Skip to main content

August 2022 Broker Newsletter

Tuesday, August 16, 2022

Pay or Play Affordability Percentage Decreased for 2023

On August 1, 2022, the IRS issued the contribution percentages in 2023 for determining the affordability of an employer’s plan under the Affordable Care Act (ACA). For plan years beginning in 2023, employer-sponsored coverage will be considered affordable if the employee’s required contribution for self-only coverage does not exceed:

    • 9.12% of the employee’s household income for the year
    • 8.17% of the employee’s household income for the year for purposes of an individual mandate exemption (adjusted under separate guidance)

Please click here to learn more about these affordability changes.

Anthem Individual SEP Bonus

Starting with 7/1/2022 through 12/1/2022 effective dates, brokers can earn more for each Anthem Individual enrolled during a special enrollment period (SEP). Anthem will pay you $125 per member enrolled once you've enrolled at least 10 members.

Click here to learn more.

Optima Medical Loss Ratio Rebates for 2021

Based on a preliminary assessment, Optima anticipates that all HMO large group clients (fully insured groups with 51 or more total employees) who paid premiums in 2021 will receive a premium rebate check. In addition, Individual & Family Plan subscribers who paid premiums in 2021 will receive rebate checks.

Optima does not anticipate rebates for PPO regulatory large group clients or any regulatory small groups.

The deadline to issue the rebate checks is September 30, 2022.

Are You Implementing Voluntary Benefits in Your Group Portfolios?

Voluntary Benefits are more popular than ever before. Our Voluntary Benefits division can help you implement plans from Aflac, Allstate, Colonial, and more while taking the ongoing service of these plans off your plate as well. 


The information herein should not be construed as legal or tax advice in any way. This content is provided for informational purposes only. You should seek the advice of your attorney or tax consultant for additional or specific information.