Health Alliance Offers New Self-Funded Options for Groups of 25 to 125

As of November 1, we will offer self-funded plans to groups with 25 to 125 total employees. We will rate groups without 3 years of experience based on member medical applications.

To help your new clients, please use the current small group application available on the Your Health Alliance for brokers. We are developing a shorter member application and will provide this once we finalize it.

The Standard Plan designs we developed will feature several specific deductible options, as well as December 12 and December 15 contract options.

Contact your client consultant for a detailed fact sheet on these new offerings.

Individual Penalties Align with Open Enrollment Period

Individuals who enroll in a qualified plan in the final weeks of the Open Enrollment Period (October 1, 2013 to March 31, 2014) can file a hardship exemption from the shared responsibility payment without asking for an exemption from the marketplace.

Before this ruling from the Department of Health and Human Services (HHS), if an individual enrolled in a qualified plan on, for example, March 30, 2014, they would exceed the 3-month maximum for not having minimum essential coverage, which would result in a penalty. Now, this individual is in the clear and will not be hit with a fine on his or her federal income tax return in 2015.

HHS Issued This on October 28, 2013:

HHS (Department of Health and Human Service) recognizes that the duration of the initial open enrollment period implies that individuals have until the end of the initial open enrollment period to enroll in coverage through the new marketplaces while avoiding liability for the shared responsibility payment.

HHS has determined that it would be unfair to require individuals in this situation to make a payment. Accordingly, HHS is exercising its authority to establish an additional hardship exemption in order to provide relief for individuals in this situation

See the full Q & A for this.