Q: What do I need to know about the new health reform law?  Answer

SBAM has put together a brief document explaining the changes.


Q: I was told that the Healthcare Reform Act/Law has made some changes in how group health insurance rates are implemented. How can I be sure that my company’s rates are “where they should be”?  Answer

Most companies will require an annual review of your company’s payroll records to assure “compliance” with the Reform Act. Unless submitted, your company stands to see your rates raised 15% on top of any rate adjustment at renewal time. Benefits Resource will work closely with your company to seek compliance.


Q: I understand there is an additional fee that businesses will see on their Group Health Plan invoice beginning in 2013...is this true?  Answer

Beginning in 2013, a new fee will be assessed against employer-sponsored health plans (including self-funded plans). The Patient-Centered Outcomes Fee was established through the Affordable Care Act. It will fund comparative clinical research around patient-centered outcomes.

The fee will be collected as follows:
  • Year 1: $1 per member, per year for policy years ending after September 30, 2012
  • Year 2: $2 per member per year
  • Year 3 through 2019: $2 PMPY plus medical inflation
Employers with self-funded plans are responsible for paying the fee via an excise tax return (form 720) beginning in July 2013. Self-funded employers should discuss this fee with their tax consultant.
Health insurers are responsible for collecting and submitted the fee for fully funded plans. Priority Health will include this fee in premium calculations and will not charge the fee as a separate line item.
Calculations for determining the average number of covered lives differ based on the plan's funding type. Health reimbursement arrangements (HRAs) and flexible spending accounts (FSAs) are subject to the fee, even if integrated with a fully funded product.
Final regulations regarding the collection of this fee have not been issued. This fee was previously referred to as the Comparative Effectiveness Research Fee.



Q: Our company has made several changes over the past few years to keep rates as low as possible. Is there anything else available to lower our group insurance rates without compromising benefits?  Answer

Absolutely!…and, without changing benefits. Contact us to learn more.


Q: I have heard a little bit about COBRA (the law concerning offering continued health insurance). How do I know if my company needs to worry about COBRA?  Answer

The COBRA “law” is not as complicated as many of us perceive it to be. Benefits Resource offers COBRA compliance solutions for its group customers – thus taking the worries out of the law and keeping your concerns on your business operations.


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