General Discussion

hill2016

(1,772 posts)

49. well

Thu Nov 19, 2015, 05:00 PM

Nov 2015

https://www.cms.gov/cciio/resources/files/downloads/ehb-faq-508.pdf

How would the intended EHB policy affect self-insured group health plans,
grandfathered group health plans, and the large group market health plans? How would
employers sponsoring such plans determine which benefits are EHB when they offer
coverage to employees residing in more than one State?

A: Under the Affordable Care Act, self-insured group health plans, large group
market health plans, and grandfathered health plans are not required to offer EHB.
However, the prohibition in PHS Act section 2711 on imposing annual and lifetime
dollar limits on EHB does apply to self-insured group health plans, large group
market health plans, and grandfathered group market health plans. These plans
are permitted to impose non-dollar limits, consistent with other guidance, on EHB
as long as they comply with other applicable statutory provisions. In addition, these
plans can continue to impose annual and lifetime dollar limits on benefits that do
not fall within the definition of EHB.

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ACA is in trouble and could be on course for a death spiral [View all] hill2016 Nov 2015 OP

Actually, you just repeated a bunch of pro-insurance company RW memes about the ACA like FSogol Nov 2015 #1

did hill2016 Nov 2015 #3

Besides the Wall St Journal article you posted being nothing but bullshit? FSogol Nov 2015 #5

the thing about facts is hill2016 Nov 2015 #6

Yes to some, 23 million more insured people is the worst thing in the world. FSogol Nov 2015 #11

like I said hill2016 Nov 2015 #22

The required benefits are the same whether offered on the exchange or not jberryhill Nov 2015 #26

not hill2016 Nov 2015 #32

Hobby Lobby begs to differ with you jberryhill Nov 2015 #33

it's a different part of the law hill2016 Nov 2015 #43

If you are going to sell something and call it "health insurance" jberryhill Nov 2015 #47

well hill2016 Nov 2015 #49

Careful zipplewrath Nov 2015 #40

well hill2016 Nov 2015 #45

The co-op thing is about cash flow zipplewrath Nov 2015 #50

so hill2016 Nov 2015 #55

Depends upon how you define "improve" zipplewrath Nov 2015 #63

But we can't even get Congress to get rid of the 20% doctor markup Recursion Nov 2015 #86

Perhaps, but the ACA is pretty pro-insurance company on its own. marmar Nov 2015 #16

Yes, it is terrible when the uninsured get insurance, or when kids can stay on their FSogol Nov 2015 #17

And who said it was terrible? marmar Nov 2015 #18

I don't qualify for either 2naSalit Nov 2015 #79

My premium is $50 cheaper a month this year. ScreamingMeemie Nov 2015 #2

Good for you. bigwillq Nov 2015 #7

I don't love it either, but it is what we have. It's better than the $1400/month ScreamingMeemie Nov 2015 #10

Mine will be cheaper next year than this Maeve Nov 2015 #12

Ours is going up $450/month. City Lights Nov 2015 #19

My insurance went up $6 a month. JoePhilly Nov 2015 #4

Mine went from $1,200 per month to... meaculpa2011 Nov 2015 #8

... SammyWinstonJack Nov 2015 #9

How are you being asked to pay more than 9.5% of your income? (nt) Recursion Nov 2015 #65

The 9.56% rule is for employer... meaculpa2011 Nov 2015 #83

You're above 400% of the FPL? Recursion Nov 2015 #84

Yeah. I think the number in New York... meaculpa2011 Nov 2015 #85

The median household income in NYC is about $51K Recursion Nov 2015 #87

Believe me, I'm not crying... meaculpa2011 Nov 2015 #89

Murdock says what? edhopper Nov 2015 #13

Congress could not kill it even after 50 tries! The $COTUS had to leave it be. Rex Nov 2015 #14

1. Rising rates, but, no mention of rebates. 2. Profits down, but, down to what? 3. ... Festivito Nov 2015 #15

Some facts & analysis from NBER & HHS, via Naked Capitalism magical thyme Nov 2015 #20

So why do you think young people would be willing to pay more in taxes pnwmom Nov 2015 #21

I really think hill2016 Nov 2015 #24

I think most of them are assuming it wouldn't cost them much. pnwmom Nov 2015 #25

This ^^^^^^^ treestar Nov 2015 #56

Because a tax based system spreads the costs more widely. Xithras Nov 2015 #61

Does it? Mitt Romney and Warren Buffet pay a lower tax rate than I do Recursion Nov 2015 #66

Yes, I think they would davidpdx Nov 2015 #80

My son has an ACA plan and he's been very happy with it. pnwmom Nov 2015 #82

Honestly I can't answer that one davidpdx Nov 2015 #93

It IS the right thing to do. pnwmom Nov 2015 #94

One way to frame it for them is to ask them how they feel knowing they won't have davidpdx Nov 2015 #95

UnitedHealth warns it may exit Obamacare plans TampaAnimusVortex Nov 2015 #23

Maybe if the CEO didn't take a 102 million dollar payout in 2010, they wouldn't have an issue still_one Nov 2015 #30

both statements can be true hill2016 Nov 2015 #34

No, they have been badly managed even before the ACA. Wise and other rating agencies have rated still_one Nov 2015 #35

so if they are badly managed before ACA hill2016 Nov 2015 #37

they are turning a profit, it just isn't a large as was estimated, but it is still huge. Even if still_one Nov 2015 #38

They still need offsetting losses from other plans jberryhill Nov 2015 #48

That's absurd; a bonus of 0.1% of market cap is not what causes their financial problems Recursion Nov 2015 #67

Fuck UHC. They wait until the 89th day to pay things that are due on day 90. X_Digger Nov 2015 #75

I am not sure if this is the way for the insurance companies to bargin or not, but I would pretty still_one Nov 2015 #27

At this point, what we need is a Congress that will act to fix problems in the ACA... Agnosticsherbet Nov 2015 #28

I don't think Rupert Murdoch's WSJ is a good source for the status of the ACA. Todays_Illusion Nov 2015 #29

As the penalties ratchet up, more healthy people will join taught_me_patience Nov 2015 #31

penalties can be avoided easily hill2016 Nov 2015 #36

Not really.. virginia mountainman Nov 2015 #76

the insurance & drug lobbies are NOT going to let ACA die Doctor_J Nov 2015 #39

don't know what you googled, or when, but this is what simple "aca" yielded for news just now: magical thyme Nov 2015 #54

We were told our non-ACA HMO premiums are rising 40% next year nt Laura PourMeADrink Nov 2015 #41

Thanks for your concern and tabasco Nov 2015 #42

i know you didn't take a position on aca vs sp, restorefreedom Nov 2015 #44

My DW attended a conference last month of Virginia FQHCs ileus Nov 2015 #46

Michigan has a decent expanded medicaid program that is Purveyor Nov 2015 #51

I hear this all the time from ACA opponents, and it makes me wonder onenote Nov 2015 #52

The Wall Street Urinal is a Murdoch rag. They hate the ACA and slant their coverage of anything madinmaryland Nov 2015 #53

facts are facts hill2016 Nov 2015 #74

Mine went up 23% treestar Nov 2015 #57

more facts: CMS determined to make full ACA fallback payments magical thyme Nov 2015 #58

it means hill2016 Nov 2015 #59

I don't trust the Wall Street Journal on Politics nt BootinUp Nov 2015 #60

this isn't politics hill2016 Nov 2015 #68

Financial analysis with a pretty clear set of political implications. Warren DeMontague Nov 2015 #73

"...forces the mainly young/healthy/male to subsidize ..."..hahahahahaha SoCalDem Nov 2015 #62

ok hill2016 Nov 2015 #69

here's an article you might be interested in hill2016 Nov 2015 #71

"young/healthy/male to subsidize the old/sick/female". ARE THERE NO OLD/SICK/MEN???????????????????? WinkyDink Nov 2015 #64

insurance hill2016 Nov 2015 #70

The WSJ was also the source of that absurd assertion that "Sanders' Plan will cost 17 Trillion" Warren DeMontague Nov 2015 #72

If it dies it will be directly the result of not having a public option. yourout Nov 2015 #77

My premiums rose on average 7-1/2% per year, every year cheapdate Nov 2015 #78

This "old/sick/female" on social security is paying almost $900 a month Contrary1 Nov 2015 #81

Horseshit. 6000eliot Nov 2015 #88

"UnitedHealth's Warning Shows How Medicaid Is Taking Over Obamacare" ecstatic Nov 2015 #90

Some of the Medicaid HMO's are horrible GusBob Nov 2015 #92

Kick Omaha Steve Nov 2015 #91

"Health Insurers Struggle to Profit From ACA Plans" oh, boo hoo. lindysalsagal Nov 2015 #96