We periodically post articles and information to keep you informed on the latest compliance and regulatory matters. This newsletter is intended to provide information of general interest, and does not intend to provide legal advice.
The Department of Labor’s Employee Benefits Security Administration has posted the following related to preexisting condition exclusions, lifetime and annual limits, rescissions and patient protections under the Affordable Care Act:
Published version of Interim Final Regulation, available at: http://www.dol.gov/federalregister/HtmlDisplay.aspx?DocId=23983&AgencyId=8&DocumentType=2
Model Notice on Patient Protections, available at http://www.dol.gov/ebsa/patientprotectionmodelnotice.doc
Model Notice on Lifetime Limits No Longer Applying and Enrollment Opportunity, available at http://www.dol.gov/ebsa/lifetimelimitsmodelnotice.doc
Model Notice of Opportunity to Enroll in Connection with Extension of Dependent Coverage to Age 26, available at http://www.dol.gov/ebsa/dependentsmodelnotice.doc
[PPACA: Preexisting Condition Exclusions, Lifetime and Annual Limits, Rescissions, and Patient Protections, 26 CFR Parts 54 and 602; 29 CFR Part 2590; 45 CFR Parts 144, 146, and 147]
Regulations:
http://www.federalregister.gov/OFRUpload/OFRData/2010-15278_PI.pdf
Fact Sheet:
http://www.healthreform.gov/newsroom/new_patients_bill_of_rights.html
The IRS, DOL, and HHS have jointly issued interim final regulations implementing the health care reform rules for group health plans and health insurance coverage in the group and individual markets regarding preexisting condition exclusions (PCEs), lifetime and annual dollar limits on benefits, rescissions, and certain patient protections. The regulations generally apply to group health plans and insurers for plan years beginning on or after September 23, 2010 (i.e., January 1, 2011 for calendar-year plans).
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On June 14, 2010, the Department of Health and Human Services (”HHS”), the Department of Labor (”DOL”), and the Internal Revenue Service (”IRS”), jointly released their “Interim Final Rule for Group Health Plans and Health Insurance Coverage Relating to Status as a Grandfathered Plan under the Patient Protection and Affordable Care Act” (the “Rule). The Rule addresses what changes an insurer or plan sponsor may make to health insurance coverage or a group health plan without loss of its “grandfather” status under the Patient Protection and Affordable Care Act (”PPACA”) and what administrative steps a plan must take to maintain grandfather status.
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Recent health care reform legislation requires group health plans (and insurers of group or individual health coverage) that offer dependent coverage to continue making such coverage available for an adult child until age 26.
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The Department of Labor’s Employee Benefits Security Administration COBRA page now has available updated Model Notices, Application for Expedited Review of Denial of COBRA Premium Reduction, Fact Sheet, and Frequently Asked Questions (FAQs) that reflect the provisions of the Continuing Extension Act of 2010. They are available at http://www.dol.gov/COBRA.
Due to the interest in the Early Retiree Reinsurance Program that was part of the new Healthcare Reform laws, we are sharing information in the below articles and attachments that we believe you will find of interest. This information should not be construed as legal advice nor as an endorsement of the law firm or others providing it. Please read more to learn about:
The U.S. Department of Health and Human Services’ regulations establishing the Early Retiree Reinsurance Program in the Affordable Care Act; Interim final regulations; and the available final application.
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GPA is providing a copy of the following DOL announcement for your convenience.
The U.S. Department of Labor (DOL) today announced the availability of a new tool to help America’s employers ensure their employment policies and practices do not discriminate against qualified individuals with disabilities.
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The Department of Labor has revised the model notice on its website. The updated model notice for employers to use regarding eligibility for premium assistance under Medicaid or CHIP with updated contact information for Arizona, Idaho, Louisiana, and Oregon is available at http://www.dol.gov/ebsa/chipmodelnotice.doc
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The following article was published by Alison Fox and Andrew Murphy, attorneys in the Employment and Labor division of Baker & Daniels. While outside of our normal health arena, we thought that, as employers, you would be interested. We are passing this along for informational purposes. For advice on this laws application to your situation, please consult your legal counsel.
A short and largely unpublicized provision in the Patient Protection and Affordable Care Act, which President Obama signed into law on March 23, 2010, expands employer requirements for lactating employees.
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