Presently, there’s not much new in the association healthcare arena. Unfortunately, there are no healthcare plans with association group pricing that would include the many sole proprietors and small firms that are AIA members. However, there are some important aspects of healthcare coverage for AIA members to keep in mind.
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. Some important facts to know about healthcare coverage now include:
- The next Affordable Care Act (ACA) annual Open Enrollment period begins on November 1, 2020 and ends on December 15, 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: https://www.healthcare.gov/glossary/qualifying-life-event/
- Starting January 1st this year, , employees are now able to use employer-funded Individual Coverage HRAs (ICHRAs) to buy individual-market insurance, including insurance purchased on the public exchanges. For more information about ICHRAs: https://www.healthcare.gov/ichra/
- For more information about health savings accounts: https://theaiatrust.com/filecabinet/HSA-Fact-Sheet.pdf
- The Coronavirus continues to dominate 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: https://www.ahip.org/health-insurance-providers-respond-to-coronavirus-covid-19/
- In addition, there is expert advice on avoiding the Coronavirus: https://khn.org/news/how-to-avoid-coronavirus-lessons-from-people-whose-lives-depend-on-it//
- Over 40 million people have filed for unemployment due to the impact of COVID-19. There are options for people who lose their employer sponsored coverage: https://www.kff.org/coronavirus-covid-19/issue-brief/eligibility-for-aca-health-coverage-following-job-loss/
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.
The IRS released two Notices in May related to cafeteria plans and flexible spending arrangements (“FSAs”). Notice 2020-29 provides, among other things, some flexibility for mid-year election changes under an employer’s cafeteria plan and it also extends the periods after which participants must forfeit FSA balances. The Groom Law Group provides this summary: https://www.groom.com/resources/ch-ch-ch-changes-in-elections-and-grace-periods/?utm_source=vuture&utm_medium=email&utm_campaign=coronavirus
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 and unless the Court rules otherwise, the ACA remains in effect.
As the AIA Trust explores potential healthcare coverage options, we will keep you informed via this quarterly newsletter, free to AIA members and components, and our website, theAIATrust.com. Members may subscribe to the newsletter by clicking here.
The AIA Trust has compiled a list of resources about how requirements may impact your healthcare coverage and your firm: https://www.theaiatrust.com/healthcare-coverage/