Healthcare

Thursday, 30 July 2015

Do HIPAA portability and ACA rules apply to our dental benefits?

Written by Thomson Reuters

Question: Do the portability rules of the Health Insurance Portability and Accountability Act (HIPAA), and the various requirements of the Affordable Care Act (ACA), apply to our company’s dental benefits? Answer: If your dental plan qualifies as a HIPAA “excepted benefit,” it’s exempt from that law’s portability requirements (such as the need to provide special enrollment periods). And, as we’ll explain, it should be exempt from many of the ACA’s mandates. Whether your company’s dental benefits are an excepted benefit depends on how those benefits are set up...

Published in Healthcare
Thursday, 30 July 2015

Reviewing the final regulations for the ACA’s SBC requirement

Written by Thomson Reuters

The IRS, Department of Labor (DOL) and Department of Health and Human Services (HHS) have issued final regulations addressing the Affordable Care Act’s summary of benefits and coverage (SBC) requirement. The final regs, which generally apply to group health plans for plan years beginning on or after September 1, 2015, amend the 2012 final regulations while largely following the December 2014 proposed regulations. 6 highlighted areas Here are six highlighted areas of the regs that employers should be aware of going forward: 1. When to provide an SBC...

Published in Healthcare
Thursday, 30 July 2015

High-deductible health plans may be on the rise again

Written by Thomson Reuters

High-deductible health plans (HDHPs) began drawing interest well before the enactment of the Affordable Care Act (ACA) in 2010. Although the prevalence of these plans did grow following the ACA, it eventually leveled off as companies explored many options for offering health care benefits to their employees. But, as the scheduled 2018 imposition of the “Cadillac” excise tax draws nearer, many employers are feeling more pressure to control costs. And, with fresh data now available, organizations that had previously sat out of the HDHP trend may now begin to stand up and pay attention...

Published in Healthcare
Monday, 29 June 2015

FAQs address required preventive services under the ACA

Written by Thomson Reuters

The IRS, Department of Health and Human Services (HHS) and Department of Labor have jointly issued FAQ guidance on the required coverage of preventive health services. The Affordable Care Act (ACA) requires nongrandfathered, nonexcepted group health plans to provide coverage for various preventive services delivered by in-network providers without cost-sharing. In other words, no deductibles, copayments, coinsurance or other cost-sharing may be imposed on these services. Here are highlights of this latest guidance...

Published in Healthcare
Monday, 29 June 2015

FAQs address required preventive services under the ACA

Written by Thomson Reuters

The IRS, Department of Health and Human Services (HHS) and Department of Labor have jointly issued FAQ guidance on the required coverage of preventive health services. The Affordable Care Act (ACA) requires nongrandfathered, nonexcepted group health plans to provide coverage for various preventive services delivered by in-network providers without cost-sharing. In other words, no deductibles, copayments, coinsurance or other cost-sharing may be imposed on these services. Here are highlights of this latest guidance...

Published in Healthcare
Monday, 29 June 2015

Forms 1094 and 1095: New IRS guidance available

Written by Thomson Reuters

The IRS has provided both new and updated Q&A guidance on the reporting requirements for large employers, as defined under the Affordable Care Act (ACA). Beginning in 2016, these large employers must file Forms 1094 and 1095 to provide information to the IRS and plan participants about health coverage provided in the previous year. The forms are used by the IRS to enforce the ACA's shared-responsibility (or "play or pay") provision, as well as individual mandate and tax credit eligibility rules. The latest guidance consists of an updated Q&A document covering basic reporting requirements and a new Q&A document addressing more specific issues that may arise while completing Forms 1094 and 1095...

Published in Healthcare

Question: Our organization offers a grandfathered group health plan. The plan covers dependent children until age 26 — even if they're eligible for coverage under another plan. Aren't grandfathered plans permitted to deny coverage to a dependent child in these circumstances? Answer: Not anymore...

Published in Healthcare

On June 25, the U.S. Supreme Court, in a much-anticipated ruling, essentially again upheld the Affordable Care Act (ACA), this time by upholding premium tax credits for qualifying taxpayers whether they purchase coverage through a federal or a state exchange. At issue in King v...

Published in Healthcare
Monday, 01 June 2015

EEOC proposes long-awaited wellness program regulations

Written by Thomson Reuters

The Equal Employment Opportunity Commission (EEOC) has proposed long-awaited regulations on how employer wellness programs may comply with the Americans with Disabilities Act (ADA). For organizations with established wellness programs, or those that are implementing one because of incentives offered under the Affordable Care Act (ACA), the proposed regs are an important development. Introduction The ADA permits a wellness program to include disability-related inquiries or medical examinations, such as health risk assessments or medical screenings, only if: Participation is voluntary, Information is maintained according to ADA confidentiality requirements, and Information isn't used to discriminate against an employee. The proposed EEOC regulations address the interplay between ADA requirements and the wellness program rules under the Health Insurance Portability and Accountability Act (HIPAA)...

Published in Healthcare
Monday, 01 June 2015

Looking into the trends and traits of private insurance exchanges

Written by Thomson Reuters

Interest in private health insurance exchanges (HIX), and the defined contribution model of health benefits delivery, appears to be growing at a meteoric rate. Enrollment this year hit 6 million — double last year's figure, according to Accenture. The consultancy also predicts the number will rise to 40 million by 2018. In other words, more people will be enrolled in HIX than via a public Health Insurance Marketplace, such as healthcare...

Published in Healthcare
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