Tag Archives: Department of Treasury

Regulatory roundup

More healthcare-related regulatory news for plan sponsors, including links to detailed information.

Technical guidance for self-insured health plans on federal external review process
The U.S. Department of Health and Human Services issued “Technical Guidance – Standards for Self-Insured Non-Federal Governmental Health Plans and Health Insurance Issuers Offering Group and Individual Coverage.” This release replaces the technical guidance issued June 22, 2011, with standards adopted in the final regulation at 76 FR 37208 that further define requirements under Public Health Service Act (PHS Act) section 2719(b)(1).

For more information, click here.

Agencies issue ACA FAQs, Part 37
The U.S. Departments of Treasury, Labor (DoL), and Health and Human Services released frequently asked questions (FAQs) Part 37 regarding Patient Protection and Affordable Care Act (ACA) implementation. The FAQs highlight: health reimbursement arrangements (HRAs); integration of HRAs with group health plans sponsored by the employer of a spouse of an employee; Code Section 162(m)(6); and more.

To read the FAQs, click here.

DoL issues FY 2016 MHPAEA enforcement fact sheet
The Employee Benefits Security Administration (EBSA) enforces the law governing 2.2 million private employment-based group health plans, which cover 130.8 million participants and beneficiaries. EBSA relies on its 460 investigators to review plans for compliance with ERISA, including the Mental Health Parity and Addiction Equity Act (MHPAEA). EBSA released its first annual MHPAEA enforcement fact sheet, summarizing its enforcement activity in fiscal year (FY) 2015.

To read the fact sheet, click here.

Agencies propose new, expanded Form 5500 group health plan reporting

Group health plan sponsors would be required to provide significant amounts of information about the plans when filing the annual Form 5500 with the U.S. Department of Labor (DoL), under a recently released proposed rule from the agency, along with a separate proposed rule from the DoL, Treasury/Internal Revenue Service (IRS), and the Pension Benefit Guaranty Corporation (PBGC).

The DoL’s proposal, which affects only ERISA-covered plans, would amend the reporting and disclosure requirements for other welfare benefits and retirement plans, but this Client Action Bulletin (CAB) focuses only on group health plan information, including from sponsors of grandfathered group health plans and from sponsors of certain small plans that to date have been exempt from filing. The DoL anticipates applying the new requirements to plan years starting in 2019 (i.e., filings made in 2020).

For simplicity, this CAB refers to both sets of rules as the DoL’s proposed rule.

Regulatory roundup

More healthcare-related regulatory news for plan sponsors, including links to detailed information.

House panel advances health bills
The House Ways and Means Committee approved seven healthcare bills recently, including the following that would apply to employer-sponsored plans:

• H.R.5445 (the “Health Care Security Act”), which would increase the annual contribution limits for health savings accounts (HSAs), allow for catch-up contributions by both spouses to a single account, and permit the payment of expenses incurred 60 days before an account is established.
• H.R.5447 (the “Small Business Health Care Relief Act”), which would permit qualified small employers that do not offer a group health plan to reimburse up to $5,130 annually/employee ($10,260/family) for the cost of buying health insurance.
• H.R.210 (the “Student Worker Exemption Act”), which would exclude full-time students who are employed by an institution of higher education from being counted as full-time employees in calculating the institution’s shared responsibility coverage requirement under the Patient Protection and Affordable Care Act (ACA).
• H.R.3080 (the “Tribal Employment and Jobs Protection Act”), which would eliminate the ACA’s employer mandate for businesses owned by Indian tribes.

House panel approves mental health bill with group health plan implications
The House Energy and Commerce Committee voted 53-0 to approve a substitute mental health bill (H.R.2646) called the “Helping Families in Mental Health Crisis Act.” The full House is not expected to act on the measure until sometime in September.

The bill generally calls for improving oversight of certain mental health and substance abuse programs. There are, however, some provisions that affect employer-sponsored plans, including a directive for the Departments of Health and Human Services, Labor, and Treasury to coordinate and issue a “compliance program guidance” document relating to mental health parity that provides examples/illustrations of informative disclosures and nonquantitative treatment limitations, as well as descriptions of the violations uncovered during the course of compliance investigations.

In addition, if a group health plan or group insurance provides coverage for eating disorder benefits, then the plan/insurance, under the bill, must provide such benefits consistent with the mental health/substance use disorder benefits parity requirements.

Regulatory roundup

More healthcare-related regulatory news for plan sponsors, including links to detailed information.

Treasury, DOL, HHS issue proposed rule on expatriate health plans
The Departments of Treasury, Labor (DOL), and Health and Human Services (HHS) have released a proposed regulation on the rules for expatriate health plans, expatriate health plan issuers, and qualified expatriates under the Expatriate Health Coverage Clarification Act of 2014 (EHCCA).

The proposed rule affects expatriates with health coverage under expatriate health plans and sponsors, issuers and administrators of expatriate health plans, individuals with and plan sponsors of travel insurance and supplemental health insurance coverage, and individuals with short-term, limited-duration insurance.

For more information, click here.

Regulatory roundup

More healthcare-related regulatory news for plan sponsors, including links to detailed information.

IRS verification of ACA premium tax credit claims during the 2015 filing season
The Treasury Inspector General for Tax Administration (TIGTA) released “Affordable Care Act: Internal Revenue Service verification of premium tax credit claims during the 2015 filing season.” The report analyzes more than 2.6 million tax returns with a premium tax credit (PTC) claim that were filed between January 20, 2015, and May 28, 2015. The analysis found that the Internal Revenue Service (IRS) accurately determined the allowable PTC on more than 2.4 million (93%) returns. TIGTA is continuing to work with the IRS to determine the cause for calculation differences in 150,385 of the remaining 182,884 tax returns. Computer programming errors resulted in an incorrect computation of the allowable PTC for 27,827 tax returns.

To download the entire report, click here.

Regulatory roundup

More healthcare-related regulatory news for plan sponsors, including links to detailed information.

New ACA implementation FAQs: Preventive services, mental health parity, and women’s health
The U.S. Departments of Treasury, Labor (DOL), and Health and Human Services (HHS) published frequently asked questions (FAQs) about the Patient Protection and Affordable Care Act (ACA) implementation (Part 31). The FAQ covers:

• Coverage of Food and Drug Administration (FDA)-approved contraceptives
• Rescissions
• Out-of-network emergency services
• Coverage for individuals participating in approved clinical trials
• Limitations on cost-sharing under the ACA
• Mental Health Parity and Addiction Equity Act of 2008
• The Women’s Health and Cancer Rights Act

To read the entire FAQ, click here.