Dependent Coverage Under Scrutiny

A 25-year old female employee enrolled her neighbor’s three children under her new large employer’s health plan.  While not their legal guardian, the employee was the designated caregiver while their mother was deployed overseas.  She was surprised to learn during a recent Dependent Eligibility Audit conducted by MBP Inc. that the children were ineligible for the plan.

Dependent Eligibility Audits are rapidly gaining ground as another method for containing high health care costs. According to a recent study, the immediate and long-term savings gained from these audits can be substantial.  Average cost savings for every ineligible dependent removed from the plan is estimated at $1,900. 

It is estimated that 3-5% of covered family members cannot produce valid verification of eligibility during an audit.  Audits typically offer employees a “three strikes and you’re out” opportunity to produce valid marriage licenses, birth certificates, and/or tax returns. The goal: to cull the benefits rolls of ineligibles, which could include ex-spouses, stepchildren who live elsewhere, or dependent children over age 26.

For employers who impose Spouse Carve-Out rules, these audits also serve to double check that spouses who are required to take coverage at their own employer are meeting those guidelines.

"Amnesty" programs are also popular; companies urge employees to come forward voluntarily, without consequences, if they're covering people they shouldn't.  Some employers report employees responding to the first Dependent Audit letter by dropping dependents during the Amnesty period immediately, rather than waiting for potential consequences.

MBP Inc. provides full dependent audit services.  Please let us know if you would like an evaluation.
 

Supreme Court Hears Oral Arguments On Health Care Reform: Will The Afforable Care Act Survive?

After three days of oral arguments, the fate of the Patient Protection and Affordable Care Act (ACA) now lies in the hands of the nine Supreme Court justices. What, if any, provisions of the sweeping health care reform law will survive remains very much in question after the historic arguments. The questioning revealed deep divisions within the Court about the constitutionality of the law's so-called "individual mandate" and whether the rest of the Act should stand if the mandate is struck down. Even after the Supreme Court renders its decision, which is expected in June, the debate over the landmark legislation likely will continue for years to come.
 

Background
The Supreme Court agreed to review the following four issues:

• Does the Anti-Injunction Act bar challenges to the individual mandate?
• Whether the Affordable Care Act's provisions requiring virtually all individuals to obtain health insurance or pay a penalty as of 2014 – commonly referred to as the law's "individual mandate" – is constitutional. Specifically, in enacting the individual mandate, did Congress exceed its enumerated powers under the Constitution?
• If the individual mandate is unconstitutional, do the remaining portions of the law still stand, should the Court also strike those portions of the law that it deems to be directly dependent on the individual mandate, or is the entire law rendered invalid because it is non-severable?
• Is the law's expansion of the Medicaid program constitutional?

To find out more about the arguments and “impressions”, click here:  Will the ACA Survive?

Join the Just Move It! Summer Fitness Challenge

As part of our continuing efforts to help you promote employee wellness, we would like to challenge you and your employees to participate in our Just Move It! Summer Fitness Challenge.

What? Companies will compete for the highest average fitness miles. 

When?  June 1st - August 31st

How?  Participants walk, run, swim, bike and track their miles.

Prizes?  Better health and sense of accomplishment of course!  And...participants from the top three placed companies will be entered into a drawing for a Garmin GPS or Dick's Sporting Goods gift cards.  

If you are interested in participating or need more information, please contact Deanne Gustafson, Wellness Coordinator, at dgustafson@mbbenefits.net (815) 986-0059 ext. 225.

Are You HCR Grandfathered?

As part of the Health Care Reform guidelines, Plans must allow eligible dependent children to remain on the Plan until age 26.  This is regardless of student status, marital status, whether they live with their parents or can be claimed as a dependent on their parent’s tax return.

It is important to note that dependent children eligibility differs if your Plan is Health Care Reform “Grandfathered”.  Under this scenario, the dependent child would not be eligible to remain on the Plan if coverage is available through their own employer.

If you are unsure of your grandfathered status, contact your MBP Inc. Account Manager for assistance.