Health coverage providers and applicable large employers – and those assisting them in preparation for electronically filing the 2015 health care information returns – need to understand the IRS ACA Information Return electronic filing process. Publication 5165, Guide for Electronically Filing Affordable Care Act Information Returns for Software Developers and Transmitters, outlines the communication procedures, transmission formats, business rules and validation procedures for returns transmitted electronically through the AIR system. To develop software for use with the AIR system, software developers, transmitters, and issuers should use the guidelines provided in this publication along with the XML schemas published on IRS.gov.
Blue Cross, Blue Shield fined over bad doctor directories
The California Department of Managed Health Care (DMHC) announced today that it issued a $350,000 fine against Blue Shield of California (Blue Shield) and a $250,000 fine against Anthem Blue Cross (Anthem) for inaccurate provider directories.
Healthcare.gov tests health plan selection by doctor search function
Beginning today, HealthCare.gov is piloting a new beta feature that allows consumers to search plans by their preferred provider or health facility. Some consumers will be part of a pilot that allows them to use the beta Doctor Lookup feature as they compare their coverage options in window shopping or when selecting a plan.
Voter registration by Covered California Certified Insurance Agents
Under federal and state law, Certified Insurance Agents are required to offer consumers assistance with voter registration. You are required to complete the Voter Registration training before November 1, 2015 and electronically sign the Certificate of Completion, included with the DocuSign® materials, no later than November 15, 2015 to avoid the risk of termination. You can complete the Voter Registration training now by clicking here, then navigating to the “Downloads” section to find three separate voter registration training guides.
Oscar California 2016 health plan documents
Oscar has posted plan specific documents relating to their California individual and family on and off exchange plans. These documents will help educate consumers about the Oscar health plans. In particular, consumers should carefully review and understand Oscar’s Simple and Simple Plus series of non-standard, off-exchange health plans quite different from the standard benefit design. Oscar will be offering plans in Region 16, Southwest Los Angeles County, and Region 18, Orange County.
Torrance Health IPA added to Blue Shield Medicare plans
Torrance Health IPA (THIPA) was inadvertently omitted from Blue Shield’s 2016 Provider Directory for Blue Shield 65 Plus (HMO) in Los Angeles County.
African-American community to get special attention from Covered California
Covered California officials kicked off a new marketing and outreach campaign to increase African-American enrollments in the state’s health coverage program. The campaign focuses on informing African-Americans about the affordability of quality health insurance, and the exchange will place particular emphasis on specific geographic areas across the state where higher numbers of uninsured and subsidy-eligible African-Americans live, work, play and pray.
Ranking Covered California 2016 health plans by premium
California has put together a high level overview of the health plans being offered in each of the nineteen regions in the state. Each region has two quick fact pages which gives information on rates, plans ranked by premium cost, and regional hospitals in-network.
2016 health plan changes presentation from Covered California
Covered California hosted a webinar for Certified Insurance Agents and Certified Enrollment Counselors on some of the significant changes to their individual and family plan standard benefit design for 2016. The presentation is approximately 42 minutes long and can be viewed on YouTube which can be found at the end of this post. They also created a PDF of the presentation slides that can be downloaded at the end of this post.
L.A. Care Covered 2016 health plan documents
L.A. Care Covered will offer standard benefit design health plans in all of Region 16 (S.W. Los Angeles County) and part of Region 15 (N.E. Los Angeles County). All their plans are HMOs and they offer no non-standard benefit design plans off the exchange.
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