By Ilyse Schuman The Department of Health and Human Services’ Center for Consumer Information and Insurance Oversight (CCIIO) has issued additional guidance (pdf) on the approach the agency plans to take in defining the essential health benefits (EHB) that non-grandfathered insured health plans in the individual and small group markets must cover under the Affordable… Continue Reading
Category Archives: Health and Welfare Plans
Subscribe to Health and Welfare Plans RSS FeedHHS Releases Model Notices Related to Medical Loss Ratio Requirement
By Ilyse Schuman The U.S. Department of Health and Human Services (HHS) has issued proposed notices that health insurance companies may use for compliance with the new Medical Loss Ratio (MLR) requirements under the Affordable Care Act. The new health care law mandates that health insurers, depending on the size of the insurance market, spend… Continue Reading
Agencies Issue Final Rule Regarding Summary of Benefits and Coverage
By Ilyse Schuman The Departments of Health and Human Services, Labor, and the Treasury have issued final regulations (pdf) under the Affordable Care Act to implement the requirement that group health plans and health insurance issuers provide consumers with a summary of benefits and coverage (SBC) that “accurately describes the benefits and coverage under the… Continue Reading
HHS Proposes Framework for Meeting Essential Health Benefits Requirement Under Affordable Care Act
By Ilyse Schuman On December 16, 2011, the Department of Health and Human Services’ Center for Consumer Information and Insurance Oversight (CCIIO) released an essential health benefits bulletin (pdf) that describes a proposed regulatory approach that the HHS will use to define essential health benefits (EHB) under the Affordable Care Act. The health care reform law… Continue Reading
HHS Issues Final Rule Addressing Issues Related to Affordable Care Act’s Medical Loss Ratio Requirements
By Ilyse Schuman The Department of Health and Human Services’ Centers for Medicare & Medicaid Services (CMS) has issued a final rule (pdf) regarding certain issues associated with the Affordable Care Act’s medical loss ratio (MLR) requirements. The new health care law mandates that health insurers, depending on the size of the insurance market, spend… Continue Reading
Reports Provide Insight into Employer-Provided Healthcare Costs, Efforts to Stem Expenses
By Ilyse Schuman Two recently-released healthcare studies indicate that the rise in employer-provided healthcare coverage costs is part of a long-term trend, and that employers are taking affirmative steps to counter this escalation. The first survey, conducted by the Mercer consulting firm, suggests that while healthcare costs have increased over the years, the pace of… Continue Reading
Agencies Delay SBC Application Date, Issue New Guidance on MHPAEA
By Ilyse Schuman The Departments of Labor, Treasury, and Health and Human Services (HHS) have issued a new set of frequently asked questions (FAQs) announcing the delay of the Affordable Care Act’s summary of benefits and coverage (SBC) requirements for insurers and health plans, and providing guidance on the Paul Wellstone and Pete Domenici Mental… Continue Reading