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Health Insurance Rules Changing In 2016 For Businesses Considered Large; Those With 100 or Fewer Employees Could Still See Big Advantages.

When it comes to the Patient Protection and Affordable Care Act, many employers have to determine if their business is big enough, where they must offer health insurance to their employees under the law.

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Payments for cost sharing increasing rapidly over time

Rising cost-sharing for people with health insurance has drawn a good deal of public attention in recent years.  For example, the average deductible for people with employer-provided health coverage rose from $303 to $1,077 between 2006 and 2015.

While we can get a sense of employees’ potential exposure to out-of-pocket costs by looking at trends in deductibles, many employees will never reach their deductibles and other employees may have costs that far exceed their deductibles.  In addition to deductible payments, some employees also have copayments (set dollar amounts for a given service) or coinsurance payments (a percentage of the allowed amount for the service).  To look at what workers and their families actually spend out-of-pocket for services covered by their employer-sponsored plan, we analyzed a sample of health benefit claims from the Truven MarketScan Commercial Claims and Encounters Database to calculate the average amounts paid toward deductibles, copayments and coinsurance.

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Trends in Employer-Sponsored Insurance Offer and Coverage Rates, 1999-2014

The majority of nonelderly people get their health coverage through an employer-based plan. This issue brief uses data from the National Health Interview Survey (NHIS) to examine trends in employer-sponsored health insurance (ESI) for different types of people and households.1 While ESI remains the leading source of coverage for nonelderly people (those under age 65), the percentage covered by an employer plan has declined over the last fifteen years. A similar pattern exists with firm offer rates; fewer workers were offered health insurance from their employer in 2014 than in 1999. The decrease in offer and coverage rates has not been universal; families with low and modest incomes have been most affected by the decline. While coverage rates have declined over time, the percentage of the nonelderly population covered by ESI is similar between 2013 and 2014.

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Rise Of Latino Political Power In Capitol Could Give New Momentum To Health Care

When Anthony Rendon (D-Paramount) is sworn in as assembly speaker Monday, it will mark a historic moment in California politics: For the first time, the two top posts in the state legislature will be held by Latinos.

Rendon will join Senate President Pro Tem Kevin de León (D-Los Angeles) at the top of the Capitol’s political pyramid, a development that could signal much brighter prospects for health care legislation — especially the effort to provide adult immigrants who are living here illegally with coverage under Medi-Cal, the government program for people with low incomes.

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State Legislature Passes New MCO Tax, Rescues Over $1 Billion for Medi-Cal

The California legislature Monday approved a new health care tax, capping a months-long quest to safeguard over $1 billion in annual Medi-Cal funding the federal government had threatened to take away.

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Covered California for Small Business boosts coverage for small companies

This is an important year for small businesses looking to gain an edge on the competition by offering group health insurance to its employees through Covered California for Small Business (CCSB) and the Patient Protection and Affordable Care Act.

In 2016, businesses with up to 100 employees can apply for coverage for their workers. That is an increase from 2015, when only businesses with fewer than 50 workers could apply for coverage through the Covered California exchange.

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A Last-Minute Reprieve For Some Consumers On California Exchange

Covered California, the state's insurance exchange, announced Friday that it was extending its enrollment deadline until Feb. 6 for people who had officially begun the process of signing up by Sunday.

Exchange officials said they extended the Sunday deadline to accommodate a surge in enrollment in the previous week involving “tens of thousands” of consumers.

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2015 Southern California State of Reform Health Policy Conference

The Los Angeles Area Chamber of Commerce is pleased to be a Major Sponsor of the 2015 Southern California State of Reform Health Policy Conference being held on Nov. 6. The event convenes senior health care executives and health policy leaders from across the spectrum of care to dialogue on the most pressing issues facing health care today. This conference relies on a Convening Panel of folks which you will recognize as a diverse set of thought leaders, policy makers and executives from a wide range of California’s health care sector.
Chamber members can utilize a 30 percent discount code by registering for the event with the code CHAMBER. The event is held at the JW Marriott at LA Live and is an all day, single day conference.

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Congress Stops ACA's New Definition of Small Business

An Affordable Care Act (ACA) provision that changes the definition of a "small business employer" has garnered bipartisan opposition in Congress and was effectively reversed last week. The Protecting Affordable Coverage for Employees (PACE) Act, stops the ACA from requiring that businesses of 51-100 people enter the small-group insurance market in 2016 and manage the costs of new coverage.

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Is your employee health plan compliant with the ACA?

If you have a small business that offers health insurance, make sure your plan complies with Affordable Care Act (ACA) rules that take effect at the end of the year. If your business offers a grandfathered plan or if your health insurance does not comply with the ACA, then you have until Dec. 1, 2015 to enroll in an ACA compliant plan to ensure your coverage meets the terms of the law on Jan. 1, 2016.

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