2014 Obamacare Enrollment Stats Inflated with Dental Numbers

What the Republicans in Congress quickly dubbed “Obamacare obfuscation,” Health and Human Services (HHS) Secretary Sylvia Mathew Burwell called merely “a mistake.”

Whatever you call it, the HHS-released figured of 7.1 million Obamacare enrollees in 2014 included 400,000 standalone dental plan enrollees, so the official figure for health care enrollment has been corrected to 6.7 million.

“This mistake was unacceptable,” Burwell said. “I will be communicating that clearly throughout the department. While we understand some will be skeptical, our clarity that this is [a] mistake and the fact that we have quickly corrected the numbers should give people confidence. It is important to continue to focus on the fact that millions of Americans are getting affordable health care.”


With the Obamacare Marketplaces now operating for the 2015 Open Enrollment period, it’s a good time to post Personnel Concepts’ All-On-One ACA Information Center Poster to keep your employees up to date.


NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
GoTo top Top

HHS Mostly Mum About Open Enrollment Results

Since reporting that 500,000 logged onto HealthCare.gov and 100,000 submitted applications on Saturday, the Department of Health and Human Services (HHS) has remained silent on the results of Obamacare sign-ups, even refusing to answer media requests from the Washington Post and others.

The Post‘s Erik Wemple, writing about his attempt to elicit an answer from HHS, noted that Massachusetts’s health care website displays a dashboard with daily results on it and then asked, “Why can’t the feds act more like these states?”


For the full story on how the Affordable Care Act (ACA, or Obamacare) affects your business, no matter how large or small, please obtain a copy of our comprehensive and easy-to-follow Affordable Care Act Compliance Kit.


NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
GoTo top Top

Audit Faults DOL’s Data Security

An audit by KPMG found security vulnerabilities in the IT systems at the Department of Labor (DOL), threatening the agency’s financial and support systems and increasing the risk that “current employees, separated employees, and/or contractors may obtain unauthorized or inappropriate access to financial systems and/or data.”

“Vulnerabilities that are not remedied in a timely manner may result in information leaks or system threats,” the audit said. “Collectively, the aforementioned IT control deficiencies pose a significant risk to the integrity of DOL’s  data, which could ultimately impact its ability to accurately and timely perform its financial reporting duties.”


NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
GoTo top Top

Health Plan Head Count Delayed Until Dec. 5

The Center for Consumer Information and Insurance Oversight (CCIIO) has extended its health plan enrollee report deadline until 11:59 p.m., Dec. 5.

Originally due by Nov. 15, the report requires employers and insurers to indicate how many health insurance enrollees they have. They then have to pay a reinsurance fee of $63 per enrollee as part of a pool to help cover catastrophic claims (because insurers can no longer refuse coverage to anyone, no matter how sick).

Of the sum, $52.50 has to be paid by Jan. 15, 2015, with the remaining $10.50 due by Nov. 15, or the whole sum can be paid by Jan. 15. The payment deadlines have not been changed, even though the report deadline has, CCIIO officials confirmed.

Both the report and the reinsurance fee came about as part of the Affordable Care Act (ACA).

For the full story on how the Affordable Care Act (ACA, or Obamacare) affects your business, no matter how large or small, please obtain a copy of our comprehensive but easy-to-follow Affordable Care Act Compliance Kit.


NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
GoTo top Top

OFCCP to Send Out 2,500 Advance Audit Notifications

The Office of Federal Contract Compliance Programs (OFCCP) is sending out 2,500 Courtesy Scheduling Announcement Letters (CSALs) nationwide to notify employers that they are being slated for audits.

Once a company receives one of these letters, it must submit detailed pay data for each of its employees. The company must also submit a copy of its Affirmative Action Program (AAP) and its Section 503 and Section 4212 AAPs. The CSAL urges the recipient to “submit your information in an electronic format to reduce the amount of time it takes to complete our evaluation.”

The data and document submission is used to complete what OFCCP calls a “desk audit.” Desk audits are generally followed by an “on-site review” and then by an “off-site analysis.”


NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
GoTo top Top

Obamacare Open Enrollment Starts Tomorrow

Marred by glitches in its inaugural year, HealthCare.gov will begin accepting enrollments for 2015 beginning tomorow, Nov. 15, and ending Feb. 15, 2015.

Health and Human Services Secretary Sylvia Mathew Burwell promises a much smoother operation this time as the site has undergone extensive testing and changes and the call center staff has been beefed up.

Burwell also says site security is improved: “We’ve tested and retested our systems, putting ourselves through some of the industry’s most stringent protocols to ensure we’re taking the steps necessary to safeguard consumers’ personal information.”

At question is whether the bugs found in the recently relaunched SHOP (Small Business Health Insurance Option Program) section on the site will function fully. When five states were given an early test run this month, numerous glitches were found.

For the full story on how the Affordable Care Act (ACA, or Obamacare) affects your business, no matter how large or small, please obtain a copy of our comprehensive and easy-to-follow Affordable Care Act Compliance Kit.


NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
GoTo top Top

Some ‘Skinny’ Health Plans Get a Stay of Execution

What are referred to as “minimum value” or “skinny” health plans have been ordered to include physician services and hospitalization by way of a new regulation, but the issuing federal agencies have now given a reprieve to certain plans already in effect.

By way of background, the Affordable Care Act (ACA) mandated that all health insurance plans include “essential services” but never listed which services were mandatory, so some insurers and plan administrators devised health plans without hospitalization or physician services by using a Minimum Value (MV) Calculator created by the Department of Health and Human Services (HHS).

(Basically, so long as these “skinny” plans paid 60 percent of all services they offered, the MV Calculator would pass them.)

Minimum value plans that relied on the MV Calculator and were subject either to a written binding employer agreement or actual enrollment of employees prior to Nov. 4, 2014 (when the new regulation was issued) will be allowed to keep operating through their 2015 plan year. However, once the year is up, the new plans must conform to the requirements for physician and hospitalization services.

Sound complicated? Get our Affordable Care Act Compliance Kit to understand the details and nuances of the ACA.


NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
GoTo top Top

HHS Clarifies When and How Patient Information Can Be Shared

The Department of Health and Human Services (HHS) and its Office for Civil Rights (OCR) have issued a bulletin in “light of the Ebola outbreak and other events” to clarify “the ways in which patient information may be shared under the HIPAA Privacy Rule in an emergency situation.”

The bulletin notes that the HIPAA Privacy Rule is balanced so that, when necessary, protected health information (PHI) can be shared or disclosed to help treat a patient, to protect the nation’s public health and “for other critical purposes.”

For instance, a patient’s PHI may be disclosed without that person’s authorization if it’s needed to treat that patient or to treat a different patient. PHI can also be shared with public health authorities at the federal, state or local level to help them “carry out their public health mission.”

For further details and examples, please read “HIPAA Privacy in Emergency Situations.”

For further understanding of HIPAA and its rules, please visit the HIPAA & COBRA Compliance section on our website.


NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
GoTo top Top

CBO, HHS Disagree on Obamacare Enrollments in 2014 and Beyond

The Congressional Budget Office (CBO) expects health care sign-ups in the state and federal exchanges during the open enrollment period starting Nov. 15 to total about 13 million people, but Health and Human Services (HHS) officials said Monday they expect only 9 to 10 million to sign up, including 6 million or so who renew.

The CBO anticipates a steady climb in enrollments during the first three years, topping off at about 25 million people. HHS officials say the process will take longer, maybe even five years or more.

Noting that open enrollment this year lasts just three months and not six as it did in the inaugural year, HHS Secretary Sylvia Mathew Burwell said, “We do have a shorter period of time and we are moving to a group of folks who may be harder to reach.”

There are currently about 7 million Americans enrolled in Obamacare policies.


NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
GoTo top Top

Supreme Court to Review Legality of ACA Health Care Subsidies

With just a few days to go before the start of the second open enrollment period under the Affordable Care Act (ACA), the Supreme Court has agreed to hear both sides in the King v. Burwell lawsuit, which aims to strike down health care subsidies in the 36 states that chose not to establish insurance exchanges.

At question is language in the original reform bill that says tax credits would be available for qualifying residents in states that operated their own exchange, or health insurance marketplace. Despite the plain language, the Internal Revenue Service (IRS) issued guidelines saying that tsuch subsidies are available across the board, both in states with their own exchanges and in states where the federal government operates the marketplace (HealthCare.gov).

The U.S. Court of Appeals for the Fourth Circuit sided with the IRS, but the high court has agreed to settle the issue. To do so means that at least four justices agreed to review the case, which further means that at least four justices don’t agree with the IRS’s ruling. There would be no reason for a review if the four (or more) justices agreed with the Fourth Circuit’s decision.

Most major Supreme Court decisions are not released until the end of the session, generally in late June, so expect a ruling next summer.


NOTE: The details in this blog are provided for informational purposes only. All answers are general in nature and do not constitute legal advice. If legal advice or other expert assistance is required, the services of a competent professional should be sought. The author specifically disclaims any and all liability arising directly or indirectly from the reliance on or use of this blog.
GoTo top Top