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Employee Benefits Counsel Legal Insights into the Developments that Impact the Employee Benefits Community

Monthly Archives: August 2010

Safe Harbor (Of Sorts) on Federal External Review Procedures for Self-Insured Plans

In guidance issued last week (pdf), the federal agencies charged with administering the Affordable Care Act of 2010 provided a fuller picture of what will be required of self-insured plans to satisfy the new external review rules.  The law, as amended, requires certain non-grandfathered health plans and health insurance issuers to provide new internal claims… Continue Reading

Posted in Healthcare Reform

Massachusetts DOMA Ruling On Hold

Last month’s landmark ruling in Gill v. Office of Personnel Management that declared Section 3 of the Federal Defense of Marriage Act (DOMA) unconstitutional has been temporarily stayed pending an appeal, and the judgment has been modified to clarify that it applies only to the named plaintiffs.  The U.S. Department of Justice has 60 days… Continue Reading

Posted in Benefits & Wellness

CBO Projects Health Care Law Will Result in Slight Decline in Labor Participation, Budget Deficit

A new report released by the Congressional Budget Office (CBO) estimates that the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 (“Affordable Care Act”) will result in a modest decline in labor market participation over the next 10 years. The report – The Budget and… Continue Reading

Posted in Healthcare Reform

Obama Signs Bill Providing State Aid for Medicaid

On Tuesday, President Obama signed into law the Education Jobs and Medicaid Assistance Act, (H.R. 1586), (pdf) a bill that will provide $16.1 billion in assistance to states to fund Medicaid payments through the first half of 2011. An additional $10 billion will be allocated to state and local governments to cover teacher salaries. In… Continue Reading

Posted in Healthcare Reform

HHS Permits Insurers to Establish Open Enrollment Periods for Child Coverage

Responding to concerns that the new health care law’s prohibition on denying coverage to children with pre-existing conditions would significantly drive up costs, the U.S. Department of Health and Human Services (HHS) has clarified that plans may set up specific enrollment periods. Insurers had predicted that the non-discrimination coverage requirement that takes effect for most… Continue Reading

Posted in Healthcare Reform

Court Allows Virginia Suit Challenging Health Care Law to Proceed

On Monday a federal court denied the Obama Administration’s motion to dismiss a Virginia lawsuit challenging the Constitutionality of the new health care law, thus permitting the case to go forward. The suit, filed by Republican Attorney Gen. Ken Cuccinelli II, alleges that the government has overstepped its bounds by mandating that individuals purchase health… Continue Reading

Posted in Healthcare Reform