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

Tag Archives: PPACA

Congressional Hearing Examines Impact of Health Care Law on Small Business

By Ilyse Schuman During a hearing conducted by the House Committee on Small Business’s Subcommittee on Healthcare and Technology, lawmakers, policy analysts, academics and a business owner expressed varying opinions on how the Affordable Care Act has and will continue to impact small businesses and the economy. The focus of the hearing – Small Businesses… Continue Reading

Posted in Healthcare Reform

Federal Funds for Workplace Wellness Programs

By Russell D. Chapman The U.S. Department of Health and Human Services (HHS) recently announced the availability of $10 million to advance workplace wellness programs for employers.  Initiated by the Affordable Care Act (ACA), the funds will be awarded through a competitive contract to an organization with expertise in working with both small and large… Continue Reading

Posted in Benefits & Wellness

House Committee Addresses Costs of the Affordable Care Act

By Ilyse Schuman Just days after returning from a week-long recess, Congress has wasted no time in scheduling yet another round of hearings on the new health care law. On Wednesday the House Committee on Energy and Commerce’s Subcommittee on Health conducted a meeting to discuss the Affordable Care Act’s impact on the budget and… Continue Reading

Posted in Healthcare Reform

House Passes Health Care Repeal Bill

As expected and after two days of debate, the House of Representatives on Wednesday approved by a vote of 245-189 the Repealing the Job-Killing Health Care Law Act (H.R. 2), legislation that would repeal the Affordable Care Act in its entirety. Although the vote was largely along party lines, Reps. Dan Boren (D-OK), Mike McIntyre… Continue Reading

Posted in Healthcare Reform

Study Finds Health Care Law’s Self-Insured Exemptions May Make Such Plans More Attractive to Small Firms

An issue brief published by the National Health Policy Forum claims that as the provisions of the Affordable Care Act take effect, the benefits of self-insuring health plans may make doing so more attractive to small businesses. Generally, although employers and employees contribute toward the cost of coverage under both self-insured and fully insured health… Continue Reading

Posted in Healthcare Reform

How Will the Midterm Election Results Impact Healthcare Policy?

Tuesday’s historic election radically changed the composition of Congress and the balance of power in Washington. While a few election results are still trickling in, Republicans are projected to gain around 60 seats in the House of Representatives, regaining majority control. Democrats will still control the Senate, albeit with a much slimmer margin. This new… Continue Reading

Posted in Healthcare Reform

EBSA Clarifies GINA Provisions for Insurance Providers and Group Health Plans

The Department of Labor’s Employee Benefits Security Administration (EBSA) has issued guidance in the form of Frequently Asked Questions (FAQs) that explains how the Genetic Information Nondiscrimination Act (GINA) impacts employer-provided group health plans and insurance providers. Among other things, Title I of GINA prohibits group health plans and health insurance issuers from discriminating based… Continue Reading

Posted in Benefits & Wellness

Nondiscrimination Requirements for Insured Group Health Plans

One of many important changes made by the Patient Protection and Affordable Care Act (“Affordable Care Act”) is the application of new rules prohibiting discrimination in favor of highly compensated individuals to insured group health plans.  Effective for plan years beginning on or after September 23, 2010, an insured group health plan that fails to… Continue Reading

Posted in Healthcare Reform

Upcoming Affordable Care Act Presentations

With all the reports last week about the provisions of the Patient Protection and Affordable Care Act (“Affordable Care Act”) that went into effect beginning on or after September 23, 2010, some employers may want to revisit the short-term and long-term implications of the legislation. The timeline for implementing some changes is now and the strategic… Continue Reading

Posted in Healthcare Reform

EBSA Provides Grace Period, Compliance Guidance for Certain Affordable Care Act Provisions

On September 20, 2010, the Department of Labor’s Employee Benefits Security Administration (EBSA) issued a technical release document that gives health insurance plans and issuers until July 1, 2011, to make certain procedural and computer system changes to comply with the regulations governing internal claims and appeals procedures under the Patient Protection and Affordable Care… Continue Reading

Posted in Healthcare Reform

IRS Guidance on Over-the-Counter Drug Reimbursements

Under the Affordable Care Act, employer-provided health plans, including health flexible spending accounts (FSAs) and health reimbursement arrangements (HRAs), may not pay or reimburse participants’ purchases of over-the-counter (OTC) medicines and drugs without a prescription after December 31, 2010.  The new restrictions also apply to reimbursements from health savings accounts (HSAs).  On September 3, 2010,… Continue Reading

Posted in Healthcare Reform

Many Employer Health Plans Will Forfeit Grandfathered Status, Survey Indicates

A survey of more than 1,000 employers has found that slightly more than half (53%) believe that they will be able to maintain their health care plan’s grandfathered status in 2011. This percentage is lower than the projected 67-85% of employer plans that recent regulations claimed would be able to qualify as “grandfathered” and therefore be… Continue Reading

Posted in Healthcare Reform

New Guidance on Waiver Process for Annual Dollar Limits

As most employers were shutting their doors for the long Labor Day weekend, the U.S. Department of Health & Human Services (HHS) released guidance on the process for waiver applications related to the annual dollar limit policy under the Patient Protection and Affordable Care Act (PPACA), which bans certain annual limits in medical benefits coverage. … Continue Reading

Posted in Healthcare Reform

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

New Health Plan Regulations: Internal & External Review for Denied Claims

The Internal Revenue Service and the Departments of Labor (DOL) and Health and Human Services have issued interim final regulations imposing new requirements on group health plans (both self-insured and insured) that dictate procedures for internal appeals of adverse claims decisions and require an independent external appeal process for denied health plan claims.  The new… Continue Reading

Posted in Healthcare Reform

The Newest PPACA Regulations: What You Need To Know

                                         On June 22, 2010, the Departments of Treasury, Labor and Health and Human Services issued interim final regulations that provide detailed guidance for health plans and insurance policies – over 190-pages worth – on the prohibition of lifetime and annual limits, rescission of coverage, the exclusion of pre-existing condition clauses and additional patient protections. … Continue Reading

Posted in Healthcare Reform

Obama Administration Unveils Patient’s Bill of Rights

Three months after the Patient Protection and Affordable Care Act (“Affordable Care Act” or PPACA) was signed into law, President Obama released a Patient’s Bill of Rights outlining consumer protections provided by the health care law, and implemented by newly-issued interim regulations. Specifically, these regulations put into practice the rules for group health plans and health… Continue Reading

Posted in Healthcare Reform

Long-Awaited “Grandfathered” Regulations Released: Top 11 Things to Know

Employers have anxiously awaited the release of the interim final rules (pdf) relating to “grandfathered” health care plans under the Patient Protection and Affordable Care Act (PPACA).  The regulations have garnered a significant amount of controversy in the past couple of days, as a leaked draft version indicated that more than half of employer-sponsored plans… Continue Reading

Posted in Healthcare Reform

Survey Suggests PPACA’s Wellness Provisions Will Provide Boost to Wellness Programs

In our review of health care reform’s impact on wellness programs last month, we forecasted that the Patient Protection and Affordable Health Care Act (PPACA) would boost the adoption of workplace wellness programs and help lay the foundation for creating a culture of health and prevention in the workplace.  A recent survey, conducted by the… Continue Reading

Posted in Benefits & Wellness

Health Care Law Likely to Impact Sales Commissions

Buried deep in the Patient Protection and Affordable Care Act (PPACA) – the health care overhaul bill signed into law in March – are provisions governing the health insurance industry that could greatly impact how insurers pay their sales employees. Section 2718 – Bringing Down the Cost of Health Care Coverage – stipulates that on… Continue Reading

Posted in Healthcare Reform

New Instructions for the Small Employer Tax Credit Under PPACA

Small employers (generally defined as fewer than 25 full-time employees with average annual wages less than $50,000 per full-time employee) should take note of new guidance that makes it easier for them to determine whether they are in fact eligible for the new health care tax credit under the Patient Protection and Affordable Care Act… Continue Reading

Posted in Healthcare Reform

HHS Health Care Webinar to Focus on Disability Benefits

The eighth in a series of health care webinars produced by the U.S. Department of Health and Human Services (HHS) will address how the Patient Protection and Affordable Care Act (PPACA) will impact individuals with disabilities. The live web chat can be viewed at www.hhs.gov/live, and will take place on Thursday, May 20 at 1:00… Continue Reading

Posted in Healthcare Reform