Employer Notices:

Notice of the Exchange due before October 1

Beginning January 1, 2014, individuals and employees of small businesses will
have access to coverage through a new health insurance market. In Oregon, the
marketplace is called Cover Oregon, and in Washington, it is called Washington
Healthplanfinder.

The Affordable Care Act (ACA) requires all employers who are subject to the
Fair Labor Standards Act (FLSA) to notify their employees by October 1, 2013
of the existence of these marketplaces and to provide information regarding
coverage options.

As part of providing this notification, employers will need to indicate if
their health coverage meets the minimum value standard set by the ACA. Most
carriers have conducted this minimum value analysis on the plans for all groups
for which they provide health benefits coverage. You should have received or
will receive a letter from your insurance carrier indicating whether or not
your plan meets the minimum value standard set by the ACA.   Following
is a link to the model notice: http://www.dol.gov/ebsa/pdf/FLSAwithplans.pdf.

When
sending this notice to your employees, we encourage you to include DDI’s contact
information (info@ddibenefits.com or
503-206-5654) as a health insurance resource for your employees and their families.  DDI
is an affiliated producer with Cover Oregon.

Learn more / Get help

Search
FAQ’s at http://www.dol.gov/ebsa/.   Contact
DDI with any questions regarding the model notice or the exchange.  DDI
also offers benefits outsourcing services which includes sending required employer
notices on your behalf. Contact us for more info.

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Medicare D Notices due before Oct 15

By Oct. 15 (beginning of the annual Medicare coordinated election period),
employer groups that offer prescription drug coverage to employees should notify
their members of the creditable coverage status of their plan and of possible
penalties for late enrollment in Medicare Part D if their current coverage
is not creditable.

As defined by the Centers for Medicare & Medicaid Services, coverage
is considered creditable if its actuarial value equals or exceeds the actuarial
value of standard prescription drug coverage under the Medicare prescription
drug benefit.  How do you know if your prescription plan is creditable
or not? Your insurance carrier should notify employers by October 1st of the
status or you can contact DDI.

The Medicare Modernization Act imposes a late enrollment penalty on individuals
who do not maintain creditable coverage for a period of 63 days or longer following
their initial enrollment period for the Medicare prescription drug benefit.

How should I notify employees of the creditable coverage status of their prescription
drug plan?

The Centers for Medicare & Medicaid Services provide sample notices for
your convenience.

• Model Creditable Coverage Disclosure Notice:  (PDF)
• Model Non-Creditable Coverage Disclosure Notice

Learn more / Get help

For more information, visit the Centers for Medicare & Medicaid
Services website or contact DDI.  DDI also offers benefits outsourcing
services which includes sending required employer notices on your behalf. Contact
us for more info.

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Changes to Individual Plans in 2014

Individuals and families who have non-employer sponsored health insurance;
in other words, they buy their own coverage, will have big changes in 2014.  Most
carriers are sending notices to policy holders in August and September notifying
them of these changes. Below is a summary of the changes.

Under the Affordable Care Act (ACA), all health insurance companies are required
to update health insurance plans to include specific benefits for people who
buy their own insurance.  To meet those requirements, carriers have developed
new health insurance plans to replace their current plans effective in 2014.

What does this mean?

Individuals and families will have new choices.

• You can do nothing and most carriers will move you to a new ACA compliant
  plan either effective 1/1/14 or by the end of the open enrollment period,
  March 31, 2014.
• You can select a different ACA compliant plan with the same carrier or
  a new carrier.
• If you qualify for a subsidy and /or tax credit based on your income (Example:
  households who earn less than $45,960 for an individual and less than $94,200
  for a family of 4), you may want to consider purchasing your health insurance
  on Cover Oregon, Oregon’s new health insurance exchange.  The 2014 open
  enrollment period begins October 1, 2013 and ends March 31, 2014.  DDI
  is an affiliated producer with Cover Oregon, contact us to see if you qualify.

What happens if you don’t have coverage?

Beginning in 2014 all Americans will be required to get health insurance. All health
plans will be guaranteed issue, meaning you can’t be declined coverage and
pre-existing conditions will be covered. However, you will only be able to
purchase a plan during open enrollment or when you have a qualifying event.
Open enrollment this year will be longer than normal, beginning October 1,
2013 and ending March 31, 2014 for plans effective January 1st – April 1st,
2014.  Next year and in future years it will be October 15 – December
7th for plans effective January 1st

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For more information on creating a customized benefits package for your employees,
contact DDI Benefits at 503.206.5654, or via email to dena@ddibenefits.com