Medical Billing Blog

The federal government may not completely finish the automated payment system for Healthcare.gov for “several months,” White House spokesman Jay Carney said Friday. Until that system is fully running, the administration won’t be able to verify how many of the consumers who signed up for through the health insurance website are, in fact, paying their premiums and are hence truly enrolled. The administration reported earlier in the week that nearly 3.3 million people have selected plans on through the marketplace as of Feb. 1. However, insurance companies are saying that about 20 percent of those people failed to pay their premiums on time and consequently didn’t receive coverage in January, the New York Times reports. Paying the first month’s premium is the final step in completing an enrollment. Under federal rules, people must pay the initial premium to have coverage take effect. In view of the chaotic debut of the federal marketplace and many state exchanges, the White House urged insurers to give people more time, and many agreed to do so. But, insurers said, some people missed even the extended deadlines.

The Obama administration announced Monday it would give medium-sized employers an extra year, until 2016, before they must offer health insurance to their full-time workers. Firms with at least 100 employees will have to start offering this coverage in 2015. Small businesses with fewer than 50 workers have always been exempt from the new coverage requirements but the law originally required all other businesses to start covering their workers for face penalties beginning Jan. 1, 2014. Under the Affordable Care Act, larger employers are generally subject to tax penalties if they fail to offer "minimum essential coverage" to full-time employees and their dependents. The administration laid out a three-tier approach. For larger employers with 100 or more employees (about 2 percent of employers): Seventy percent of employees must be offered coverage in 2015, and in later years at least 95 percent of employees must be offer coverage. Employers that do not meet these standards will be subject to tax penalties. For employers with 50 to 99 employees (about 2 percent of employers): Companies with 50 to 99 employees will have an extra year, until 2016, to provide coverage or pay tax penalties. For small businesses with fewer than 50 employees (about 96 percent of all employers): These companies will not be required to provide coverage or fill out any forms in any year. Officials Monday said that the delay in the Affordable Care Act mandate will affect 50 percent of the businesses that were supposed to be complying by 2015. About 7.8 million workers are employed by the affected businesses. However, those officials also took pains to note that the so-called employer mandate to offer affordable health insurance to workers does not affect 96 percent of the employers in the U.S., because they have fewer than 50 full-time employees.