By Employee Benefit Research Group
More healthcare-related regulatory news for plan sponsors, including links to detailed information.
Medicare Parts A and B COLAs for 2015
The Centers for Medicare & Medicaid Services (CMS) has issued the cost-of-living adjustments applicable to components in the Medicare program. For 2015, the rates will be as follows:
• Medicare Part A (Hospital Insurance) payroll tax remains at 1.45% (paid by employers and employees) on all wages, plus an additional 0.9% (for a total of 2.35%) for high-income individuals (earnings over $200,000 for an individual ($250,000 for joint filers)), to be assessed only the employees.
• Medicare Part A inpatient hospital deductible increases to $1,260 (up from $1,216 in 2014).
• Medicare Part A daily coinsurance amounts: $315 for the 61st through 90th days of hospitalization in a benefit period (up from $304), $630 for lifetime reserve days (up from $608), and $157.50 for the 21st through 100th day of extended care services in a skilled nursing facility in a benefit period (up from $152).
• Medicare Part A premium to purchase coverage: $407 (down from $426 in 2014), and for those entitled to a reduced monthly premium, $224 (down from $234 in 2014).
• Medicare Part B deductible: $147.00 (unchanged from 2014).
• Medicare Part B standard monthly premium: $104.90 (unchanged from 2014).
The following chart shows the 2015 Medicare Part B monthly premiums based on income tax filing (unchanged from 2014):
|| Part B Premium
|$85,000 or less
||$170,000 or less
|$85,001 – $107,000
||$170,001 – $214,000
|$107,001 – $160,000
||$214,001 – $320,000
|$160,001 – $214,000
||$320,001 – $428,000
The figures above are from notices that have been published in the Federal Register of October 10, 2014.
• Medicare Part A
• Medicare Part A (hospital deductible)
• Medicare Part B
CMS issues guidance for small employers to enroll in SHOP coverage
The CMS has issued an announcement with helpful links for employers to enroll online in the Small Business Health Options Program (SHOP). The announcement reminds small employers that starting November 15, 2014, they will be able to begin enrolling their small businesses. To enroll in SHOP coverage, employers must have less than 50 full-time employees and meet certain other requirements.
For more information, click here.
ACA’s FAQs on reference pricing and maximum out-of-pocket limitations
The Departments of Treasury, Labor, and Health and Human Services, and the CMS have issued Patient Protection and Affordable Care Act (ACA) frequently asked questions (FAQs) regarding pricing and the maximum out-of-pocket requirements.
To read the FAQs about ACA implementation (Part XXI), click here and here.
CBO working paper: Assessing the design of the low-income subsidy program in Medicare Part D
The Congressional Budget Office (CBO) released a new working paper entitled “Assessing the design of the low-income subsidy program in Medicare Part D.” The study finds that the rules of the low-income program in Part D create incentives for low-income subsidy plans to be less responsive to the number of plan sponsors, to raise their bids toward the benchmark, and to strategically bid in ways that raise the low-income benchmark and the government’s cost.
To read the entire working paper, click here.