Health Care Reform Dashboard

Health Care Reform Dashboard

Charting developments on the
Affordable Care Act

Plan Design Requirements

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07/30/2015

Final Rules for Preventive Services

The U.S. Departments of Treasury, Labor (DOL) and Health and Human Services (HHS) have issued interim final regulations and Frequently Asked Questions and Answers on the cost-free coverage of preventive services under the Affordable Care Act (ACA). Although the regulations address many preventive care subjects, all of the attention has focused on the changes to [&hellip… Continue Reading »
05/26/2015

New Guidance on Cost-Sharing Limits and Provider Nondiscrimination Rules

The U.S. Departments of Labor, Health and Human Services, and the Treasury have jointly issued a new set of FAQs that clarifies the application of the rules establishing cost-sharing limits. For 2016, non-grandfathered group health plans must cap the amount that plan participants pay in deductibles, copayments, coinsurance and the like at $6,850 for self-only [&hellip… Continue Reading »
05/13/2015

Guidance Clarifies Certain Preventive Care Requirements

Recent guidance issued jointly by the U.S. Departments of Labor, Health and Human Services, and the Treasury clarifies how the Affordable Care Act’s requirement to provide cost-free coverage for preventive care applies to several types of products and services. In particular, the guidance clarifies that:  Coverage for all types of contraception (currently 18 different types are [&hellip… Continue Reading »
04/21/2015

EECO Tackles Wellness Programs

After much silence, some litigation, and recent congressional hearings, the Equal Employment Opportunity Commission (EEOC) has at long last proposed regulations (together with a fact sheet and set of frequently asked questions and answers) that interpret how the Americans with Disabilities Act (ADA) applies to wellness program incentives. Employers that sponsor wellness programs are likely [&hellip… Continue Reading »
02/25/2015

Partial Relief for Employer Payment of Individual Insurance Premiums

In a recent notice, the Internal Revenue Service has tempered prior guidance that closed the door on employer arrangements for paying the cost of individual health insurance for employees. The IRS still views these premium reimbursement arrangements as group health plans that fail to meet the Affordable Care Act (ACA) prohibition against annual dollar limits [&hellip… Continue Reading »
01/09/2015

Expatriate Plans Exempted from Many Affordable Care Act Provisions

In the Consolidated and Further Continuing Appropriations Act (the recently enacted federal budget bill often known as the “CRomnibus” legislation), Congress has exempted health plans designed to cover expatriates from most of the requirements of the Affordable Care Act. The exemption will generally apply where a group health plan provides significant health coverage and substantially [&hellip… Continue Reading »
11/05/2014

IRS Seeks to Curb Popularity of ‘Skinny’ Health Plans

The Internal Revenue Service, in Notice 2014-69, has concluded that certain unconventional group health plan designs that offer limited or no coverage for in-patient hospitalization services and/or physician services will not provide “minimum value.” Consequently, this may expose large employers to financial penalties under the Affordable Care Act’s (ACA’s) “pay-or-play” employer mandate. These plans, sometimes [&hellip… Continue Reading »
08/25/2014

Government Agencies Release Further Accommodations to Organizations Opposing Mandated Contraceptive Coverage

In response to the recent U.S. Supreme Court decision in Burwell v. Hobby Lobby, Inc., the U.S. Departments of Health and Human Services (HHS) and Labor (DOL) published proposed rules on August 22, 2014, expanding the availability of the religious accommodation to the contraceptive mandate provided in their July 2013 final regulations to closely held [&hellip… Continue Reading »
07/14/2014

Midyear Check on Health Plan Compliance

If you sponsor or administer a group health plan, you are almost certainly taking steps to prepare for legal requirements that will become effective on or before January 1, 2015. New rules under HIPAA, the Affordable Care Act (ACA), and other laws will affect your plans. As we pass the midpoint of 2014, it is [&hellip… Continue Reading »
05/07/2014

New FAQs Address Effect of Affordable Care Act on COBRA and Other Matters

In a wide-ranging set of frequently asked questions (FAQs) and other guidance, the U.S. Departments of Labor, Treasury, and Health and Human Services have addressed a number of issues pertaining to the Affordable Care Act (ACA). They include issues pertaining to COBRA and the Children’s Health Insurance Program Reauthorization Act (CHIPRA), annual cost-sharing limits, preventive care, [&hellip… Continue Reading »
04/03/2014

IRS Issues Guidance on Health FSAs

The IRS has issued guidance on two issues affecting health flexible spending arrangements (health FSAs). The first provides guidance on how a health FSA that consists solely of amounts carried forward from the prior year (through rules issued last fall that allow up to $500 to be carried forward) may be coordinated with coverage under [&hellip… Continue Reading »
11/12/2013

Final Mental Health Parity Act Regulations Released

The Internal Revenue Service, U.S. Department of Labor, and U.S. Department of Health and Human Services have jointly released final regulations and new FAQs implementing the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). MHPAEA provisions generally became effective for plan years beginning on or after October 3, 2009, with [&hellip… Continue Reading »
07/02/2013

Final Regulations Issued on Contraceptive Coverage, Religious Organizations

The U.S. Departments of Health and Human Services, Labor, and Treasury recently released final regulations on the exemption from providing coverage for contraceptive and certain other preventive services that is available to certain religious organizations. The final regulations apply to plan years beginning on or after January 1, 2014. The final rules adopt most of the [&hellip… Continue Reading »
06/03/2013

Final Wellness Program Nondisrimination Rules Published

The U.S. Departments of Treasury, Labor, and Health and Human Services have issued final regulations on the nondiscrimination requirements applicable to wellness programs. The new rules essentially follow the terms set forth in the proposed regulations, with several clarifications, all of which will apply to plan years beginning on and after January 1, 2014. The final [&hellip… Continue Reading »
02/26/2013

HHS Finalizes Essential Health Benefits and Related Health Plan 2014 Requirements

The U.S. Department of Health and Human Services has issued final regulations and a set of frequently asked questions and answers establishing standards for the provision of essential health benefits in the individual and small group insurance markets, both inside and outside of an Exchange. In large part, the final rules adopt standards set forth in the proposed regulations [&hellip… Continue Reading »
02/26/2013

Agencies Issue New FAQs on Affordable Care Act Issues

The U.S. Departments of Labor, Health and Human Services, and Treasury have collectively issued a new series of frequently asked questions and answers primarily directed toward preventive care issues. The new FAQs address a range of specific issues relating to the requirement that health plans (other than grandfathered plans) make coverage for preventive care available without [&hellip… Continue Reading »
02/05/2013

Expanded Contraception Coverage Exemption for Religious Organizations Proposed by HHS and IRS

The U.S. Departments of Health and Human Services and Treasury have released proposed regulations, a fact sheet, and a press release on the Affordable Care Act contraceptives coverage under Women’s Preventive Health Services and the exemption for religious organizations. This proposal, issued on January 30, 2013, attempts to accommodate religious employers’ objections to all or some [&hellip… Continue Reading »
11/29/2012

Guidance Issued on Essential Health Benefits and Other Individual and Small Group Market Reforms

The U.S. Department of Health and Human Services (HHS) has issued two sets of proposed regulations issued under the Affordable Care Act (ACA) that will affect the design, availability, and cost of health insurance plans, primarily in the individual and small group markets. Most significantly, HHS has published proposed regulations defining the “essential health benefits” [&hellip… Continue Reading »
11/27/2012

Proposed Regulations Address Discrimination in Wellness Programs

The Departments of Treasury, Labor, and Health and Human Services have issued a revised set of proposed regulations for nondiscrimination in wellness programs. The regulations prohibit a wellness program offered as part of a health plan from discriminating against individuals on account of an adverse health factor. The revised rules are scheduled to apply in [&hellip… Continue Reading »
05/31/2012

IRS Issues Guidance on $2,500 Health FSA Contribution Limit

The Affordable Care Act (ACA) imposes an annual $2,500 limit on the amount of salary reduction contributions that an employee may make to a health flexible spending account (Health FSA). This limit applies to tax years beginning after December 31, 2012, and is indexed for inflation in ensuing years. In a recently issued notice, the [&hellip… Continue Reading »
02/27/2012

HHS Releases FAQs on Essential Health Benefits

On February 17, 2012, the U.S. Department of Health and Human Services (HHS) released a set of FAQs concerning the Essential Health Benefits Bulletin it issued on December 16, 2011. The FAQs offer new guidance and raise new questions about the scope of what is considered an essential health benefit (EHB) for purposes of applying [&hellip… Continue Reading »
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