The Open enrollment period for Individual and Family Health Insurance policies begins November 1st, 2015 and ends January 31st, 2016. During the open enrollment period you and your family may purchase a new policy if you are currently uninsured or change your policy if you have coverage now. This open enrollment period is available to you and your family regardless of medical or insurance history.
The New York City Bar Association is sponsoring Mercer Consumer, a service of Mercer Health and Benefits Administration LLC as a broker-administrator for both individual and small group health insurance. You can shop your options, enroll in new coverage, and support the work of the City Bar by purchasing your individual or small group health insurance through Mercer.
For information or assistance in seeking coverage please call: 888-882-2269
Individual Medical Plans — Individuals, Sole Proprietors and Partnerships without a non-spouse employee will need to enroll as an individual due to ACA legislation. Individuals must enroll during Federally mandated open enrollment periods, or any time they have a Qualifying Event such as the loss of employer provided insurance.
Individuals may purchase either Oxford or Empire Blue Cross Blue Shield products through Mercer. The New York State of Health exchange is available for those persons whose income levels qualify for a subsidy. (Information about the exchange can be found at the nystateofhealth.ny.gov.) Please see the Forms tab for more information and enrollment materials from each carrier.
Group Medical Plans — We can assist you to navigate the changes mandated by the Affordable Care Act by evaluating and placing your medical insurance plan in the appropriate market for your situation. Small groups can apply for coverage at any time during the year.
Small groups (2 to 50) may select from 26 PPO/EPO plans and 2 HMO plans offered by Oxford. The Liberty and Freedom networks are both available so that you can get the care you need from the doctors and hospitals that you currently use.
Group coverage is available for all business forms that include at least one non-spouse W-2 employee in addition to the owner(s). Tax form verification of your status as a small group is required. We can help you to determine whether your business structure and enrollment will qualify for small group coverage if you are not sure. Please see the forms tab for enrollment materials.
Now with the ACA are the Platinum, Gold, Silver, and Bronze classifications of health plans. This new concept categorizes plans around “actuarial value”. A Platinum plan represents an actuarial value of 90%, meaning the participant will be expected to shoulder 10% of their projected health costs for the year and the plan should cover 90%. Platinum, Gold, Silver, and Bronze represent 90%, 80%, 70%, and 60% actuarial value respectively.
What this means for you is that plans within a metal level are basically equivalent to each other, making for a more consumer friendly shopping experience. You can feel confident that a Platinum plan is better than a Bronze plan and that you are not paying more just because the plan is more profitable for the insurance company.
Regardless of metal tier, all the plans include the Minimum Essential Benefits mandated by the ACA, assuring that your plan provides benefits for the most important healthcare services. Any level of plan will also satisfy the Individual Mandate which requires all US citizens to have health insurance coverage.
Click on the links to download the enrollment kit components that fit your situation:
We're here to help! Please contact us in whatever manner is most convenient for you.
Mercer Consumer, a service of Mercer Health & Benefits Administration LLC
777 South Figueroa Street
Los Angeles, CA 90017
From healthy young adults to senior citizens to individuals struggling with chronic diseases, the effects of the Affordable Care Act (“ACA”) are far-reaching for members. Since January 1, 2014, new regulations provided most Americans access to health insurance that covers essential care. Attorneys need to understand the impact ACA has on them as individuals as well as employers. You need to evaluate how ACA influences your medical insurance buying decisions and the impact the change has on your employees.
One thing is for certain: the amount of healthcare reform information available to absorb is overwhelming. While much of the following may not be new to you, we hope to provide members with the information and guidance necessary to help review the decision making process for their practices, their families and their employees.
For more information on Healthcare Reform, please visit www.MercerHealthOptions.com.
Employer Required Notices
Employers, whether they provide health insurance to their employees or not, must distribute notices to their employees advising them of the existence of the state health insurance exchange and the potential availability of subsidies to assist with the purchase of health insurance.
Federal regulators released model notices, copies of which appear below, that employers can provide to employees to satisfy the federal health care reform law notice requirement. Among other things, the notices from the U.S. Department of Labor — one for employers who offer a health plan to some or all employees, and one for employers who do not offer a health plan — explain how exchanges operate, and that certain conditions will have to be satisfied for employees to obtain federal premium subsidies to purchase exchange-provided coverage. Employers can provide a link in the notice to a Department of Health and Human Services website, www.healthcare.gov, for information on specific state exchanges.
Employers who offer health plans
Employers who do not offer health plans
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