The Coronavirus currently dominates the healthcare discussion in the United States and around the world. Large insurance carriers have announced policies regarding out-of-pocket expenses and what is covered – and there are expert suggestions on where we might go from here.
Regarding healthcare insurer policy changes, see: ahip.org/health-insurance-providers-respond-to-coronavirus-covid-19/
In addition, there is expert advice on avoiding the Coronavirus: khn.org/news/how-to-avoid-coronavirus-lessons-from-people-whose-lives-depend-on-it/
On March 11, 2020 the IRS issued Notice 2020-15 to advise that high deductible health plans (HDHPs) can pay for 2019 Novel Coronavirus (COVID-19) testing and treatment before plan deductibles have been met, without jeopardizing their status. According to the IRS, this also means that individuals with HDHPs that cover these costs may continue to contribute to their health savings accounts (HSAs). For more information, read this article by Hodge, Hart & Schleifer, Inc.
On March 18, 2020, The Families First Coronavirus Response Act was passed into law addressing paid sick leave, testing for the Coronavirus and emergency grants for states to provide and process unemployment benefits. Here is a summary of key points as provided by The Henry J. Kaiser Family Foundation:
On March 27, 2020 The CARES Act was signed into law addressing a wide variety of relief measures including broader unemployment insurance provisions, tax relief, SBA loans, health care coverage and family leave. Steptoe and Johnson, LLC provided a summary of key provisions:
For more information about unemployment insurance provisions, see the article, How the “CARES Act” May Assist Self-Employed Architects.
The next Affordable Care Act (ACA) annual Open Enrollment period will begin on November 1, 2020. You may be eligible for a special enrollment period if you experience a qualifying life event such as a loss of coverage, a change in your household or a change in your address. For a complete list of qualifying live events: healthcare.gov/glossary/qualifying-life-event/
Unfortunately, most of the news regarding new health insurance products for association members has been related to court rulings. The Affordable Care Act (ACA) essentially provides two options to obtain private health insurance: as an individual via the exchanges or as an employee through your employer. In 2018, the Department of Labor issued regulations that expanded the eligibility for Association Health Plans (AHPs) to include sole proprietors. However, in March of 2019 a federal judge ruled that major provisions of the new regulations were unlawful. That decision is under appeal at this time.
Regarding, the ACA, another federal judge ruled in December of 2018 that since Congress eliminated the individual mandate penalty, the ACA is no longer constitutional under Congress’s taxation power. On appeal, the 5th circuit ruled that it was unconstitutional for the ACA to require individuals to purchase health insurance and returned the case to the district court for further review. However, the Supreme Court has decided to take the case in the next term. Unless the Supreme Court rules otherwise, the ACA remains in effect.
Currently, there are no healthcare plans with association group pricing that would include the many sole proprietors and small firms that are AIA members. The AIA Trust continues to monitor healthcare insurance reform to identify any potential future healthcare coverage options and will continue to publish quarterly healthcare updates.
The AIA Trust has compiled a list of resources about how requirements may impact your healthcare coverage and your firm: theaiatrust.com/healthcare-coverage/