Final Rules on Employment Based Wellness Programs Released

On May 23, 2013, the DOL, Treasury and HHS finalized the HIPAA Nondiscriminatory Wellness Programs Regulations that were proposed in November 2012, clarifying what will work and what will not work for 2014 and beyond.

 

The accompanying news release stated that the “final rules ensure flexibility for employers by increasing the maximum reward that may be offered under appropriately designed wellness programs.”

Health Insurance Exchange and Revised COBRA Model Election Notices Released

The Affordable Care Act (ACA) added a section to the Fair Labor Standards Act (FLSA) that said an applicable employer must provide a written notice to each existing employee no later than March 1, 2013, and to new hires beginning on that date. But on January 24, 2013, the Department of Labor (DOL) put out an FAQ that recognized that was an unrealistic deadline.

On May 8, 2013, the DOL provided an update with temporary guidance and templates of the required Exchange Model Notices (For Employers who offer a health plan and Employers who do not offer a health plan) and the Revised Model COBRA Election Notice. Starting on October 1, 2013, the notices have to be given to new employees on the day they are hired. The notices have to be given to existing employees no later than October 1, 2013.

The notices, along with further guidance, can be found at www.dol.gov/ebsa. Please review the attached Health Care Reform Hot Topic for more information on the Model Notices Explanation.

Will Health Care Reform Make Workers Cheaper to Insure?

DOL Releases Guidance on Model Exchange Notice & Model COBRA Election Notice

The Department of Labor released Technical Release 2013-02 on May 8, 2013. It provided guidance for the Model Exchange Notice and the Model COBRA Election Notice. A copy of Technical Release 2013-02 follows:

I. Introduction

This Technical Release provides temporary guidance regarding the notice requirement under FLSA section 18B and announces the availability of the Model Notice to Employees of Coverage Options. This Technical Release also provides an updated model election notice for group health plans for purposes of the continuation coverage provisions under Title X of the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) to include additional information regarding health coverage alternatives offered through the Marketplace.

New forms in health care's reform - Simplified Applications

On April 30, 2013, the Centers for Medicare & Medicaid Services (CMS) announced that the application for health coverage has been simplified and significantly shortened. The application for individuals without health insurance has been reduced from twenty-one to three pages, and the application for families is reduce by two-thirds. The consumer friendly forms are much shorter than industry standards for health insurance applications today.

In addition, for the first time consumers will be able to fill out one simple application and see their entire range of health insurance options, including plans in the Health Insurance Marketplace, Medicaid, the Children's Health Insurance Program (CHIP) and tax credits that will help pay for premiums.

Departments Issue FAQ on Summary of Benefits & Coverage Changes

On Tuesday, April 23, 2013, HHS, Treasury and the DOL published Part XIV of their FAQs on the Affordable Care Act, focusing on revisions to the Summary of Benefits and Coverage (SBC).

 

The seven-question FAQs introduce two primary changes, which take effect for plan years starting on or after January 1, 2014:

• A statement indicating whether a plan provides minimum essential coverage (MEC)
• A statement answering whether the plan's share of the total allowed costs of benefits meets applicable minimum value (MV) requirements (i.e., at least 60 percent of allowed charges for covered services, also known as bronze level coverage)

Plans may provide this information by either updating their SBCs or providing it in a cover letter. The departments provided sample language in the FAQs. In addition, the SBC template has been updated as well as the sample completed SBC. The uniform glossary remains unchanged.

 

In a previous notice, the departments indicated that more wholesale changes would be likely for 2014, including revisions and additions to the coverage examples. However, these FAQs confirm that the MEC and MV statements are the only required changes. Also, much of the transition relief provided in 2013 has been extended to 2014. See Q/A-5 in the FAQs for additional details.

 

FAQs about the the Affordable Care Act Implementation Part XIV

 

Original article courtesy of Infinisource:  http://newsroom.infinisource.com/post/2013/04/25/Departments-Issue-FAQ-on-Summary-of-Benefits-Coverage-Changes.aspx

Affordable Care Act Rate Shock?

Come January 1 of next year, those with the lowest health insurance risk may be hit the hardest with premium increases as high as 40%.

If you are young, healthy and qualify for non-group coverage, you could face rate hikes forcing you to reconsider how you spend your health care dollars.

And because of new age rating band requirements tied to the ACA, the 18 to 44 age group’s premiums will increase while the over 57 group will decrease.

Full Article:  Affordable Care Act Rate Shock?