Boca Benefits Consulting Group Inc.

The below info is excerpted from a Zane Benefits information piece published Sunday, Sep 15, 2013.  The entire technical discussion can be accessed at their RSS blog feed by clicking here.  The essence of the discussion is that unlike what some major group insurance carriers have been indicating, newly stuctured HRP’s ( i.e., a limited healthcare reimbursement plan) can be used as the vehicle to shift employees from a group plan to individual purchases on exchanges. Wallgreens is the most recent large company to announce such a shift (click here for info on annoncement today 9/18/2013). IBM and Time Warner have made similar announcements.

[Begin Excerpt] ____________________________

Now, the good news

Employers can still reimburse employees for individual health insurance premiums.

For the first time, the Department of Labor, the Department of Treasury, and Health and Human Services have coordinated to issue formal confirmation that employers are 100% allowed to reimburse individual health insurance premiums tax-free under the tax code. This is a MAJOR positive.

We repeat – employers are still allowed to reimburse employees tax-free for individual health insurance premiums.

 

What is the solution for plan years beginning on or after January 1st, 2014?

For plan years beginning on or after January 1st, 2014, the solution is to adopt a limited Healthcare Reimbursement Plan (HRP), such as ZaneHealth.

The HRP is structured to only reimburse:

1. Health insurance premiums up to a specified monthly healthcare allowance,
2. Preventative care as required by PHS Act Section 2713 at 100% without cost-sharing.

This structure ensures the HRP complies with the PHS Act 2711 annual limit requirements and the PHS Act 2713 preventative care requirements as outlined in the Technical Release.

Additionally, care must be taken in the design and administration of the HRP to ensure the plan does not meet the definition of an eligible employer-sponsored plan in IRC Section 5000A and consequently qualify as minimum essential coverage. This ensures employees participating in the HRP are able to receive a tax subsidy via the new health insurance marketplaces assuming they meet additional eligibility criteria.

Conclusion / Next Steps

With the Departments all in agreement, everyone should be excited there is finally a clean, final process for employers to reimburse employees for individual policies that are guaranteed-issue.

Sponsors of stand-alone HRAs should begin preparing to convert their plan to an HRP for plan years beginning after 2014.

Finally, our nation can rid itself of one-size-fits-all employer group health insurance policies that hamper businesses, employees and their families.

[End Excerpt] _____________________________________

 

 

Below is the new link for United Healthcare’s “UnitedHealthOne” individual health insurance product (i.e., Golden Rule Insurance). We will be re-coding all our various prior Instant Quote links with the below.

This link is now active. Click on the below icon to access the FREE to browse & quote.  Application also available via same online link. If you have had prior experience with the Golden Rule Instant Quote, we are sure you will agree that this is a substantial upgrade.

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As you may have noticed from experience using the existing Instant Quote function from UnitedHealthOne (i.e., Golden Rule Insurance), it has lacked some degree of user friendliness. Effective Monday, August 30, 2010, there will be an upgraded Instant Quote function via a new link. We will add the new code as soon as it is available to us.

NEW DATE: UnitedHealthOne (i.e., Golden Rule) has decided to keep the below link live as a redirect function to the new web pages for 60 days (i.e., approximately November 1, 2010) at which time it will become a dead link. This is an update to the dates we provided earlier.

For persons who prefer to do business with a long-established insurance carrier in the individual healthcare market, BBCG offers United Healthcare’s “UnitedHealthOne” (f/k/a Golden Rule) products. Various traditional, high deductible, point-of-service and HSA products are available. Please feel free to use this service to explore options that you feel might meet your needs.

Please click on the above Golden Rule icon to open the auto-quoting page. This is a free and non-binding service unless the user actually submits an application.

Please see on the blog page list at right here “Individual Health Policy Quoting Links”. This page has two additional carriers that can be used to benchmark UnitedHealthOne (i.e., Golden Rule) plans. 

Quick Jump to Presentation

Has group insurance seen its best days? I had to ask myself that today. In 2016 medical underwriting of individual policies will no longer be allowed. There will no longer be uninsurables that get treated differently under group plans than they do under individual policies. Why would an employer continue to stay on the back of a bronco that has been trying to throw it off for 20 years?

If the employer thinks it has a financial incentive to keep the group plan in place, that is likely not true. Changes in the Internal Revenue Code effective in 2009 makes purchase of individual policies with pre-tax HRA salary reduction amounts, as well as pre-tax employer HRA contribution amounts, permissible. The HRA contributions become “defined” in that the employer can fix the amount, if any, per class of employee, often at a level less that group plan levels.  How the employee uses it is entirely employee driven. The employer steps out of the equation for everything except the regulatory framework of a Section 125 HRA approach.  Employees make their own product purchase and just file the required paperwork with the administrator.

This is an exciting new concept about which only a few really knowledgable consultants are assisting employers. Let BBCG show you how this might work for your workforce.  Please click here to open a link to a preseentation from one of our strategic partners which is a nationally recognized leader in the implementation of this concept.

Please note that this concept is not carrier dependent. Employees can buy any healthplan they desire. However, for ease of transition BBCG can make available to the purchasing employees from one up to three individual plan carriers and assist with the purchase process.  For very large employers considering this transition, BBCG would actually put enrollers on site to assist. Note that with 3 carriers, three basic plans, and dozens of variable alternatives within the plans the decision points can exceed 100 for an employee. Using lowest cost as the driver can often be very dangerous for some employees.

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As you may have noticed from experience using the existing Instant Quote function from UnitedHealthOne (i.e., Golden Rule Insurance), it has lacked some degree of user friendliness. Effective Monday, August 30, 2010, there will be an upgraded Instant Quote function via a new link.  We will add the new code as soon as it is available to us.

Note:  the existing link below will continue to function via a redirect to the new Instant Quote  web pages until approximately September 1, 2010 at which time it will become a dead link.

For persons who prefer to do business with a long-established insurance carrier in the individual healthcare market, BBCG offers United Healthcare’s “UnitedHealthOne” (f/k/a Golden Rule) products. Various traditional, high deductible, point-of-service and HSA products are available. Please feel free to use this service to explore options that you feel might meet your needs.

Please click on the above Golden Rule icon to open the auto-quoting page. This is a free and non-binding service unless the user actually submits an application.


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For those persons who prefer to do business with a long-established insurance carrier in the individual healthcare market, BBCG offers United Healthcare’s “UnitedHealthOne” (f/k/a Golden Rule) products. Various traditional, high deductible, point-of-service and HSA products are available. Please feel free to use this service to explore options that you feel might meet your needs.

Please click on the above Golden Rule icon to open the auto-quoting page. This is a free and non-binding service unless the user actually submits an application.

This service is in addition to the similar auto-quote function provided by BBCG via the CIGNA individual/small group market segment per our earlier blog entry at http://bocabenefits.com/blog/?p=588.

Both CIGNA and United Healthcare offer individual products as solutions to the “To Age 26” gap many college seniors may face while waiting for eligibility under one of their parent’s health plans.


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In addition to the UnitedHealthOne (f/k/a Golden Rule) individual products auto-quote function from United Healthcare , BBCG now has a similar auto-quote function available for CIGNA products. Just click on the CIGNA logo above to open the quoting window.

Like the UnitedHealthOne products, CIGNA products also address the “To Age 26” issue for graduating college seniors.

This is a free and non-binding process unless an application is actually submitted by the user. 


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Notes to this post:

1. BBCG has licensed agents in Florida and Washington D.C.  For other prospects, we will most often make the appropriate referral. In cetain cases, where it makes economic sense, BBCG will have an agent request a non-resident license in the appropriate state.

2. Golden Rule has changed its name to UnitedHealthOne as a subsidiary of United Healthcare.

3. BBCG now offers CIGNA indidivual and small group health plans in this same market segment.

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BBCG has selected Golden Rule, a United Healthcare company since 2003, as its primary carrier for the needs of individuals and families in Florida. We offer qualified HSA, traditional high deductible, and traditional copay type plans for individuals and families without access to employer sponsored group insurance programs. In addition to full benefit plans, there are also available “saver” type plans which provide high cost services coverage while trading off frequent lower cost services in return for lower premium levels (i.e., sometimes referred to as “catastrophic” type plans). Short term medical plans (i.e., up to six months) are also available for those temporarily between group sponsored plans.

These plans are excellent for those persons who are self-employed, who have taken early retirement, who are at the end of their COBRA eligibility, for students who have exceeded the limiting age of their parent’s group plan, who individually purchase health coverage with the assistance of their employers, etcetera.

These plans are also excellent for the public sector employee with one young dependent child (25 or less) who is in relatively good health. We have seen the standard underwriting of school systems, cities, tax districts, etc., pass along the average age skewing of the group to the “+1” dependent even when that dependent is actually substantially younger than the average. Retirees who may pay the entire true cost of the dependent coverage on a college age child would be well served to consider Golden Rule individual coverage. In addition to price, there is substantial flexibility in plan designs.

Those purchasing individual Golden Rule medical are also now eligible for two excellent Golden Rule dental plans.

Golden Rule plans are individually medically underwritten and are issued under a group association master contract. As such they cannot be considered “group insurance” plans per se. However, for smaller employers who facilitate the individual purchase of health coverage by their employees, a list bill to the employer can be provided as a vehicle for individual employee payment.

Although we feel Golden Rule’s on-line quoting and application procedures are state-of-the-art, as well as both flexible and price competitive, if a client does not feel they meet their needs adequately, BBCG has numerous other individual carrier markets from which we can solicit proposals.

Link for Free On-line Golden Rule Quote

 

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