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Employers are understandably nervous about the transitional reinsurance fee, which health insurers and employer health plans must pay from 2014 through 2016. The fee will be collected by HHS, even though the states will tailor their own risk adjustment programs. It must be paid annually. Plans will probably make their first payment for 2014 a […]
Employer group health plans must eliminate waiting periods of more than 90 days before enrolling otherwise eligible employees (or dependents) into health coverage, under proposed rules issued on March 18 by the federal agencies implementing health reform. For Clear Full-time Hires, It’s 90 Days Group health plans and health insurers in the group plan setting […]
With thousands of pages of new laws and rules, there must be thousands of new reasons for employees to sue for health benefits not delivered properly in the wake of near-complete enactment of health reform starting in 2014, one could be forgiven for thinking. Health reform certainly does appear to be somewhat of a litigation […]
It’s been busy recently for the federal government when it comes to implementing various health reform requirements. Here’s an overview of new guidance issued the week of Feb. 25-March 1 on health insurer fees, market reforms, the Small Business Health Options Program, multiple employer welfare arrangement regulation and information reporting. Self-insured Health Plans Exempt from […]
Final health insurance market reform rules issued Feb. 22 could result in higher health premiums, a major association of health insurers predicted, even though the policy goal is make health insurance more dependable and valuable for consumers. The final rules issued by the U.S. Department of Health and Human Services are designed to ensure that […]
Health reform’s final essential health benefits rule makes it clear that self-insured and large group health plans do not need to comply with limits on growth in employee cost-sharing, offer all 10 categories of essential health benefits, or meet actuarial minimums like small-group and individual policies. However, the regime explained in the rule is still […]
Along with newly issued health reform rules finalizing essential health benefits provisions comes a new series of FAQs from the U.S. departments of Labor, Health and Human Services and Treasury. This guidance addresses specific questions raised about the scope of reform’s cost-sharing and preventive services provisions, and provides some transition relief for large group and self-insured […]
A federal district court blocked an effort to force an ERISA health plan to pay secondary for an expensive specialty drug that was excluded from coverage because it wasn’t filled at an in-network provider as required by plan terms. The U.S. District Court for Northern Illinois rejected the plaintiff‘s argument that whenever Medicare covered a […]
To further accommodate religious organizations outraged over a health care reform requirement mandating the coverage of contraceptive care, three federal agencies — Treasury, Labor and Health and Human Services — jointly issued final regulations Feb. 1 that would exempt more group health plans and policies established or maintained by certain religious organizations from the requirement, […]
Employers will not have to start distributing notices to all employees on the existence of health insurance exchanges on March 1 as required by the health reform law. This requirement is now deemed impracticable because many state exchanges have not been set up, and do not become operational until Jan. 1, 2014. Also, the requirement […]