.gif)
WASHINGTON—House Republican leaders on Monday said several House committees will develop legislation to repeal the health care reform law's grandfather plan rules.
Failure to follow those rules will result in health care plans losing an exemption from complying with several health care reform law requirements, such as providing full coverage for preventive services.
Under those rules, to win grandfathered status, a health care plan, among other things, can't ever increase coinsurance requirements or boost the percentage of the premium paid by enrollees by more than 5 percentage points.
Employers may see higher costs
House Majority Leader Eric Cantor, R-Wis., said in a memorandum sent to House Republicans that employers losing grandfathered status for their health care plans will face higher costs, “negatively affecting wages and job growth.”
Rep. Cantor said the House Education and Labor, Energy and Commerce and Ways and Means committees, will “soon” develop legislation “to repeal these ObamaCare restrictions.”
Last year, the Senate defeated a proposal by Rep. Mike Enzi, R-Nev., that would have effectively nullified the grandfather rules.
Tuesday, August 30, 2011
Thursday, August 18, 2011
Federal rules would dictate how employers explain health plan coverage
WASHINGTON—Employers would have to revamp how they communicate and explain their health care plans next year under health care reform law rules proposed Wednesday.
The rules, which would be effective March 23, 2012, would require employers to provide employees with an “easy-to-understand” summary of benefits and coverage and, upon request, a glossary of commonly used health care coverage terms, such as deductible and copay.
The summary of benefits and coverage would have to include the portion of expenses a health care plan would cover in each of three situations: having a baby, treating breast cancer and managing diabetes.
Additional examples might be added in the future, according to the rules proposed jointly by the Health and Human Services, Labor and Treasury departments.
Benefit experts say they have never before heard of using such an approach.
In addition under the proposal, employers would have to notify plan participants at least 60 days before making any significant modification to plan coverage during the plan or policy year.
For employers, complying with the new rules “will be a major effort,” said Jennifer Henrikson, senior counsel at Aon Hewitt Inc. in Lincolnshire, Ill.
The proposed rules are to be published in the Aug. 22 issue of the Federal Register.
The proposed rules on communicating health care benefits followed by one week the three agencies’ proposed rules that would make it easier for employers to determine if their health care plans are affordable. Starting in 2014, employers whose plans fail that affordability test are liable for a $3,000 penalty for each employee that is eligible for federal premium subsidies to purchase coverage through state health insurance exchanges.
To view the artcile click here
The rules, which would be effective March 23, 2012, would require employers to provide employees with an “easy-to-understand” summary of benefits and coverage and, upon request, a glossary of commonly used health care coverage terms, such as deductible and copay.
The summary of benefits and coverage would have to include the portion of expenses a health care plan would cover in each of three situations: having a baby, treating breast cancer and managing diabetes.
Additional examples might be added in the future, according to the rules proposed jointly by the Health and Human Services, Labor and Treasury departments.
Benefit experts say they have never before heard of using such an approach.
In addition under the proposal, employers would have to notify plan participants at least 60 days before making any significant modification to plan coverage during the plan or policy year.
For employers, complying with the new rules “will be a major effort,” said Jennifer Henrikson, senior counsel at Aon Hewitt Inc. in Lincolnshire, Ill.
The proposed rules are to be published in the Aug. 22 issue of the Federal Register.
The proposed rules on communicating health care benefits followed by one week the three agencies’ proposed rules that would make it easier for employers to determine if their health care plans are affordable. Starting in 2014, employers whose plans fail that affordability test are liable for a $3,000 penalty for each employee that is eligible for federal premium subsidies to purchase coverage through state health insurance exchanges.
To view the artcile click here
Friday, August 12, 2011
Appeals court rules against Obama healthcare law
WASHINGTON (Reuters) - An appeals court ruled on Friday that President Barack Obama's healthcare law requiring Americans to buy healthcare insurance or face a penalty was unconstitutional, a blow to the White House.
The Appeals Court for the 11th Circuit, based in Atlanta, found that Congress exceeded its authority by requiring Americans to buy coverage, but also ruled that the rest of the wide-ranging law could remain in effect.
The legality of the so-called individual mandate, a cornerstone of the healthcare law, is widely expected to be decided by the U.S. Supreme Court. The Obama administration has defended the provision as constitutional.
It is expected that the U.S. Supreme Court will hear the case sometime in mid-2012.
To view the full artile click here.
The Appeals Court for the 11th Circuit, based in Atlanta, found that Congress exceeded its authority by requiring Americans to buy coverage, but also ruled that the rest of the wide-ranging law could remain in effect.
The legality of the so-called individual mandate, a cornerstone of the healthcare law, is widely expected to be decided by the U.S. Supreme Court. The Obama administration has defended the provision as constitutional.
It is expected that the U.S. Supreme Court will hear the case sometime in mid-2012.
To view the full artile click here.
Tuesday, August 2, 2011
Employers must provide preventive health care services to women: Rules
WASHINGTON—Group health care plans would have to provide full coverage—with neither copayments nor deductibles—for a wide range of women’s preventive services under rules issued Monday.
The rules stemming from the 2010 health care reform law and jointly issued by the departments of Health and Human Services, Labor and Treasury, require full coverage with no plan enrollee cost-sharing for services such as well-woman visits; screening for gestational diabetes; sexually transmitted infection counseling; breastfeeding support, supplies and counseling; domestic violence screening; and U.S. Food and Drug Administration-approved contraception methods and counseling.
2012 start date
The mandate would apply for plan years starting on or after Aug. 1, 2012. For calendar years, compliance would begin on Jan. 1, 2013. However, what are known as “grandfathered plans” would be exempt from having to meet the requirements.
In addition, religious organizations would not be required to cover contraceptives if it is inconsistent with their beliefs. A religious employer is one that, among other things, primarily employs individuals who share its religious beliefs and primarily serves those who share in its religious beliefs, according to the regulations, which are scheduled to be published in Wednesday’s Federal Register.
While the vast majority of plans will have to expand coverage to comply with the rules, employers should have sufficient time to make the needed changes, said Susan Margolis, a director with PricewaterhouseCoopers L.L.P. in New York.
Compared with the overall cost of coverage, the new requirement will result in “very modest” cost increases, said Rich Stover, a principal with Buck Consultants L.L.C. in New York.
The women’s preventive services come about a year after regulations mandating coverage—except for grandfathered plans—for a wide range of other preventive services, such as blood pressure, diabetes and cholesterol tests and annual physicals.
To view the interim final rule click here
The rules stemming from the 2010 health care reform law and jointly issued by the departments of Health and Human Services, Labor and Treasury, require full coverage with no plan enrollee cost-sharing for services such as well-woman visits; screening for gestational diabetes; sexually transmitted infection counseling; breastfeeding support, supplies and counseling; domestic violence screening; and U.S. Food and Drug Administration-approved contraception methods and counseling.
2012 start date
The mandate would apply for plan years starting on or after Aug. 1, 2012. For calendar years, compliance would begin on Jan. 1, 2013. However, what are known as “grandfathered plans” would be exempt from having to meet the requirements.
In addition, religious organizations would not be required to cover contraceptives if it is inconsistent with their beliefs. A religious employer is one that, among other things, primarily employs individuals who share its religious beliefs and primarily serves those who share in its religious beliefs, according to the regulations, which are scheduled to be published in Wednesday’s Federal Register.
While the vast majority of plans will have to expand coverage to comply with the rules, employers should have sufficient time to make the needed changes, said Susan Margolis, a director with PricewaterhouseCoopers L.L.P. in New York.
Compared with the overall cost of coverage, the new requirement will result in “very modest” cost increases, said Rich Stover, a principal with Buck Consultants L.L.C. in New York.
The women’s preventive services come about a year after regulations mandating coverage—except for grandfathered plans—for a wide range of other preventive services, such as blood pressure, diabetes and cholesterol tests and annual physicals.
To view the interim final rule click here
Subscribe to:
Posts (Atom)
Posts
