Vol. XI, Issue 7
May 2, 2014
- May Plan Sponsor Webconferences—Save the Dates
- Plan Design Options for 2015
- 2015 Adoption Agreements Coming Soon
- Plan Sponsor Annual Reports—Mid-May
- Q1 Claim Experience Reports Delayed
May Plan Sponsor Webconferences—Save the Dates
Mark your calendar to participate in the next HealthFlex plan sponsor webconferences, which are scheduled for:
- Thursday, May 8, from 10:30 to 11:30 a.m., Central time; and
- Wednesday, May 14, from 2:00 to 3:00 p.m., Central time.
An agenda and dial-in details will be distributed next week via HealthFlex Express.
Plan Design Options for 2015
HealthFlex continues to refine plan options in response to plan sponsor input and regulatory changes. Please note the following plan details for the 2015 plan year:
Combined out-of-pocket maximum (OOP max) for 2015—The Affordable Care Act (ACA, i.e., health care reform law) limits participants’ combined OOP maximums for medical and pharmacy to $6,600 for self-only coverage and $13,200 for family coverage in 2015.
- During the HealthFlex Summit and prior plan sponsor webconference calls, HealthFlex indicated it would administratively combine medical and pharmacy OOP maximums for a single, aggregated OOP maximum per year, with targeted implementation for this aggregated OOP maximum to be January 1, 2015. However, in order to ensure that the administration of this aggregated OOP maximum is aligned with our service expectations, HealthFlex is delaying that target implementation date until January 1, 2016. As such, HealthFlex will continue having separate OOP maximums for medical and pharmacy that—together—equal no more than the $6,600 for self-only coverage and $13,200 for family coverage limits.
- This new direction with respect to the aggregated OOP maximum materially impacts one of the 2015 plan offerings. The Bronze (60% equivalent) plan design introduced at the Summit requires an integrated OOP maximum; therefore, for 2015 HealthFlex will not be able to support that exact plan design. However, HealthFlex could support an alternative Bronze plan design (with separate OOP maximums). Therefore, any plan sponsors considering the Bronze plan for 2015 should contact Kelly Wittich ASAP to discuss further.
For more details about 2015 plan design, contact Kelly Wittich at kwittich@gbophb.org or 1-800-269-2244, ext.4058.
2015 Adoption Agreements Coming Soon
Adoption agreements for the 2015 plan year will be distributed electronically in mid-May. Completed and signed adoption agreements will be due back to the Center for Health by June 30. Please contact your conference/plan sponsor liaison or Paul Ziemann at pziemann@gbophb.org or 1-800-269-2244, ext. 4076 with any questions.
Plan Sponsor Annual Reports—Mid-May
Plan Sponsor 2013 Annual Reports are expected to be e-mailed to plan sponsors the week of May 12. For more information, contact Kasima Imamovich at kimamovich@gbophb.org or 1-800-269-2244, ext. 4309.
Q1 Claim Experience Reports Delayed
Delivery of claim experience reports for Q1 2014 will be delayed due to an issue experienced with HealthFlex’s data warehouse partner, the source of quarterly report data. HealthFlex is working directly with its medical and pharmacy carriers on an alternative approach and anticipates being able to provide a Q1 quarterly report near the end of this month.
For more information, contact Kasima Imamovich at kimamovich@gbophb.org or 1-800-269-2244, ext. 4309.
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