American Benefits Group (ABG) Navigating the Road to Consumer Directed Healthcare 2.0
The rapid adoption of consumer-directed health plans and accounts is a megatrend. In 2021 over 80 percent of U.S. employers offer a High Deductible Health Plan (HDHP) with a pre-tax consumer spending account or an HSA. According to Employee Benefit Research Institute (EBRI), the average industry-wide Health Savings Account (HSA) balance is about $2,100, while an average couple will require more than $285,000 in savings at retirement age to cover their likely out-of-pocket healthcare costs. Moreover, only 30 percent of health savings account holders fall in the ‘saver’ category, carrying account balances from year to year. These statistics highlight the need for better education, tools, and resources to help consumers better manage the financial responsibility for their current and future healthcare costs.
On Feb. 7, 2021, a group of Democratic senators introduced the Worker Health Coverage Protection Act, which would protect unemployed or furloughed workers from losing their health insurance during the COVID-19 pandemic. The bill would allow laid off workers to remain on their employer health plans, through the COBRA program, at no cost.
The legislation would also provide a 100 percent subsidy of COBRA health insurance premiums owed by unemployed workers to ensure that they do not lose coverage due to the COVID-19 pandemic. Furloughed workers whose health benefits continue while pay is suspended would also have their employee contributions 100 percent subsidized. These subsidies would not impact workers' eligibility for unemployment benefits or other types of state or federal assistance.
In addition, the bill would extend the period during which workers could elect COBRA coverage, and enable workers to access coverage even if they declined it before the subsidy was made available, thereby ensuring continuity of care amid the health and economic challenges of the COVID-19 pandemic.
American Benefits Group (ABG) Upping the Benefits Administration Game
In recent years, the US’ employee benefits landscape has rapidly evolved owing to factors such as escalating healthcare costs, changes in employment and benefits laws, and new initiatives and options in healthcare benefits. As employers continue to explore various ways to manage the costs and strategic design of their health benefits programs, integrated consumer-driven accounts such as Healthcare FSA, Health Savings Accounts (HSAs), and Health Reimbursement Arrangements (HRAs) play an instrumental role to empower participants with the tools they need to manage their health care spending and out of pocket costs. Delivering comprehensive tools and guidance to manage these accounts in one place with access real time healthcare cost and quality assessment tools and data is a responsibility that Massachusetts-based American Benefits Group (ABG) take very seriously.
On May 4, 2020 Internal Revenue Service (“IRS”) and Employee Benefits Security Administration (“EBSA”) issued a final ruling regarding the extension of certain COBRA timeframes during the COVID-19 National Emergency in its “Extension of Certain Timeframes for Employee Benefit Plans, Participants, and Beneficiaries Affected by the COVID-19 Outbreak” notice. The intent of this ruling is to provide relief that is immediately needed to preserve and protect the benefits or participants and beneficiaries in all employee benefit plans across the Unites States during the National Emergency.
IRS and DOL Provide Relief for Participants and Plan Sponsors from Certain Time Deadlines Due to COVID-19 Pandemic
Yesterday, recognizing the impact of the COVID-19 Pandemic, the Internal Revenue Service and the Department of Labor released guidance that extends the period of time that a participant has in enrolling in coverage under a health plan, paying for COBRA continuation coverage, submitting claims for coverage and disputing denials of claims for benefits. The guidance also extends the period of time that a group health plan sponsor or administrator has to provide a COBRA election notice. Agency FAQs were also released related to the guidance. Essentially, the guidance provides that actions that must be taken with the time period from March 1, 2020 until 60 days after the time the federal government declares the COVID-19 emergency (referred to as the “Outbreak Period”) has ended will be disregarded .
The guidance states that the following actions that are required to be taken during the Outbreak Period are extended until after the Outbreak Period ends:
As we continue to monitor developments and consider American Benefits Group’s response and contingency plans in the context of the coronavirus developments, our priority is the safety of our employees and ensuring our ability to continue to service our clients’ needs.
Our Critical Response Group is composed of leaders and subject matter experts across our business lines. This group is meeting daily to assess the impact across our business and in our communities, advise the executive management, develop and deploy actions.
American Benefits Group CEO and Founder Bob Cummings Reelected as President of NAPBA May 28th 2019 - Bob Cummings has been reelected to serve as President of The National Association of Professional Benefits Administrators (NAPBA). A NAPBA Trustee since 2007, Cummings was first elected NAPBA president in 2015, and has been an instrumental force in the emergence of the Consumer Directed HealthCare industry over the last 20 years, orchestrating the growth of NAPBA as the primary compliance standards and best practice organization for third party employee benefits administrators serving the consumer directed healthcare industry.
American Benefits Group (ABG) of Northampton MA, a leading national benefits service and solution provider in the health benefits industry has been recognized by healthcare benefits payments giant Alegeus as the 2018 APEX Award winner for Operational Efficiency and Excellence. The award was presented at the Alegeus National Conference on May 16th in Orlando Florida.
Similar to action taken a few weeks ago in response to Hurricane Harvey, the IRS and DOL both recently published guidance containing certain relief for those individuals and businesses in Hurricane Irma’s path.
The IRS and DOL both recently published guidance containing some relief for those individuals and businesses in designated Texas counties that have been impacted by Hurricane Harvey. Specifically, the IRS offered extensions for certain tax filing deadlines that applies automatically to any individual or business who resides with the affected Texas counties (as outlined in the notice). As a result, if a form was due on or after Aug. 23, 2017, the form is now due on Jan. 31, 2018. The relief would apply to those employers that may have previously applied for a Form 5500 filing extension (either automatically or via Form 5558), as well as for any quarterly payroll/employment/excise tax filings due. Employers should work with their broker and/or professional accountant (or outside tax counsel) when it comes to appropriately filing extensions.
When Bob Cummings started out in benefits administration, health-insurance co-pays were $3, premiums were well under $100 a month, his office ran on MS-DOS, and it issued paper statements. Much has changed since then, obviously, but not his company’s success formula, based on personalization, creativity, knowledge of a complex and ever-changing subject, and what American Benefits Group prefers to call ‘enabling technology.’
American Benefits Group of Northampton, MA has been recognized as the 2015 Customer Service Champion by healthcare consumerism market leader Alegeus Technologies. The award was presented to ABG management on May 8th at the national Alegeus Client Conference in San Diego.
On May 2, 2014, the Centers for Medicare and Medicaid Services (part of HHS) issued a bulletin to deal with Special Enrollment Periods (SEPs).
HHS is concerned that former Model COBRA Continuation Coverage Election Notices (Model Election Notices) published by the Department of Labor and other documents provided by employers did not address, or did not sufficiently address, Marketplace options for persons eligible for COBRA.
The concern? Persons eligible for COBRA and their qualified beneficiaries may have had insufficient information to understand that they cannot voluntarily drop COBRA and enroll in the Marketplace outside of Marketplace open enrollment.
As a result, in accordance with 45 CFR 155.420(d)(9), HHS is providing an additional special enrollment period based on exceptional circumstances so that persons eligible for COBRA and COBRA beneficiaries are able to select Qualified Health Plans (QHPs) in the Federally Facilitated Marketplace (www.healthcare.gov).
On May 2, 2014, EBSA released an advanced copy of proposed rulemaking, which will be published in the May 7, 2014, Federal Register. The guidance amends notice requirements for COBRA so as to better align PPACA and COBRA notice requirements and to add information relating to special enrollment rights in the state health insurance exchanges.
On April 21, 2014, CMS issued guidance, in the form of a frequently asked question (FAQ), clarifying how COBRA coverage impacts an individual's eligibility to enroll in the exchange and to receive a premium tax credit. As background, the open enrollment period for almost all exchanges ended March 31, 2014. Individuals may only enroll in the exchange midyear if they qualify for a special enrollment period due to a qualifying event. The FAQ clarifies that during the open enrollment period for the exchange, an individual who has voluntarily terminated his/her COBRA coverage (i.e., COBRA coverage has not been exhausted) will be eligible to enroll in a qualified health plan through the exchange.