New Poverty Guidelines: What Employers Need to Know for 2025
The Department of Health & Human Services released 2025 federal poverty guidelines, impacting ACA employer mandate affordability. For plans starting February 1, 2025 or later, the monthly affordability safe harbor is $117.63 in most states. January 1, 2025 plans use 2024 guidelines. Employers must offer affordable coverage to avoid penalties. Affordability is based on 9.02% of the applicable federal poverty line.
Access Healthcare from Home: IBX Virtual Health Care
Independence Blue Cross offers virtual care options for members, including Teladoc, provider-led virtual visits, and specialized behavioral health resources. Teladoc provides 24/7 access to doctors, mental health professionals, and dermatologists for various non-emergency conditions, often with $0 cost-share. Members can also utilize their existing PCP or specialist’s virtual services, or access behavioral health support through Quartet and Shatterproof Atlas. Access instructions are provided for each service via phone, website, and mobile app.
Additional Life & Disability Insurance from Precision Benefits Group
For assistance with the following, please contact us:
We specialize in helping individuals and businesses with:
- Executive Benefits: tailored to meet the specific needs of your key personnel. Retain top talent, giving your business a significant edge.
- Personal Life Insurance
- Personal Disability Insurance
- Buy-Sell Agreement Funding with Life and or Disability Insurance
- Key-Man Policies funding with Life and or Disability Insurance
We partner with multiple carriers to secure optimal policies for your needs. Contact us today to learn more.
New Jersey Level Funding: Oxford and UHC Options
New Jersey Oxford Level Funded groups will have UHC Level Funded Surest plans as an option from May 1st. Though Surest plans won’t appear in Oxford renewals, they’re available on SAMx LF. Groups changing between Oxford and UHC LF require submission five business days before renewal. This rule doesn’t affect fully insured to UHC LF conversions. SAMx LF will provide reminders.
Compliance Corner! 2024 RxDC Reporting for Insured Groups: Our Approach
Our Approach to the CAA RxDC 2024 Reporting for Fully Insured Groups (including Level-Funded Plans). We will be working with our clients to assist with gathering the information that is required.
The “RxDC report” collects prescription drug cost data. While the first report covered 2020-2021, yearly submissions are now due June 1st, reflecting the previous year. Plan sponsors can use insurers, TPAs, or PBMs for filing. Though employers can submit directly, it’s expected to be uncommon. Using vendors is anticipated to be the standard practice for fulfilling these reporting obligations.