was being shut down as of 11/30 by the state of New York. As if it wasn’t busy enough during open enrollment! To add insult to injury, guess who hasn’t been paid by the co-ops since September? How we all love to work for free! Click here to continue reading.
Filed under: Best Rising Star, Exciting News, Health Insurance, Motivational, National Underwriter Industry Elite Awards, Susan L Combs | Tags: Best Rising Star, National Underwriter Industry Elite Awards, Susan L Combs
This year’s nominations for the National Underwriter Industry Elite Awards were stronger than ever, a who’s who of the best and brightest in the realms of market innovation, industry awareness, community outreach and young talent. Our winners and honorable mentions this year stand out for their leadership, drive and brilliance that only the Industry Elites can offer. It was an especially difficult selection process as each and every entry stood with great merit. But alas, only one can be chosen. With that, we present to you the 2014 National Underwriter Industry Elite Awards.
To read the full write up on the award, click here!
Filed under: Affordable Care Act, Health Insurance, HR, Obamacare, PPACA, Reform | Tags: ACA Auditing Services, Insurance Consulting
Since the start of 2014 we’ve been approached by CPAs, attorneys, and other trusted advisors to assist them with Affordable Care Act (ACA) audits, to determine if their clients will be subject to the “Pay or Play” provision come 2015, and then in 2016 if they have more than 50 Full-Time Equivalent (FTE) employees. I wanted to take this opportunity to introduce our ACA auditing services to you.
Currently I’m one of seven brokers in the New York Metro area with a Patient Protection & Affordable Care Act (PPACA) certification through the National Association of Health Underwriters (NAHU). The certification is key, as I’m trained on all the variables within the ACA law and how it impacts companies of various sizes; plus the continuing education keeps me fully informed as Washington adjusts different provisions of the law.
For 2015, companies that have more than 100 FTE employees will be required to offer health coverage to all employees or they will be subject to a fine. That coverage must include the 10 Essential Benefits, or the company will be subject to a different fine. Combs & Company will perform the ACA audit and produce a report that highlights all provisions with which a company must comply (and the consequences if they don’t). We’ll also devise a look-back measurement the company should use to minimize any potential penalties. We’ll also review any Common Ownership issues, as these are often overlooked areas that can impact companies.
This is not a pitch to replace a company’s current broker. We’re offering this service to support a company’s current setup and because we know the level of expertise we bring to the table is not yet common in the industry. (Nor do most brokers want to assume the liability.) We will work with your client’s current broker to gather as much information as possible and then incorporate them into the audit process.
Our service is offered at a rate of $250/hour. The length of each audit depends on the complexity of your client’s business and health plans. We also have an in-house ERISA Attorney who can provide additional services for a flat fee, should any compliance issues come to light during the ACA audit.
If you’re interested in finding out more or having your client schedule a planning meeting with us, feel free to reach out!
Filed under: Affordable Care Act, Health Insurance, Important Notice, National Healthcare, Obamacare, PPACA, Reform
You’d be amazed at how many phone calls and emails we have been getting about signing up for the exchange after the deadline. Unfortunately….people that have waited are not special. Everyone had an Open Enrollment Period began October 1st and officially ended in the state of NY as of March 31st, that was 6 months….no one can say they didn’t have enough time but still so many people chose to bury their head in the sand. So if you are one of these people that didn’t sign up what does this actually mean to you:
- If you had started an enrollment on the New York State of Health Exchange Marketplace (https://nystateofhealth.ny.gov/) you have until April 15th to get your act together and get your application completed.
- If you haven’t started an application yet and you are CURRENTLY UNINSURED, then you are out of luck with Exchange and other Private options until the next Open Enrollment which is set to begin on 11/15/14 for an enrollment of January 1st, 2015. Sorry, no one’s special here.
- If you are CURRENTLY INSURED you will be able to take coverage with the Exchange or other private insurance for effective dates after 4/1 as long as you can prove that you have had a Qualifying Life Event. These are listed below:
- Individual or dependent loses minimum essential coverage due to:
- job loss
- divorce
- death of a spouse
- becoming ineligible for Medicaid or Child Health Plus
- expiration of COBRA
- health plan is decertified
- Marriage, birth, adoption, or placement for adoption
- Gaining status as a citizen, national, or lawfully present individual
- Consumer is newly eligible or ineligible for tax credits and/or cost sharing reductions
- Permanent move to an area that has different health plan options
- Marketplace staff or contractor enrollment error
- Qualified Health Plan violated a provision of its contract
- American Indians can enroll or change plans one time per month throughout the year
- Individual or dependent loses minimum essential coverage due to:
Not considered a Qualifying Life Event:
- Voluntarily dropping other health coverage
- Being terminated for not paying your premiums
- Losing coverage that is not minimum essential coverage, in accordance with HHS guidelines
Moral of the story: Be more proactive next year!!!
Filed under: Affordable Care Act, Exciting News, Health Insurance, HR, Important Notice, National Healthcare, Obamacare, PPACA, Reform
A question that comes up time and time again with the Affordable Care Act is: “How does the Individual Responsibility (aka Mandate) Penalty work?”
To avoid the penalty you must enroll in a marketplace plan OR have private coverage no later than March 31st, 2014. If you do not, below are a breakdown of the penalties you will face.
- 2014: Greater of $95 per adult and $47.50 per child under age 18 or 1% of household income
- 2015: Greater of $325 per adult and $162.50 per child under age 18 or 2%
- 2016: Greater of $695 per adult and $347.50 per child under age 18 or 2.5% of taxable gross income capped at the average bronze-level insurance premium (60% actuarial) rate for the person’s family.
**The total family penalty is capped at 300% of any annual flat dollar amount for those 18 and over.
**If the penalty applies for less than a full calendar year, the penalty will be 1/12 of the annual amount per month without coverage.
Example:
Let’s look at the O’Brien family of 4 that has 2 children under the age of 18 and the family household income is $100,000 per year.
Just to make the example easier, we are giving everyone names….Meet the O’Brien Family: Mom – Samantha; Father – Mark; Son – Luke; Daughter – Sarah
Upfront we know that the Max Penalty the O’Brien’s’ can be given is: $570 (this is figured by a $95 penalty each for Samantha & Mark since they are the only ones over 18 x 300%), now let’s look at the breakdown if they would hit the Max Penalty….
Remember, it is the GREATER of the below up to the Max Penalty:
Flat dollar amount penalty calculation : $95 (Samantha) + $95 (Mark) + $47.50 (Luke) + $47.50 (Sarah) = $285
Percentage amount penalty calculation: 1% of $100,000 = $1000
Results: Since the Max Penalty the O’Brien family can be given in this example is $570, this will be the penalty they will be responsible for, since the 1% of household income exceeds this amount. This amount will be tacked on when Samantha and Mark’s taxes are calculated at the end of the year, so if they were planning on a nice refund this year, that will be deducted from that refund. Keep in mind that if the O’Brien’s do not pay taxes, as of now, there is no mechanism to collect this penalty.
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