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New health reform rules finalize policies for non-profit organizations that object on religious or moral grounds to gain an exemption from having to “contract, arrange, pay or refer for” contraceptive coverage. The final rules reflect public feedback received in response to Feb. 6, 2013 proposed rules (78 Fed. Reg. 8456). In the proposed rule, the […]
Self-funded student health plans and state high-risk pool coverage will be considered minimum essential coverage for calendar year 2014, but they will have to get approved by a health insurance exchange to gain such consideration in 2015, under rules from the Centers for Medicare and Medicaid Services Carrying minimum essential coverage is required for an […]
More than a month after Max Baucus, D-Mont., an early proponent of health reform, said the implementation of state-based health insurance marketplaces was going so poorly that a “train wreck” would ensue, the Obama administration is now launching a public relations effort aimed at teaching consumers how to buy marketplace coverage. Marketplaces are supposed to […]
How health insurance exchange money is spent, which private insurance products may be offered on exchanges, who advises exchange consumers on plan choices and how well exchanges handle personal data will be under federal scrutiny, as explained in proposed program integrity rules issued by CMS on June 17. The rules also propose tweaks to existing regulatory language […]
An increasing number of employers are examining providing a low-benefits health plan that covers only preventive health services but not high-price major medical claims. Offering this type of low cost or “skinny” plan is allowed under the health reform law. The question is: Will skinny plans trigger a large-employer exodus to de minimis coverage, and if so, […]
Health reform fees that health insurers and self-funded plans must pay in order to fund the Patient-Centered Outcomes Research Institute are “ordinary and necessary business expenses,” and therefore qualify as deductible from federal taxes, a recent IRS memo states. Insurers and health plans will pay the $1 (soon to become $2) per covered life fee […]
Starting July 31, 2013, the IRS will start collecting, and employers will start paying, a new excise tax authorized by the health reform law. This annual fee will be imposed on most insured and self-insured group health plans for the next seven years. The feds have amended the April 2013 IRS Form 720 (Quarterly Federal […]
A health reform requirement that all insurers offer four levels of health coverage to small businesses will be delayed until 2015. Under a final rule from HHS (to be officially published June 4), many small employers will have fewer plans to choose from the Small Business Health Options (SHOP) program in 2014. Background Starting in 2014, small […]
Federal agencies just issued new final rules for contingency-based wellness program goals under health reform. If employers offer to give a reward (such as discounted health insurance premiums) to workers who accomplish some kind of biometric goal (a contingency standard), then employers must have a standing “reasonable alternative” to the contingency-based standard, government officials told […]
Determining whether group health coverage provides “minimum value” is key to avoiding penalties under health reform’s premium tax credit program, so employers will likely welcome new proposed rules that further explain MV criteria. The proposal, to be published May 3 by IRS, would complement language in final rules issued in February on how reform’s MV […]