President Trump’s Nominee for HHS Does Not Support Privatization of Medicare

Price was previously noted as supporting the privatization of Medicare, though he commented that his role as health secretary would prompt him to make decisions differently than when he was in his role as congressman.

The HHS nominee was also under scrutiny from Democratic Senator Ron Wyden for stock trading as a lawmaker, which included health industry stocks that could be affected by legislation. The Senator noted the stock trading as a “conflict of interest” and “an abuse of position.” Price maintains that his work with stock trading was ethical and completely transparent.

Click here for the full article.

Aetna’s Proposed Merger with Humana Prompts Concerns of Reducing Competition in the Marketplace

U.S. District Judge John Bates intercepted Aetna’s proposed acquisition of Humana, a deal the judge declared was “presumptively unlawful” in the private marketplace. The proposed $37 billion acquisition, which was focused on Medicare Advantage plans, a market in which Humana is particularly strong, was blocked because it was thought that it would lessen competition for Medicare Advantage plans in the marketplace. The judge declared the merger would not be in the best interest of the companies’ consumers, especially in other markets where the merger would have a large share of business.

Judge Bates commented, “The court is unpersuaded that the efficiencies generated by the merger will be sufficient to mitigate the anticompetitive effects for consumers in the challenged markets.”

This interception came just 6 months after a proposed merger between Anthem and Cigna was blocked by the Justice Department.

This is a developing story. Stay tuned for more information regarding the Aetna-Humana merger proposal.


Judge Blocks Aetna’s $37 Billion Deal for Humana, The New York Times

Judge Cites ‘Serious Concerns,’ Blocks Aetna’s $37B Merger with Humana, BenefitsPro

WEBINAR: What are Hospital Indemnity Plans and Why Should I Sell Them?

Retain clients and double your commissions with Hospital Indemnity Plans!

Join Cornerstone’s Individual Division and Senior Marketing for a webinar about hospital indemnity plans, how to sell them, and just how they’ll benefit your business! Learn different strategies for offering and communicating plan options to your clients and maximize your health coverage portfolio today.


Training Agenda:

  1. HIP Product Overview
  2. How to Sell HIP
  3. Quoting HIP — Demonstration
  4. HIP Value — Commission

Offer hospital indemnity plans as a single-packaged solution and find out how they can profit your business. Sign up today.

Date: Tuesday January 31, 2017
Time: 9:00 am–10:00 am
RSVP here.

Date: Thursday February 2, 2017
Time: 9:00 am–10:00 am
RSVP here.

Space is limited! RSVP today to secure your seat.

Open Enrollment is Ending: Important OEP and AEP Information for a Successful Enrollment Period

This message is intended for Agent use only.

Continuing Announcement: Please take a moment to review the following for a successful enrollment period:

  • Open enrollment comes to a close Tuesday January 31st. With that in mind, please submit any and all referrals that are seeking health care coverage for 2017 as soon as possible. Individuals with a QE (Qualifying Event) that makes them eligible for an SEP (Special Enrollment Period) do not have the same deadlines, but these referrals also need to be submitted as soon as possible to ensure eligibility and enrollment. Please be sure to designate the effective date coverage is to begin on all referrals so we can prioritize them appropriately.
  • To access information regarding the status of your clients in our referral process, please use our online broker portal. Attached you will find step-by-step instructions on how to access this information. Checking this information online instead of contacting us by phone or email will save valuable time during OEP.
  • When a referral is received, we contact that referred client directly. This ensures us to ensure that we have done our part in reviewing all the necessary information to assist the client in making an informed decision regarding their insurance needs.

If you have any questions about the information covered above or on any other topic please call (877) 432-8803 and select option 1. Thank you for your trusted referrals and we look forward to continuing this successful relationship in the future.

21st Century Cures Act

Nelson Culp, Director, Employee Benefits

On December 13, 2016, President Barack Obama signed into law the 21st Century Cures Act. This new law reverses a prohibition on small-employer funding of individual health insurance premiums. Effective January 1, 2017, small employers with fewer than 50 full-time employees will be able to offer employees a standalone health reimbursement account (HRA) without being subject to an excise tax. Prior to January 1, 2017, the Affordable Care Act (ACA) prohibited such an arrangement because it did not meet the ACA’s market reforms, and employers were subject to a tax of $100 per day for each affected participant. Under the new law, a small employer that does not offer a group health plan to its employees may offer their employees a health reimbursement arrangement, though it must be considered qualified. A Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) must meet the following conditions:

  1. The employer must be a small employer, not subject to the pay or play mandate (i.e. they must have fewer than 50 full-time employees and full-time employee equivalents) and the small employer must not offer a group health plan to its employees.
  2. This arrangement must be offered to all full-time employees on the same terms and conditions. The benefit can vary based on the cost of individual health insurance in the market due to age and number of enrolling family members. For example, an older employee could be provided with a greater benefit than a younger employee based on the age-based pricing under the ACA.
  3. The QSEHRA must be funded solely by the employer. No employee contributions are permitted.
  4. Reimbursements under the HRA is capped annually at $4,950 for an individual, but may be increased to $10,000 if the QSEHRA also provides benefits for the employee’s family members. The maximum annual benefit would be pro-rated for employees not covered by the QSEHRA for the entire year (such as a newly hired employee). Please note the employer is required to report the available benefit under the QSEHRA on each employee’s W-2 form beginning in calendar year 2017.
  5. The QSEHRA can reimburse any medical expenses as defined in Section 213(d) of the Internal Revenue Code including, but not limited to, the cost of individual health insurance. Reimbursement is tax free to the employee, provided the employee is enrolled in minimum essential health coverage.

There are a few exclusions to who would be eligible for the QSEHRA. To name a few, employees that have not yet met the employer’s waiting period (which, under the ACA, cannot be longer than 90 days), employees younger than age 25, part-time and seasonal employees, union employees and non-resident aliens.

Small employers must provide eligible employees with a written annual notice at least 90 days before the beginning of the year regarding the option of the QSEHRA. Due to the fact that the law was just passed in December, employers have until March 13, 2017 to provide the notice to their employees for the 2017 plan year. If the employer has a newly hired employee, the employer must provide notice to the new employee prior to the employee’s date of eligibility. This notice must include the annual amount of the benefit under the QSEHRA. The notice must also include a statement explaining to the employee that the amount of the benefit could affect their eligibility or amount of a premium tax credit if coverage is purchased through the Health Insurance Marketplace/Exchange. The employee must inform the marketplace of the amount of the permitted benefit under the QSEHRA. Lastly, the notice must include a statement that if the employee is not enrolled in minimum essential coverage, he or she may be subject to the individual mandate penalty and that the QSEHRA reimbursements will be taxable. Employers will be subject to a penalty of $50 per employee for failure to provide the notice, up to $2500 per year.

Please note, a QSEHRA is not considered a group health plan and therefore is not subject to COBRA continuation coverage. Therefore, upon termination of employment or occurrence of another qualifying event under COBRA, the employer is not required to provide a COBRA notice to the employee.

However, there are still many reasons for employers to offer a group health plan, especially with the confusion and network limitations of the individual marketplace. In the individual health insurance market, carrier options are much scarcer and the costs of individual plans are much higher, though an employer-funded QSEHRA will offset the employee’s out-of-pocket expense on premiums.

Employers that offer a group health insurance plan are more likely to attract and retain good employees. Contact Cornerstone today and let our experts assist with providing creative plan solutions that align with the business objectives of your small group clients.

For more information, contact Cornerstone today.

President Trump Signs Executive Order to Minimize Burdens Caused by ACA

According to the executive order, the secretary of the U.S. Department of Health and Human Services and other executive departments have the authority to “minimize ACA-related burdens” that would be fiscally or regulatorily burdensome on “individuals, families, health care providers, health insurers, patients, recipients of health care services, purchasers of health insurance, or makers of medical devices, products or medications.”

Read the full story here.

Rand Paul Brings His Own ACA Replacement Plan to the Table

BenefitsPro reports that Republican Senator Rand Paul is drafting his own solution for an ACA replacement that would endorse the sale of inexpensive abbreviated coverage. Paul’s plan would allow users to pay health care costs through tax credits or HSAs.

Paul commented on CNN: “It’s incredibly important that we do replacement on the same day as we do repeal. Our goal is to give access to the most amount of people at the least amount of cost.”

Read the full article here.

Worry Over Effects of Repealing ACA Drives Need for Republicans to Find Replacement Policy

The New York Times reports that, according to the non-partisan Congressional Budget Office, nearly 18 million Americans could lose their insurance in the first year after the Affordable Care Act is repealed. The number of uninsured Americans and the cost of premiums would continue to climb over the next 10 years.

For the full article, click here.

Health Care Changes: What to Expect at the End of January

With the new administration in the beginning stages of attempting to repeal the Affordable Care Act, the Transamerica Center for Health Studies has assembled a list of the four most prominent reforms or statements from the administration. BenefitsPro has broken down that list into 10 possible changes for which health care workers should prepare for January 20, 2017.

Read through the full list here.