Save the Date: Marketplace Open Enrollment 2023!

It’s hard to believe that Fall is here and as we gear up for the busy holiday season, we want to give you peace of mind knowing that we will make sure that you are correctly enrolled in marketplace coverage without taking too much of your time this year.  Mark your calendars for November 1st through January 15th, 2023 for open enrollment and be on the lookout for an email from us in early October to get ahead of the season.  We look forward to guiding you again this year through the always confusing puzzle of insurance.

 

nsurance Knowledge

How does a life insurance company determine my premium?
Premium rates are typically based on factors such as age, gender, height, weight, health status (including whether or not you use tobacco), and if you participate in high-risk activities or occupations. Some carriers are currently offering guaranteed insurability just by answering a few questions without having to go through an entire medical exam! 

MLR Rebates Reminder for Employers 

Insurance Carriers are required to send out Medical Loss Ratio (MLR) payments to employers by September 30th. 

When an employer receives one of these MLR checks from the insurance carrier, they’ll need to carefully consider how the funds must be spent – they should not just keep it. This is because any portion of the rebate that is considered “plan assets” has to be used in a very specific manner. In other words, if employees paid any portion of the total premium, then that portion related to the MLR rebate check is considered plan assets and can only be used to benefit those participants, not the employer. 

For instance, if employees paid 20% of total premiums last year and the employer contributed 80%, then 20% of the rebate check is considered “plan assets” and should only be used for the benefit of plan participants. 

There are 3 basic methods an employer may use to spend this portion on participants: 1) Pay out a taxable cash refund, 2) Offer a premium holiday for the amount of the rebate, or 3) Provide some type of benefit enhancement. 

There is no de minimis (minimum) amount for distribution of any portion that’s considered plan assets under the rules. The only leeway given relates to the cost of including former participants in the rebate distribution. In other words, even if the rebate is a very small amount and dividing it up between participants results in a few dollars, any portion related to plan assets still has to be given back to current participants and possibly to former employees (such as COBRA qualified beneficiaries and retirees).