Just in case anyone was enjoying their Thankgiving holiday last week and wants to catch up on the latest governmental regulatory goodies disseminated right before a vacation when public scrutiny ebbs lowest, here is the SIXTH little nugget from the delightfully dense 254 pages issued last week.
Federal Regulators published the “premium adjustment percentage” for 2015, which they say will be a 6% increase in allowable deductibles, out of pocket maximums and employer penalties.
Last week we also saw:
- Better insurer bailout terms used to appease insurers for the government's website debacles causing horrific adverse selection.
- Confirmation that the Obama Administration will let the largest unions off the hook for one of PPACA's most onerous taxes.
- The bite of that same tax has been delayed to after January 1, 2015 and split into two payments so that it won't have as damning an impact on the November midterm elections for the vast majority of plans who will have to pay it.
- The government also admitted that they cannot get the small business Exchange off the ground and scrapped that one for a whole year leaving many of those folks with nothing but broken and insecure individual Exchange sites or the technology of 1986 to enroll in Obamacare.
- Next year's Exchange open enrollment with undoubtedly higher premiums and dire political consequences have been conveniently moved to after the midterm election.
And now this, your employer mandate penalties are increasing by 6% before they are ever implemented. This discussion is verbatim from pages 139-140:
To calculate the premium adjustment percentage for the 2015 calendar year, we propose to use the most recent NHEA projections of average per enrollee private health insurance spending for 2013 and 2014 ($5,128 and $5,435, respectively). Therefore, we are proposing that the premium adjustment percentage for 2015 be (5,435-5,128)/5,128, and we propose to round the result of this formula to the nearest decimal point, which, in this case, would be 6.0 percent. We are also proposing the following cost-sharing parameters for calendar year 2015, based on our proposed premium adjustment percentage for 2015.Maximum Annual Limitation on Cost Sharing for Calendar Year 2015. Under §156.130(a)(2), for the 2015 calendar year, cost sharing for self-only coverage may not exceed the product of the maximum annual limitation on cost sharing for calendar year 2014 and the premium adjustment percentage for 2015, and for other than self-only coverage, the limit is twice the dollar limit for self-only coverage. Under §156.130(d), these amounts must be rounded to the next lowest multiple of 50. Using the proposed premium adjustment percentage of 6.0 percent and the 2014 maximum annual limitation on cost sharing of $6,350 for self-only coverage, which was published by the IRS on May 2, 2013, we propose that the 2015 maximum annual limitation on cost sharing be $6,750 for self-only coverage and $13,500 for other than self-only coverage.Maximum Annual Limitation on Deductibles for Plans in the Small Group Market for Calendar Year 2015. Under §156.130(b)(2), for the 2015 calendar year, the annual deductible for a health plan in the small group market may not exceed, for self-only coverage, the product of the maximum annual limitation on deductibles for calendar year 2014 and the premium adjustment percentage for 2015, and for other than self-only coverage, the limit is twice the dollar limit for self-only coverage. Under §156.130(d), these amounts must be rounded to the next lowest multiple of 50. Using the proposed premium adjustment percentage of 6.0 percent and the 2014 maximum annual limitation on deductibles of $2,000 for self-only coverage, as specified in §156.130(b)(1)(i), we propose that the 2015 maximum annual limitation on deductibles be $2,150 for self-only coverage and $4,300 for other than self-only coverage.
It does not tell us exactly what the 2015 numbers will be for purposes of the pay-or-play penalty, but it presumably means that the $2,000 penalty goes to $2,120, and the $3,000 penalty jumps to $3,180 (the rounding rule is different; it’s the next lowest multiple of $10).
