The Affordable Care Act (ACA)
The ACA is a health care law that went into effect in 2010 and requires certain employers to offer health insurance to their teams. It outlines health care rules for companies, individuals, insurance companies, and many other entities.
Applicable large employer (ALE)
This is any company that has 50 or more full-time equivalent (FTE) employees. These companies are required to provide their team with health care.
COBRA
COBRA stands for the Consolidated Omnibus Budget Reconciliation Act of 1985. COBRAn provides temporary health insurance for people who lose their job. It was created to ensure employees and their dependents could continue to have health insurance after losing their jobs.
COBRA General Notice
Within 90 days of enrolling in healthcare coverage on your group health plan, all employees should receive an overview that describes their rights under COBRA.
COBRA Election Notice
Within 14 days of a qualifying life event (QLE), each plan must explain how a person can continue their health insurance coverage under COBRA.
Notice of Unavailability of Group Health Coverage
If an employee doesn’t qualify for COBRA, the plan must tell them why within 14 days after their QLE.
Early Termination Notice
If a health insurance plan needs to end coverage early, they need to tell the beneficiaries why, their options, and when coverage will end.
Employer Mandate
The mandate is a section in the Affordable Care Act that requires companies with 50 or more employees to offer health insurance to their employees or get penalized.
HIPPA
HIPPA stands for The Health Insurance Portability and Accountability Act of 1996. It is a law that secures people’s protected health information or PHI. It does this by explaining the kinds of health information that must be kept private and hold everyone who has access to sensitive information responsible for its security. If you’re HIPAA compliant, it means that you follow all the laws laid out in this vital act.
Medicare Summary Notice (MSN)
People who receive Medicare benefits will receive a letter that breaks down all the services received during their 3-month window. The MSN also includes a list of any outstanding balances they might owe.
Plan Document
This is your blueprint for understanding the basics of your plan. You’ll find the terms and conditions that spell out how your plan is managed, along with a description of your benefits, the name of the person administering the plan, and other vital details.
Summary of Benefits and Coverage (SBC)
The SBC is designed to provide a quick look into coverage options so people can easily understand each’s pros and cons. This is what you’ll find inside: monthly premium, deductible, co-pay, coinsurance rate, out-of-pocket maximum, treatments that are covered, and other details.
1094-C and 1095-C Forms
Do you have 50 or more full-time employees? These two forms show the IRS that you’re giving your employees health insurance. The 1095-C must be given to their employees by January 31. Then send a copy of both the 1094-C and 1095-C to the IRS by February 28, or March 31 if you fill it out online.
ERISA
ERISA is short for Employee Retirement Income Security Act. It was created because of concerns about employee benefit plans’ labor and tax aspects. The law standardizes benefit plans for workers, and it helps champion increased access to plan information for participants. All business owners who provide health care have to abide by the rules outlined in ERISA.
Cosmo Insurance Agency is a full-service independent insurance agency based in Hackensack (Bergen County) and Lakewood (Ocean County), New Jersey that offers an all-encompassing range of insurance options for both individuals and businesses. Cosmo keeps its promise to assure an efficient and creative approach to the services we offer. Each of our clients experience a personalized and long-term relationship with us. Our New Jersey based team of health brokers guides our clients in helping them choose the most cost-effective options. By incorporating our knowledge of the insurance guidelines for healthcare, employee benefits, life insurance, self-insurance, dental, disability, and long term care insurance, we keep our clients up-to-date with affordable plans that cover all their specific insurance needs.
