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Employers and plan administrators that offer health flexible spending accounts have been bracing themselves for Jan. 1, 2013. That’s when the $2,500 limit on health FSA salary reduction contributions provided for in the Patient Protection and Affordable Care Act kicks in. The IRS on May 30 issued Notice 2012-40, which provides guidance on the limit, […]
A set of safe harbors related to the enforcement of summaries of benefits and coverage (SBCs), which insurers and plan sponsors must distribute as part of health care reform, was issued May 11 by the U.S. Department of Labor and the Employee Benefits Security Administration. The DOL/EBSA guidance creates regulatory exceptions for situations where insurers […]
The federal government seems to be fishing around for evidence showing that self-insured health health plans will siphon off healthy lives from state-run insurance exchanges (a cornerstone of reform). On April 26, the U.S. Departments of Labor (DOL), Health and Human Services (HHS) and IRS/Treasury issued a set of questions about the use of stop-loss […]
Beginning in 2014, employers that sponsor health plans will have to watch closely if any employees qualify for a premium tax credit, triggered whenever the employer-sponsored coverage is unaffordable, or does not provide minimum value. On April 26, the IRS requested comments on how to determine whether a health plan provides “minimum value.” It did […]
About a year from now, employers and plan administrators will be preparing to pay a fee to fund the Patient Centered Outcomes Research Institute (PCORI). The IRS on April 17 (77 Fed. Reg. 22691) issued proposed regulations on the fee. The Patient Protection and Affordable Care Act (PPACA) created the PCORI fee to promote research […]
As the U.S. Supreme Court decides the fate of health reform, America is getting the chance to try the law on for size while waiting for the people in the robes to say how much of it will remain in effect. Some employers are probably soft-pedaling implementation – they don’t like the law much anyway, […]
It may seem paradoxical that the U.S. Department of Labor (DOL) should begin auditing health plans for compliance with the health reform law’s mandates, given that the U.S. Supreme Court could very well strike down the Affordable Care Act (ACA) for being unconstitutional in early summer. But it’s better that plans be ready to demonstrate […]
A standard health plan identifier proposed by the U.S. Department of Health and Human Services (HHS) could cost health plans a total of up to $1.3 billion to implement. The proposed rules, released April 9, would establish a unique health plan identifier (HPID) for HIPAA-covered health plans (both group health plans and insurers), and an […]
Final rules that will govern the state-based insurance exchanges created by health reform include more detailed privacy and security requirements for the exchanges themselves and participating insurers. These restrictions also will apply indirectly to agents, brokers and others involved in this process. In the rules, published March 27 (77 Fed. Reg. 18310), the U.S. Department […]
Recent legal challenges have focused on constitutional issues, but health care reform is expected to create new reasons for benefits and employment-law litigation, according to a reform expert. Reform rules fraught with legal risk include: (1) pay-or-play requirements, (2) claims appeals and external review, (3) essential benefits; and (4) retiree medical rules. Another area of […]