More healthcare-related regulatory news for plan sponsors, including links to detailed information.
DOL issues annual report on self-insured group health plans
The U.S. Department of Labor (DOL) has released the 2015 Report to Congress-Annual Report on Self-Insured Group Health Plans.
According to the report, in 2012, 21,000, or 41%, of the approximately 50,000 private sector employer-sponsored group health plans that filed a Form 5500 can be categorized as self-insured. Of the remaining 30,000 group health plans, approximately 4,000, or 8%, can be categorized as mixed-insured, and 26,000, or 51%, can be categorized as fully insured. Of these 50,000 group health plans, 83% offered other welfare benefits in addition to health benefits (such as dental, vision, life, disability, etc.). Of all private sector single employer group health plans that filed a 2012 Form 5500, 53% provided fully insured health benefits to their employees. More than 19,000 of the group health plans categorized as self-insured are single employer plans; the remaining 1,000 are multiemployer plans.
To read the entire report, click here.
Agencies issue FAQ on summary of benefits and coverage under ACA
The U.S. Departments of Treasury, Labor, and Health and Human Services (HHS) have issued a new set of frequently asked questions (FAQ) regarding the Patient Protection and Affordable Care Act (ACA) summary of benefits and coverage. On December 30, 2014, the agencies published a notice of proposed rule-making, as well as a new set of proposed summary of benefits and coverage (SBC) templates, instructions, an updated uniform glossary, and other materials. Changes to the SBC regulations, template, and associated documents were proposed to apply beginning September 1, 2015.
To read the entire FAQ, click here.
IRS notice provides guidance on expatriate health plans
The Internal Revenue Service (IRS) has issued Notice 2015-29, which provides guidance on how the special rule for expatriate health plans applies to the health insurance provider fee under ACA § 9010 for the 2014 and 2015 fee years. Under the notice, a covered entity will receive a reduction in its 2015 fee liability for expatriate health plans, as defined by HHS’s medical loss ratio final rule, that are attributable to the 2014 and 2015 fee years.
To read the entire notice, click here.