Slideshow 5 bills in Congress for brokers to watch in 2016

  • November 30 2015, 12:00am EST
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Election Day 2015 has come and gone, which means it’s time to turn attention to the legislative matters at hand for 2016. Employers and advisers continue to seek relief from certain provisions of the Affordable Care Act and other regulatory burdens through legislative action. Here are five bills brokers and agents should be watching for a potential impact on the benefits industry and the employer clients they serve.

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Access to Professional Health Insurance Advisors Act

H.R. 815 and S. 1661

Amends the Public Health Service Act to exclude remuneration paid for licensed independent insurance producers from administrative costs for purposes of calculating the medical-loss ratio of a health insurance plan.

Defines "independent insurance producer" to mean an insurance agent or broker, insurance consultant, benefit specialist, limited insurance representative, and any other person required to be licensed under state law to sell, solicit, negotiate, service, effect, procure, renew, or bind policies of insurance coverage or offer advice, counsel, opinions, or services related to insurance.

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Employee Health Care Protection Act

S. 158

Permits a health insurance issuer that had in effect health insurance coverage in the group market on any date during 2013 to continue offering that coverage through 2018 outside of a health care exchange established under the Affordable Care Act. Treats that coverage as a grandfathered health plan for purposes of an individual meeting the requirement to maintain minimum essential health coverage.

Equalizing the Playing Field for Agents and Brokers Act

S. 1853

Directs the Department of Health and Human Services (HHS) to establish a toll-free customer service support help line to enable certified health insurance agents and brokers to seek assistance regarding qualified health plans offered in the federal health insurance marketplace.

The bill amends the Affordable Care Act to require HHS to:
make available on the federal government website for health insurance coverage a list of all certified agents and brokers;
contract with the National Insurance Producers Registry to regularly verify the licensure status of all such agents and brokers and develop a mechanism to enable submission of changes to contact and licensure information; and provide trained navigators, agents, and brokers, no later than five business days after promulgation or issuance of any new cost- or enrollment-related policies, with a clear description of the policy changes.

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Save American Workers Act

H.R. 30

This bill amends the Internal Revenue Code to change the definition of "full-time employee" for purposes of the employer mandate to provide minimum essential health care coverage under the Affordable Care Act from an employee who is employed on average at least 30 hours of service a week to an employee who is employed on average at least 40 hours of service a week.

(Passed House in January, but no Senate action yet)

Small Business Health Relief Act

S. 254

Repeals provisions of the Internal Revenue Code that: (1) impose fines on large employers (those with 50 or more full-time employees) who fail to offer their full-time employees the opportunity to enroll in minimum essential health insurance coverage, and (2) require large employers to file a report with the Department of the Treasury on health insurance coverage provided to their full-time employees.

Repeals provisions of the ACA that: (1) limit the annual deductible on health plans offered in the small group market, (2) deem catastrophic plans to meet essential health benefits coverage requirements for certain individuals, and (3) impose an annual fee on health insurance entities.

The bill would also, among other things, deem high deductible health plans to meet essential health benefits coverage requirements if the enrollee has established a health savings account; amend the Public Health Service Act to repeal the limitation on premium rate variance by age in the individual or small group market; repeal the prohibitions on payments for over-the-counter medications from HSAs, MSAs, and FSAs; repeal the $2,500 annual limit on employee contributions by salary reduction to a health flexible spending arrangement under a cafeteria plan; and allow a health plan to maintain its status as a grandfathered health plan regardless of any modification to cost-sharing, employer contribution rates, or covered benefits.