Ohio Governor Vetoes Health Care Transparency Provisions

Ohio Governor Mike DeWine recently signed the state budget bill (HB 166) into law on July 19, 2019, vetoing some of the health care transparency provisions.

The vetoed provisions established procedures for health care providers to provide cost estimates to consumers and require reimbursement for out-of-network services when performed at an in-network facility.

DeWine said: “I share the legislatures goal of providing consumers the information necessary to make informed decisions about their health care. Additionally,  President Trump has recently signed an executive order requiring implementation of health care transparency  rules, an initiative I also support. As the federal government develops these efforts and others, it is important that the state not place duplicative or burdensome regulations on health care providers, as these compliance costs will inevitability be passed on to the citizens of this State as consumers of healthcare. Over the past few months, the stakeholder community has worked toward this goal and developed common sense solutions, which should continue to be developed. I have requested that relevant state agencies collaborate with stakeholders to continue this important effort. Therefore, this veto is in the public interest.”

House Votes to Repeal ACA Cadillac Tax

On July 17, 2019, the House of Representatives voted 419–6 to pass H.R. 748 legislation to fully repeal the ACA’s Cadillac/excise tax. This the first step to full repeal. Consideration by the Senate is next, along with a companion bill S.684, which has 42 bipartisan cosponsors.

Delayed by Congress in both 2015 and 2018, the tax would impose a 40 percent excise tax on employer-provided health benefits that exceed certain limits, projected at $11,200 for an individual and $30,100 for a family in 2022.

Read more here: Cadillac Tax/NAHU

CE Available: GCAHU Presents Ethical Habits in Health Insurance

Annual Ethics with Carl: Ethical Habits in Health Insurance 2019

CE is refiled each year, so you can gain 3 hours of CE even if you don’t need to fulfill your ethics requirement

3 hours CE pending in OH and KY

DATE: Thursday, July 18, 2019

TIME: 7:30 am (registration) | CE starts at 8:00 am

LOCATION: Cornerstone Cincinnati Office | 2101 Florence Avenue | Cincinnati, OH 45206

MEETING CHARGE: GCAHU Member: $25 | Non-members: $45

Click here to register.

WageWorks Acquired By HealthEquity

WageWorks announced on June 27 that it will be acquired by HealthEquity, a deal that is expected to close by the end of the year. WageWorks has assured that there will be no changes to their clients’ teams.

For more information, contact your Cornerstone representative.

PCORI Fees Due to IRS No Later Than July 31

Fees to fund the Patient-Centered Outcomes Research Institute (PCORI) are due to the IRS no later than July 31, 2019 from employers who sponsor certain self-insured health plans, which includes all level funded as well as health reimbursement arrangements (HRAs) that are not treated as excepted benefits.

How to Pay PCORI Fees

Employers that sponsor certain self-insured health plans (Level Funded) must report and pay the required PCORI fees via IRS Form 720 along with HRA plans, Quarterly Federal Excise Tax Return. Complete Part II, line 133. Employers should note “2nd Quarter” on the 720 form.

The fee applies to each Plan year that ends after October 1, 2012, and before October 1, 2019. “Plan year” refers to the plan year for your Level Funded Medical Plans or an HRA plan. Generally the plan year and the coverage period are the same. As an example, if your HRA benefit resets each January 1, your HRA plan year and your coverage period are generally a calendar year and end December 31.

Plan Year Ending Date Fee
October 1, 2017 – September 30, 2018 $2.39
October 1, 2018 – September 30, 2019 $2.45

There are three available methods that can be used to determine the average number of lives covered under a plan for the policy year. For an HRA plan it is acceptable to use the number of subscribers only. The most commonly used method is the Snapshot Method.

  1. Actual Count Method: A plan sponsor may determine the average number of lives covered under a plan for a plan year by adding the totals of lives covered for each day of the play year and dividing that total by the total number of days in the plan year.
  2. Snapshot Method: A plan sponsor may determine the average number of lives covered under an applicable self-insured health plan for a plan year based on the total number of lives covered on one date (or more dates if an equal number of dates is used in each quarter) during the first, second or third month of each quarter, and dividing that total by the number of dates on which a count was made.
  3. Form 5500 Method: An eligible plan sponsor may determine the average number of lives covered under a plan for a plan year based on the number of participants reported on the Form 5500, Annual Return/Report of Employee Benefit Plan, or the Form 5500-SF, Short Form Annual Return/Report of Small Employee Benefit Plan.

Payments should be made payable to the U.S. Treasury and sent by July 31, 2019 to the applicable address on the attached instructions.

Tools to Assist you by Carrier:

All Savers

All Savers posts the employer group’s membership information to the employer website. The employer group is required to complete and file the IRS Form 720. For general questions please contact All Savers Broker Services at 1-866-405-7174.

Humana Level Funded

Click here.

Aetna Funding Advantage

This link takes you to your Producer World login and will assist in determining the fee due by your group.

LIVE TRAINING: Aetna’s AFA Springboard System

Cornerstone invites you to attend training on Aetna’s AFA Springboard System at the Cincinnati office!

Please join us for an overview of the Aetna Springboard process for new business submissions, presented by Aetna’s Jordan Finley and Lauren Horley.

DATE: Monday June 24, 2019

TIME: 2:00–3:30 pm

LOCATION: Cornerstone’s Cincinnati Office

2101 Florence Ave Cincinnati, OH 45206

Click here to RSVP.

SOCIAL SECURITY SPOTLIGHT: Filing for Retirement Benefits When You Have a Child Who is Disabled

Social Security Solutions, LLCIf you have a child who was disabled prior to age 22 and has never worked, you may want to consider starting your Social Security benefits at full retirement age or, in some cases, as early as age 62. The disabled child is eligible for half of your full retirement age benefit up to the family maximum.

For example, I recently had a client (born November 1952) who attained full retirement age in November 2018 (age 66). His full retirement age benefit was $2,858 per month starting November 2018. His child, who has been mentally and physically disabled since birth, would receive $1,429 per month, effective November 2018. The family maximum on his account was $4,500 per month, so his benefit ($2,858) plus the child’s benefit ($1,429) would be paid starting November 2018 ($51,444 per year). They would draw about $205,776 by age 70. The child’s benefit continues until his or her death.

This doesn’t work for everyone, but it is something to consider if you have a child who is disabled and you are approaching retirement age. For more information, contact me to discuss your situation.

For more information please contact me.

About Dennis Heywood

Denny’s career with Social Security provides an in-depth, working knowledge of the Social Security Administration’s internal organization and processes. An expert in all phases of SSA programs: retirement, survivor, disability, and Medicare, Denny has expertise with the complex Social Security regulations based on more than 40 years of experience.

ss-help.com

Cornerstone is a Top Workplace for the Fifth Year in a Row!

We did it again!

For the fifth year in a row, Cornerstone has been named a Top Workplace by The Cincinnati Enquirer.

The Top Workplace honors are awarded based solely on employee feedback gathered through an administered third-party survey. We continue to keep our top-ten standing, ranking #8 out of the 60 small businesses on the list this year.

Our exceptional employees are the driving force behind this accomplishment. Cornerstone fosters a culture of empowering our employees and creating pathways to success. Everyday we diligently work to satisfy our mission to be your trusted partner in solving complex benefit challenges.

“Every Cornerstone team member is committed to our culture. Each day, together, we determine the best solution for our partners who deserve to have their high expectations fulfilled. Every empowered member of our team of A+ players demonstrate examples of ‘perfect service’. Thank you to all who contribute to our continued success!”

Jennifer Agnello, President of Cornerstone

DON’T FORGET: Case Submission Deadlines for Small Group Aetna Funding Advantage

June 1 effective date deadlines for Aenta Funding Advantage small group (5–50*) case submissions are fast approaching. Review all new business submission deadlines for June through October below…

Effective date
Sales notice submitted
All required documents submitted
June 1
5/28/2019
5/31/2019
July 1
6/26/2019
7/1/2019
August 1
7/29/2019
8/1/2019
September 1
8/27/2019
8/30/2019
October 1
9/26/2019
10/1/2019

*2 to 50 in GA/PA/TX, 2 to 100 in N. IL, 5 to 100 in CO/CT/KY/LA/MA/NJ/OH, 10 to 50 in NV and 26 to 50 in NC.

Contact your Cornerstone representative with any questions.

Anthem SOCA BP New Sold Case Requirements

Effective May 15, Anthem SOCA BP will require the Annual Rate and Census Reconciliation (ARC) form for new sold submissions to ensure that plans comply with reporting requirements. The Quarterly Wage and Tax Statement will no longer be required.

The revised Sold Case Checklist will include the following documents:

  • Participation Agreement
  • Benefit Rate Proposal
  • Association Membership/Proof
  • Electronic Funds Transfer (EFT) Banking Form
  • Voided Check
  • Business Acknowledgement Agreement
  • Annual Rate & Census Reconciliation Form

Click here to view the 2019 Anthem SOCA Benefit Plan Sold Case Checklist.

Contact your Cornerstone representative with any questions.