Our Benefits Blog

White House Announces End to ACA Cost-sharing Reduction Payments.

Posted by Tom Stonebraker on Oct 13, 2017 12:38:41 PM

On Oct. 12, 2017, the White House announced that the federal government will no longer reimburse insurers for the ACA’s cost-sharing reductions made available to low-income individuals through the Exchanges. This is the latest action the Trump administration has taken in its efforts to dismantle the ACA. According to the administration, the federal government cannot lawfully make the cost-sharing reduction payments because there is no Congressional appropriation for those expenses.

The administration plans to end these payments effective immediately. Eliminating the ACA’s cost-sharing reductions could have a significant impact on individuals who enroll through the Exchange during the upcoming open enrollment period, which begins on Nov. 1. However, despite this announcement, premium tax credits—the other type of federal subsidy available through the Exchanges—will continue to be available.

For more information click here


Topics: Affordable Care Act, ACA

What will your insurance rates look like in 2016?

Posted by Tom Stonebraker on Jun 26, 2015 9:54:19 AM

rising_pricesWe won't know for sure until September. However, Colorado law requires health insurance companies to submit any increases to premium rates or changes to benefits to the Division of Insurance (DOI) at least 60 days prior to putting them in effect. Consumers have the right to comment on insurers' proposed rates. The DOI is providing public access to the proposed health insurance filings for 2016 health insurance plans and premiums. Go to the DOI's  "Health Insurance Rate Filings" page to find the following information about the filings for 2016:

  • Lists of insurance companies and the rates they have requested, and
  • Access to the searchable system for health insurance filings - instructions and support information are provided within the system.

Topics: Affordable Care Act

ACA Subsidies upheld by the Supreme Court

Posted by Tom Stonebraker on Jun 25, 2015 12:13:46 PM



The Supreme Court upheld the ACA Subsidies today.  To learn more click the link below.


We have a lot of information on the ACA so contact me if you would like to learn more.

Topics: Affordable Care Act

HSA Limits Will Increase for 2015

Posted by Tom Stonebraker on Apr 29, 2014 9:40:00 AM

On April 23, 2014, the Internal Revenue Service (IRS) issued Revenue Procedure 2014-30, which increases limits for health savings accounts (HSAs) effective for calendar year 2015.

 2015 HSA Contribution Limits


HDHP Minimum Deductible


Contribution Limit

HSA 55+ additional contribution amount












HSA contribution limits

2015 HSA limits

For 2015, the annual HSA contribution limit for an individual with self-only coverage under an HDHP is $3,350 (up from $3,300 for 2014).

For 2015, the annual HSA contribution limit for an individual with family coverage under an HDHP is $6,650 (up from $6,550 for 2014).

HDHP Out-of-pocket expense limits

The maximum out-of-pocket expense (deductibles, copayments and other amounts, but not premiums) limit for self-only HDHP coverage for 2015 is $6,450, which is up from $6,350 for 2014.

For family HDHP coverage, the maximum out-of-pocket expense limit for 2015 is $12,900, which is up from $12,700 for 2014.

HDHP MINIMUM deductibles

For 2015, the deductibles under an HDHP must be at least $1,300 for self-only coverage (up from $1,250 for 2014) and $2,600 for family coverage (up from $2,500 for 2014).

Effective date

These new limits are effective for calendar year 2015.

more information

For a copy of IRS Revenue Procedure 2014-30, see www.irs.gov/pub/irs-drop/rp-14-30.pdf.

For a printer frendly version click here.

Topics: Obamacare, Affordable Care Act, ACA, Deductible Limits, HSA, HDHP

Health Care Reform Pay or Play Determining Employer Size

Posted by Tom Stonebraker on Feb 8, 2013 4:44:00 PM

So what is a large employer?

Unfortunately the health care reform law doesn't have a consistent answer, it changes based on what part of the legislation we are talking about.

Here are some examples:

  • W2 reporting it's 250 or more employees during the course of the year.
  • Automatic Enrollment 200 employees is our number.
  • SBC's, 60 Day Notice, $2,500 FSA Limit, Excessive Waiting Periods all groups.
  • Pay or Play Penalties it's 50 full-time employees, including full-time equivalents (FTE's)

Today Our Focus Is On Determining Employer Size Related To Pay Or Play Penalties.

To qualify as a large employer for "Pay or Play", an employer must employ on average at least 50 full-time employees, including full-time equivalents (FTEs) on business days during the preceding calendar year. Full-time means 30 or more hours of service each week. Hours worked by employees with fewer than 30 hours per week must be counted—and then divided by 120 per month—to determine the number of FTEs. The number of FTEs is then added to the actual full-time employee count.

Employers will determine each year, based on their current number of employees, whether they will be considered a large employer for the next year. For example, if an employer has at least 50 full-time employees, including FTEs, for 2013, it will be considered a large employer for 2014.

All employers that employ at least 50 full-time employees, including FTEs, are subject to ACA’s pay or play rules, including for-profit, nonprofit and government employers. Seasonal employees and employees working abroad can be excluded under certain circumstances.  Also there are rules for common ownership that can take a company that might otherwise be a small employer and move them to large employer status.

The employee size calculation will be used later in the series when we discuss affordability and penalties.  In fact we have a calculator/spreadsheet that looks at all of the variables in the "Pay or Play" equation and will tell you what if any fines your company might have.  My main goal today is to make sure you understand the concept so we can dig deeper later.

Action Items:

  • Calculate your total employees taking into account FTE's.
  • Understand the Transition Rule for 2014 and determine what periods you will use.
  • Review the common ownership rules if applicable.

Recommended Legislative Briefs:

  • Large Employers Subject to "Pay or Play" Penalties
  • "Pay or Play" Penalty - Identifying Full-time Employees
  • "Pay or Play" Penalty - Common Ownership Aggregation Rules
These Legislative Briefs will go into more detail on all of the topics discussed as well as examples and links to the actual legislation where appropriate.

Download your Pay or Play Penalty Employer Size Legislative Briefs

Topics: Obamacare, Affordable Care Act, ACA, Pay or Play

Health Care Reform 2013 changes Checklist

Posted by Tom Stonebraker on Dec 3, 2012 10:58:00 AM

In light of the Supreme Court’s June 28, 2012, decision to uphold the health care reform law, or Affordable Care Act (ACA), employers must continue to comply with ACA mandates that are currently in effect. Employers must also prepare to comply with ACA changes that will go into effect in the future. To prepare for upcoming changes, employers need to be aware of the ACA mandates that will go into effect in 2013.  

This Talon Benefits Legislative Brief provides a compliance checklist for employers for 2013. Please contact your Talon Benefits representative for assistance or if you have questions about changes that were required in previous years.

Topics: Obamacare, Affordable Care Act, ACA, PPACA, Healthcare Reform

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