News

Now is a great time to sell Aetna and it's simple. Reminder: 2024 Broker Bonus for both Affordable Care Act (ACA) and Aetna Funding Advantage SM (AFA). Just sell Aetna new business plans to groups in California with 1-100 eligible employees. The bonus payout is the same if you sell direct with Aetna or through a General Agent. Bonus is based on the total number of enrolled employees for all the groups you sell with Aetna. Total Enrolled Employees Credit per Enrolled Employee 1-74 $50 75+ $100 In addition, when producers sell Dental or Vision with a new Medical case, they will earn: $8 per new Dental subscriber and $2 per new Vision subscriber. For More Information or Help Quoting Aetna, Please Contact Your Dickerson Sales Rep Today.

Oscar and Cigna Healthcare will not renew Cigna + Oscar Small Group plans nationally. Coverage for Cigna + Oscar Small Group services will continue through the end of each member’s policy, and specific timing is dependent on each groups’ enrollment date. Key dates to know: Cigna + Oscar will no longer enroll new small groups beginning January 1, 2025. The last date for an employer to start a new policy with Cigna + Oscar will be December 15, 2024. Cigna + Oscar will not renew Small Group plans beginning January 1, 2025. The last Cigna + Oscar Small Group plans renewed will be those with effective dates of December 15, 2024. The last date of member coverage in the market will be December 14, 2025 . Contact You Dickerson Sales Representative to Learn About Available Options.

Health Net has discovered that the Small Group HMO Silver $55 plan (or comparable plan – see list below) had a $750 single/$1,500 family Prescription Drug Deductible. The Prescription Drug Deductible amount should have been $500 single/$1,000 family. This has been corrected in their system. Following is a complete list of impacted plans by year: • 2021-2022 Small Group HMO Silver $50 plan • 2023-2024 Small Group HMO Silver $55 plan • 2021-2024 CalChoice HMO Silver A plan • 2023-2024 CalChoice HMO Silver D plan While enrolled on the impacted plans, some members paid more than the $500/$1,000 deductible amount for pharmacy claims. To correct this, a refund will be processed for the amount the member overpaid toward their pharmacy deductible. Letters and refund checks for the 2021-2022 plans will be mailed first. If members are due a refund for 2023 and/or 2024, letters and a separate refund check will be issued at a later date once they are prepared. An amendment to active 2023-2024 policyholders on the HMO Silver $55, HMO Silver A and HMO Silver D plans will also be issued. For More Information or Help Quoting Health Net, Contact Your Dickerson Sales Rep Today.

In Rev. Proc. 2024-25, the IRS released the inflation-adjusted amounts for 2025 relevant to Health Savings Accounts (HSAs) and high deductible health plans (HDHPs). The table below summarizes those adjustments and other applicable limits. 2025 2024 Change Annual HSA Contribution Limit (employer and employee) Self-only: $4,300 Family: $8,550 Self-only: $4,150 Family: $8,300 Self-only: +$150 Family: +$250 HSA catch-up contributions (age 55 or older) $1,000 $1,000 No Change Minimum Annual HDHP Deductible Self-only: $1,650 Family: $3,300 Self-only: $1,600 Family: $3,200 Self-only: +$50 Family: +$100 Maximum Out-of-Pocket for HDHP (deductibles, co-payment and other amounts except premiums) Self-only: $8,300 Family: $16,600 Self-only: $8,050 Family: $16,100 Self-only: +$250 Family: +$500 Out-of-Pocket Limits Applicable to Non-Grandfathered Plans The ACA’s out-of-pocket limits for in-network essential health benefits have also been announced and have decreased for 2025. 2025 2024 Change ACA Maximum Out-of-Pocket Self-only: $9,200 Family: $18,400 Self-only: $9,450 Family: $18,900 Self-only: -$250 Family: -$500 Note that all non-grandfathered group health plans must contain an embedded individual out-of-pocket limit within family coverage if the family out-of-pocket limit is above $9,200 (2025 plan years) or $9,450 (2024 plan years). Exceptions to the ACA’s out-of-pocket limit rule have been available for certain non-grandfathered small group plans eligible for transition relief (referred to as “grandmothered” plans) since policy years renewed on or after January 1, 2014. Each year, CMS has extended this transition relief for any grandmothered plans that have been continually renewed since on or after January 1, 2014. However, in its March 23, 2022 Insurance Standards Bulletin, CMS announced that the limited nonenforcement policy will remain in effect until CMS announces that such coverage must come into compliance with relevant requirements. Thus, we will no longer see annual transition relief announced. To Read the Full Alert, Click Here

(By Cynthia Cox and Jared Ortaliza) May 16 - In 2024, Affordable Care Act (ACA) Marketplace enrollment hit a new record high, reaching over 21 million people, almost double the 11 million people enrolled in 2020. This growth can be largely attributed to enhanced subsidies made available by the American Rescue Plan Act (ARPA) in 2021 and renewed under the 2022 Inflation Reduction Act (IRA). These enhanced subsidies significantly reduced premium payments across the board for ACA Marketplace enrollees – including providing 100% premium subsidies for the lowest-income enrollees – and made some middle-income people who had previously been priced out of coverage newly eligible for financial assistance. Although the Inflation Reduction Act’s enhanced subsidies are available nationwide, some states have seen faster growth than others. In 15 states, ACA Marketplace enrollment has more than doubled since 2020 (Figure 2). One of these states is Texas, where ACA enrollment has more than tripled since 2020. Meanwhile, 3 states’ Marketplaces have seen enrollment fall since 2020. To Read the Full Story, Click Here