Snapshot PPACA requires that health insurers offering coverage in the individual or small group health insurance markets include essential health benefits beginning January 1, 2014. There are 10 required categories of services in the essential health benefits package. On December 16, 2011 HHS issued an Informational Bulletin announcing that it intends to propose that essential […]
ACA, EHB, essential health benefits, HHSOn December 2, 2011, the DOL issued Technical Release 2011-04 concurrently with HHS issuance of an Interim Final Rule regarding Medical Loss Ratio (MLR) rebates. The Interim Final Rule appeared in the December 7, 2011 Federal Register and requests comments no later than February 6, 2012. The HHS guidance is expressed in terms of “subscribers” […]
ACA, DOL, minimum loss rebates, MLRForm W-2 Reporting As described in ErisaALERT 2011-5, the Affordable Care Act required informational reporting of the aggregate cost of employer sponsored group health plan coverage beginning with 2012 W-2s issued in January 2013. On October 31st, the IRS conducted an informative webinar which should be available shortly on their website. In addition, the IRS […]
ACA, w-2 reportingBottom line: As noted in Part I, a summary of benefits and coverages (SBC) must be provided to health plan participants and beneficiaries. The SBC consists of a 4 page (double sided) summary in a prescribed format and includes a glossary of terms as well as examples of how certain conditions will be covered by […]
ACA, SBCBottom line: Effective March 23, 2012, a summary of benefits and coverages (SBC) must be provided to health plan participants and beneficiaries. The SBC consists of a 4 page (double sided) summary in a prescribed format and includes examples of how certain conditions will be covered by the plan. A separate glossary of terms is […]
ACA, SBCBottom line: For plan years beginning on or after August 1, 2012, new plans and non grandfathered plans must offer with no cost sharing, certain preventive care and screenings for women. Exemptions may be allowed for certain religious employers. Background The Affordable Care Act (ACA) incorporates sections of the Public Health Services (PHS) Act into […]
ACA, women’s preventive servicesIn this ALERT we continue summarizing recent government guidance/announcements. Form W-2 Reporting The Affordable Care Act required informational reporting regarding the aggregate cost of employer sponsored group health plan coverage to be included in W-2s and was originally scheduled to be effective with the 2011 calendar year. Notice 2010-69 provided transition relief until 2012 although […]
ACA, w-2 reportingIn this ALERT we continue summarizing recent government guidance/announcements. Automatic Enrollment in Large Employer Health Plans Recall that Health Care Reform contained a provision requiring automatic enrollment for large employers with more than 200 full-time employees. There were varying interpretations of when this provision would take effect. EBSA recently announced that it is hosting a […]
ACA, automatic enrollment, claims appeals, CLASS ActIn this ALERT we are going to continue summarizing key government guidance issued over the past two months. It may be old news to some but hopefully will serve as a reminder. DOL FAQs As you are probably aware, the DOL has published a number of FAQs, the most recent being FAQ Part V. Two […]
ACA, automatic enrollment, SBCThere has been a lot of government guidance lately; we thought we would summarize just a few items in this ALERT as well as remind you of some action you might have to take soon! Plans that obtained waiver of annual limit rules – February 7, 2011 deadline for certain plans. As a condition of […]
ACA, creditable coverage to CMS, ndt, Nondiscrimination testing(c) 2015 Erisa Diagnostics - We focus on benefits, so you can focus on business