Tag Archives: DoL

Regulatory roundup

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

IRS releases final and temporary rule on health providers’ fee
The Internal Revenue Service (IRS) released final regulations that provide rules for the definition of a covered entity for purposes of the fee imposed by section 9010 of the Patient Protection and Affordable Care Act (ACA), as amended. The final regulations supersede and adopt the text of temporary regulations that provide rules for the definition of a covered entity. These regulations affect persons engaged in the business of providing health insurance for U.S. health risks.

To read the entire rule, click here.

Federal agencies propose rule on short-term, limited-duration insurance
The U.S. Departments of Treasury, Labor (DOL), and Health and Human Services (HHS) have released a proposed rule that would amend the definition of short-term, limited duration insurance for purposes of its exclusion from the definition of individual health insurance coverage.

The proposed rule would make it easier to obtain coverage through short-term health insurance plans by allowing insurers to sell policies that last under a year. The new rules stem from an executive order the president signed in October aimed at boosting competition, giving consumers more choices, and lowering premiums.

To learn more, click here.

How CBO and JCT analyze major proposals that would affect health insurance coverage
The Congressional Budget Office (CBO) and the staff of the Joint Committee on Taxation (JCT) released a report that estimates the budgetary effects of most types of major legislative proposals that would affect both spending and revenues using a process that involves many steps and many analysts. The report focuses on the process that the agencies use to analyze proposals affecting health insurance coverage for people under age 65, such as legislation that would make major changes to the ACA.

For more information, click here.

Regulatory roundup

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

CMS issues revocation notice bulletin
The Centers for Medicare and Medicaid Services (CMS) released a notice by issuer or third-party administrator for employers/plan sponsors of revocation of the accommodation for certain preventive services. The bulletin addresses notice requirements in the recently published interim final rules addressing the religious and moral exemptions from the requirement to provide contraceptive benefits in group health plans and health insurance coverage.

For more information, click here.

Ninety-day delay of applicability date for disability claims procedure amendments
The U.S. Department of Labor (DOL) has announced a 90-day delay of the applicability date for ERISA plans to comply with a final rule amending the claims procedure requirements applicable to disability benefits.

The three-month delay of the applicability date announced today is intended to give interested stakeholders the opportunity to submit, and for the DOL to consider, data and information related to concerns by some insurance industry and employer groups, and some members of Congress, that the claims procedure amendments will drive up disability benefit plan costs, cause an increase in litigation, and, in so doing, impair workers’ access to disability insurance benefits.

The final rule amending the disability benefits claims procedure requirements for ERISA plans was published in the Federal Register on December 19, 2016. The amendments were to become applicable to claims for disability benefits filed on or after January 1, 2018.

For more information, click here.

Regulatory roundup

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

Cost-sharing reduction subsidies to cease
The Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma issued a memorandum stating cost-sharing reduction (CSR) payments made to issuers of qualified health plans will stop. The decision is based on a legal opinion provided by the Office of the Attorney General.

Executive order on healthcare allows the purchase of insurance across state lines
President Donald Trump signed an executive order on healthcare directing the U.S. Department of Labor (DOL) to update rules allowing small employers to create association health plans. Small businesses will be able to band together if they are within the same state, in the same line of business, or are in the same trade association.

For more information, click here.

Proposed extension of information collection request submitted for public comment
The DOL released a notice providing the general public and federal agencies the opportunity to comment on a revision of the “Coverage of certain preventive services under the Affordable Care Act—private sector” information collection request (ICR). The notice was issued to align the ICR with the executive order signed on May 4, 2017, “Executive order promoting free speech and religious liberty.”

For more information, click here.

Regulatory roundup

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

CMS chief actuary releases memo on the financial effects related to the American Health Care Act
A new memorandum from the Centers for Medicare and Medicaid Services (CMS) summarizes the Office of the Actuary’s estimates of the financial and coverage effects through 2026 of selected provisions of the American Health Care Act (AHCA) of 2017 (H.R. 1628).

To read the entire memo, click here.

DOL releases information regarding mental health parity
The U.S. Department of Labor (DOL) released the following documents related to mental health parity:

Frequently Asked Questions
Draft of Mental Health Parity Disclosure Statement
Request for Information (RIF)

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.

Regulatory roundup

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

Final rule on health insurance premium tax credit
The Internal Revenue Service (IRS) released a final rule relating to the health insurance premium tax credit (premium tax credit). These final regulations affect individuals who enroll in qualified health plans through health insurance exchanges and claim the premium tax credit, and exchanges that make qualified health plans available to individuals and employers.

These final regulations also affect individuals who are eligible for employer-sponsored health coverage.

To read the entire rule, click here.

New HHS report details impact of the Affordable Care Act
The U.S. Department of Health and Human Services (HHS) released an extensive compilation of national and state-level data illustrating the substantial improvements in healthcare for all Americans in the last six years. According to the HHS data, the uninsured rate has fallen to the lowest level on record, and 20 million Americans have gained coverage thanks to the Patient Protection and Affordable Care Act (ACA). But beyond those people who would otherwise be uninsured, millions of Americans with employer, Medicaid, Medicare, or individual market coverage have benefited from new protections as a result of the law.

To access the report, click here.

Guide for electronically filing ACA Information Returns (AIR) for software developers and transmitters
A new IRS publication outlines the communication procedures, transmission formats, business rules, and validation procedures for information returns transmitted electronically through the AIR system.

For more information, click here.

DoL issues final rule on claims procedures for disability benefits
The U.S. Department of Labor (DoL) released a final regulation revising the claims procedure regulations under ERISA for employee benefit plans providing disability benefits. The final rule revises and strengthens the current rules primarily by adopting certain procedural protections and safeguards for disability benefit claims that are currently applicable to claims for group health benefits pursuant to the ACA. This rule affects plan administrators, participants, and beneficiaries of plans providing disability benefits, and others who assist in the provision of these benefits, such as third-party benefits administrators and other service providers.

To read the final rule, click here.