CalCPA ProtectPlus

It’s often said, if you don’t know where you have been, you can’t know where you are going. So, as the Board of Trustees and staff of the Group Insurance Trust position themselves to meet the challenges ahead in 2011, looking back on 2010 will help set the course for the coming year.

A year of change began when the Trust transitioned to its new plan administrator, Banyan Administrators, LLC. When Banyan replaced the Trust’s prior long-time administrator Seabury & Smith, it was with the expectation that the Trust would soon be able to provide its members with modern, improved services. We have not been disappointed. Since Banyan assumed responsibility for managing the Trust’s group insurance plans, improvements have been apparent each passing month. This summer Banyan began rolling out online self-service management capabilities to participating firms. As firms are trained and comfortable with the self-management site, a new group of firms is then invited to take part. By the end of 2011 we expect that all firms wishing to manage common tasks (such as new hire enrollments, terminations, demographic changes, dependent adds and deletions and other tasks associated with benefit management) will be trained and actively managing their benefit programs. Participating firms may also have noticed the comprehensive and timely distribution of 2011 plan renewal information. (continue reading…)

A new COBRA administrator is now in place for CalCPA-member firms with employees enrolled in the Group Insurance Trust’s medical, dental and vision plans. As subscribers are probably aware, at the beginning of 2010, Banyan Administrators, LLC replaced Seabury & Smith as administrator of the Trust’s group insurance plans. Seabury previously had provided COBRA and CalCOBRA administration to CalCPA plan members. However, with the administrative transition, the Trust found it necessary to contract with a secondary administrator for these services. After a lengthy search, the Trust engaged Infinisource, a leader in COBRA and CalCOBRA administration, to provide member firms with these specialized services.

Founded in 1986 to help employers and insurance professionals navigate complex benefit-related federal regulations, Infinisource has streamlined the complex and time-consuming procedures that all firms must adhere to. Benefit managers and individual members will be pleased to find that the new online tracking capacities now available through Infinisource will make it easier both to track payments and comply with regulations.

Administrative Procedures

Firms with an average of 20 or more employees in the previous calendar year, and, thus subject to COBRA, must contract directly with Infinisource. These firms may, however, choose to contract directly with another COBRA administrator or to self-administer these benefits. The Trust will, however, absorb the costs of administration for firms selecting Infinisource as their provider. The Trust contracts directly with Infinisource on behalf of its CalCOBRA firms (i.e., those with 2–19 employees). Whether employees qualify for COBRA or CalCOBRA, firm administrators should communicate all qualifying event information to Banyan Administrators. (continue reading…)

Whether or not you are eligible for COBRA or CalCOBRA depends on several factors. Please contact Infinisource at 800-594-6957 (Participant) or 866-320-3040 (Employers) for information specific to your coverage.

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Our group plans require that you work a minimum of 20 hours per week in order to maintain your coverage. If you plan to retire before your 65th birthday (Medicare eligible age) you will not be eligible for coverage. You may be eligible for COBRA and/or CalCOBRA coverage depending on the size of your firm. Please contact Banyan Administrators, LLC at 877-480-7923 to discuss your options.

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COBRA

means the medical plan related provisions of the Consolidated Budget Reconciliation Act of 1985, as such provisions have been subsequently amended.

COBRA Administrator

means a COBRA participating employer or third party (not the Trustees or the plan administrator) appointed by the COBRA participating employer to act as the COBRA Administrator.

The American Recovery and Reinvestment Act of 2009 (ARRA), signed into law in February, offers significant health insurance benefits to all those who are involuntarily terminated from a job between September 1, 2008 and December 31, 2009.

If you lose or have lost work during this period, you need to know about these provisions because they can save you money. Keep in mind, however, that if you voluntarily quit your job you don’t qualify. Moreover, individuals who were fired for negligence or misconduct don’t qualify either.

If you are an employer and let employees go during these 15 months, new rules under this law require action on your part. Among its many features, ARRA provides federal subsides that reduce premiums for nine months of COBRA or Cal-COBRA coverage.

During this nine-month period eligible individuals (and their qualified beneficiaries) are responsible for only 35 percent of their premiums. For COBRA recipients the remaining 65 percent must be paid by their former employer, while for Cal-COBRA recipients, the 65 percent portion must be paid by the insurer. Employer and insurer payments, however, are fully reimbursable through a tax credit.

Another provision of the new law allows COBRA recipients to switch their health coverage to a less expensive policy if that policy is available to all active employees of their former company.

Under the previous law, an eligible employee could only elect to continue coverage under the policy they had at the time they were terminated. To comply with ARRA, employers must amend their existing COBRA notice forms and distribute additional notices that include information about these benefits. (continue reading…)

This is Part 3, of a three part article.  For Part 2, see Employers, What You Need to Know About the Federal Stimulus Package: Part 2.

This article was written by Connie Chuang and Gage C. Dungy, attorneys with the labor and employment law firm of Liebert Cassidy Whitmore.

In the beginning, some covered individuals may not become aware of the new federal subsidy and therefore continue to overpay their COBRA/Cal-COBRA premiums by paying the full premium amount.  In order to reimburse the covered employee in this situation, employers will have an initial choice of either providing a refund or a credit to be used against future premium  payments.  The credit option is only available if it is expected that the full credit will be used by the individual within 180 days of the date the full COBRA premium amount was paid. (continue reading…)

This is Part 2, of a three part article.  For Part 1, an introduction, see Employers, What You Need to Know About the Federal Stimulus Package: Part 1.

This article was written by Connie Chuang and Gage C. Dungy, attorneys with the labor and employment law firm of Liebert Cassidy Whitmore.

Qualified Individuals on COBRA/Cal-COBRA Can Now Receive a 65% Federal  Subsidy for Health Insurance Premiums for up to Nine Months.

Employees who were involuntarily terminated between September 1, 2008, through December 31, 2009, will be eligible for a 65% federal subsidy of their COBRA/Cal-COBRA health insurance premium payments.

For example, an employee who normally pays $1000/month in health insurance premiums under COBRA/Cal-COBRA, would only be required to pay $350/month (35%) because the other $650 (65%) would be covered by this federal subsidy.

The federal subsidy ends after one of the following circumstances occurs (whichever comes first):

• Nine months after the first receipt of the subsidy;
• The employee becomes eligible for coverage on another employer’s plan (or Medicare); or
• The maximum period of COBRA/Cal-COBRA coverage ends.

The subsidy plan became effective on the day the federal stimulus package was signed into law.  However, for individuals whose health insurance premium payments are paid on a monthly basis, the plan becomes effective on March 1, 2009.  Although the time period for qualification dates back to September 1, 2008, the federal subsidy does not apply retroactively before the effective date of the law. (continue reading…)

This article was written by Connie Chuang and Gage C. Dungy, attorneys with the labor and employment law firm of Liebert Cassidy Whitmore.

The Federal Stimulus Package Incorporates New Temporary Revisions to COBRA/Cal-COBRA, Including a Federal Subsidy for Qualified Individuals.

Federal law (COBRA – employers with 20 or more employees) and California law (Cal-COBRA – employers with 2-19 employees) provide individuals who have experienced a “qualifying event” the ability to continue their health insurance benefits for a period of up to 36 months by having the covered individual pay up to 102% of the full health insurance premium cost.

A “qualifying event” under COBRA/Cal-COBRA includes, among other reasons, voluntary termination of employment, involuntary termination of employment (except for gross misconduct), and a reduction in hours resulting in a loss of health benefits.

On February 17, 2009, President Barack Obama signed into law a federal stimulus package – also known as the “American Recovery and Reinvestment Act of 2009” – (or, visit Recovery.gov)in an attempt to address the current economic downturn in the United States. (continue reading…)

If You Continue to Work Past 65
For those who continue working beyond the age of 65, whether solo CPAs or in firms of fewer than 20 employees, the Group Insurance Trust strongly recommends subscribing to Medicare Parts B and D and purchasing a Medigap policy. Since Medicare will be your primary payer of claims, you will receive few if any benefits from retaining your group coverage.

However, if you are employed at a firm with more than 20 employees, the opposite generally holds true. Since your group plan qualifies as the primary payer, and thus is billed before Medicare, you should retain your group coverage. In this circumstance, you can also delay purchasing any optional Medicare and Medigap plans until you do finally retire. If your spouse has been covered on your group plan and you continue working, then for solo practitioners with ProtectPlus, the choice is simple. (continue reading…)

If You Retire at Age 65 For most people who retire on their 65th birthday, there are a set of choices to be made. Assuming you have contributed the minimum amount to qualify for Social Security, you will automatically receive hospitalization coverage under Medicare Part A.

Other medical expenses, such as doctors’ fees are covered under Medicare Part B. And though optional, subscribing to Medicare Part B is universally recommended.

The small premium for this coverage is automatically deducted from your Social Security payment, or will be billed to you if you have opted to delay collecting benefits. In addition to Medicare Parts A and B, the Social Security system gives you the opportunity to subscribe to prescription drug coverage under Medicare Part D. The complicated nature of this coverage has by now been well documented, so you should be sure to budget adequate time to determine the policy that will serve you best. (continue reading…)

(Originally published by Anthem Blue Cross April 24,2009)

The new CalCOBRA legislation, California Assembly Bill 23, is expected to be signed by the Governor by the end of this week. This bill will align the current CalCOBRA legislation with the Federal Subsidy as defined by ARRA (American Recovery and Reinvestment Act). The following are high-level details you should be aware of:

• This bill states that health plans and health insurers have 14 days from the date of enactment to provide proper notification to those individuals who may qualify for the Cal-COBRA subsidy. The Department of Labor (“DOL”) has agreed that the timeliness within which the state mini-COBRA programs must comply is to be determined by the states themselves. The DOL held a call with the California Department of Insurance (“CDI”) and the Department of Managed Health Care (“DMHC”) to assure this is understood by all three regulators.
• The mailing will go out to all individuals who had a qualifying event between Sept. 1, 2008, to the present, regardless of whether or not they had already elected CalCOBRA.
• The bill (AB23) currently states that California residents who were involuntarily terminated from their jobs between Sept. 1, 2008, and the present will qualify for the Cal-COBRA special election period.
• There is a notice letter being developed by Anthem in conjunction with the California Association of Health Plans (“CAHP”) and other health plans in this state. Once finalized, this notice will be deemed approved by both the CDI and DMHC. Anthem will send the notice as soon as possible following the enactment of AB 23.
• Once the bill is finalized and signed into law, Anthem will share a more detailed summary of the specific provisions of this law.

To continue reading “In the Interim“

Understanding the Medicare system that serves as the primary health insurer for almost everyone in this country who is 65 or older is vital in planning your health insurance needs. If you are approaching that age, you should start familiarizing yourself with the system before you retire.

You need to know how various parts of Medicare work, how they relate to the supplemental insurance policies (Medigap) and how they interact with your workplace group insurance plan.

In addition, understanding the relationship between Medicare and your group health policy becomes more important and more complicated if your spouse is covered under your plan at work. HIPAA, COBRA and CalCOBRA provisions may determine the availability of his or her coverage. (continue reading…)