member questions answered by our highly-qualified technical specialists.
If you have not registered for members-only sevices from PIA click here.
Browse by topic
Life/health
Pre-existing condition
We have a small group health insurance client with 34 employees. We are putting this client into a new plan. One employee (who has been covered under the employer’s previous plan) has an ongoing health condition that requires treatment. How do we handle this pre-existing condition?
Contestability-group health
What is the incontestability period for small group health policies in New Jersey? We have a carrier that is trying to rescind a policy because of an allegedly undisclosed medical condition.
Small group—Medicare eligible
I know that we need to get eligible employees who turn down coverage under our New Jersey small employer group plan to sign a waiver. What about eligible employees who have reached Medicare age?
COBRA basics
Which employers are subject to COBRA rules? How long does COBRA entitlement last?
ERISA pre-emption
We are trying to help a client with a health claim. The family is insured under a self-insured health trust based in Pennsylvania, even though they reside in New York state. Do New York’s minimum benefit standards apply?
HIPAA ’eligible individual’ rule
One of our insureds has a New Jersey individual health insurance policy. He has a pre-existing condition. He is considering moving to another state. Does the federal law offer him portability protection?
ACA employee tax notices
I have a client who has 75 employees. What type of tax information does my client have to provide to employees to comply with the requirements of the Affordable Care Act?
Health insurance premium rebates
We received a rebate from our health insurance company because they did not meet the 80/20 rule under the federal Affordable Care Act. What can I, as the employer, do with the money?
Charging fees for health insurance in New Jersey
I am a health insurance producer. I’ve heard that I can charge a fee in addition to receiving a commission on some sales. I’m not sure if it is small or large group sales that this applies to. Can you clarify this for me?
Health-care exchanges—broker compensation
Can brokers sell through a health-care exchange? Can they be compensated?
Producer health exchange certification
What can you tell me about the interplay between being certified to sell through an exchange, being licensed as a health producer and receiving commissions?
Small business health-care tax-credit eligibility
In order to determine if you qualify for the small business health-care tax credit, you will need to answer a few simple questions:
- Do you have fewer than 25 full-time employees?
- Do those employees have an average wage of less than $53,000?