Sunday, March 24, 2013

Proposed Regs Clarify 90-Day Waiting Period Requirement

From www.buisnessinsurance.com

Newly hired employees will have to be offered health insurance coverage no later than 90 days after they begin work, under newly proposed health care reform law regulations.


The regulations, jointly issued Monday by the Internal Revenue Service and the Departments of Labor and Health and Human Services, involve a provision in the Patient Protection and Affordable Care Act that, effective in 2014, will limit health insurance coverage waiting periods to 90 days.Regulators noted that several commenters on previous guidance said it has been “common practice” for coverage to become effective the first day of the month after the 90-day waiting period.But regulators said “due to the clear text of the statute,” waiting periods may not extend beyond 90 days, with all calendar days, including weekends and holidays, counted.In the case of where an employer imposes a 90-day waiting period and the 91st day is a weekend or holiday, the employer could make coverage prior to the 91st day for administrative ease.But coverage, regulators said, cannot be later than the 91st day.

To view the entire article on Business Insurance click here

To view the federal register with the proposed regs click here

Friday, March 22, 2013

Senate calls for an end to medical device tax

On Thursday the Senate approved a bipartisan budget amendment that would repeal the unpopular medical device tax that is a part of the PPACA legislation. The amendment was agreed to by a vote of 79-20.
To read more on this budget amendment at thehill.com click here

Saturday, March 9, 2013

House Spending Bill Cuts Funding for Exchanges

From Kaiser Health News:

By Mary Agnes Carey


You don’t hear much these days about Republicans trying to repeal the 2010 health care law. The Supreme Court ruling last June upheld most of the measure. President Obama’s re-election and Democrats’ continued control of the Senate have helped “Obamacare” implementation to move ahead.


But there is one way to slow things down: use the power of the purse.

The GOP-controlled House of Representatives on Wednesday passed legislation to fund the government through Sept. 30. The measure keeps “sequestration” — the $85 billion in automatic budget cuts that began March 1 – in place. The bill would fund the government beyond March 27 when the current “continuing resolution” expires.

According to Rep. Nita Lowey, a New York Democrat who is the ranking member of the House Appropriations Committee, the measure will delay implementation of the health law’s exchanges scheduled to begin enrolling individuals in October.

“Without IT infrastructure to process enrollments and payments, verify eligibility and establish call centers, health insurance for millions of Americans could be further delayed,” Lowey said in a statement.

Funding for the health law’s implementation is one of many areas of federal spending cut as part of sequestration.

The House measure passed mostly along party lines by a vote of 261-151 but more than 50 Democrats supported the bill. Many Senate Democrats are expected to oppose the package, which is likely to be modified.

Sen. Ted Cruz, R-Tex., said Wednesday he plans to offer an amendment on the floor that would delay funding of the 2010 health law. Cruz has also introduced legislation to repeal the law.

The health law “should not be implemented at [a] time when our economy is struggling so mightily, at a time when its implementation could push us into a full recession,” he said in a statement.

House Appropriations Chairman Hal Rogers, R-Ky. praised passage of the House bill.

“The House did the right thing today by passing this legislation,” Rogers said. ”As we try to get our fiscal house in order, it’s important to come together on issues where we can agree – avoiding a government shutdown, providing our people with essential services, and supporting our troops and veterans.”

For a link to the article click here



DOL Releases Final FMLA Regulations

In early February, the Department of Labor issued new final regulations regarding the amendments to military family leave, flight crew eligibility and a handful of other relatively minor issues. This amendments are not as substantial as past updates and changes to the law. However, because of the changes in the regulations, there is an obligation to begin using updated FMLA notice and certification forms and to post the new FMLA poster, effective March 8, 2013.

To view the final rule click here

Navigating the Maze of Recent PPACA Guidance: Scott Webinar

Are you having a hard time keeping up with all the updates and guidance on PPACA?

In the latest installment of our Health Care Reform Webinar Series we sift through the recent guidance and highlight the important items that will affect employers. We also provide actionable take-aways to help keep your company compliant.

For a link to the webinar including powerpoint slides click here

For a PDF version of the slides click here

Virgina Governor Clarifies Medicaid Position


In a letter to the Secretary of Heath and Human Services, Kathleen Selibus, Virgina Governor Bob McDonnell sought to clarify that his state had not expanded Medicaid.

“The recently passed budget of Virginia contains language outlining a series of reforms that must be completed to the satisfaction of a new legislative commission prior to consideration of Medicaid expansion...some media outlets and elected officials have labeled this as approving Medicaid expansion in Virginia. This is absolutely incorrect.”


To view a copy of the letter from Governor McDonnell click here.

Expatriate Plans and PPACA

Below is FAQ XIII released by the ESBA clarifying how expatriate plans are impacted by PPACA:

Expatriate Health Plans


Q1: To what extent is expatriate group health insurance coverage subject to the provisions of the Affordable Care Act?

The Departments recognize that expatriate health plans may face special challenges in complying with certain provisions of the Affordable Care Act. In particular, challenges in reconciling and coordinating the multiple regulatory regimes that apply to expatriate health plans might make it impossible or impracticable to comply with all the relevant rules at least in the near term. For example, independent review organizations may not exist abroad, and it may be difficult for certain preventive services to be provided, or even be identified as preventive, when such services are provided outside the United States by clinical providers that use different code sets and medical terminology to identify services. Further, expatriate issuers may face challenges and delays in communicating with enrollees living abroad, and, due to the complex nature of these plans, standardized benefits disclosures can be difficult for issuers to produce. Expatriate health plans may require additional regulatory approvals from foreign governments, and, in some circumstances, it is possible that domestic and foreign law requirements conflict.
While the Departments gather further information and analyze these challenges to determine what actions may be appropriate regarding the current requirements under the Affordable Care Act, the Departments have determined that, for plans with plan years ending on or before December 31, 2015, with respect to expatriate health plans, the Departments will consider the requirements of subtitles A and C of Title I of the Affordable Care Act satisfied if the plan and issuer comply with the pre-Affordable Care Act version of Title XXVII of the Public Health Service Act.

References to subtitles A and C of Title I of the Affordable Care Act also include the corresponding provisions imported into section 715 of the Employee Retirement Income Security Act (ERISA) and section 9815 of the Internal Revenue Code.

For purposes of this temporary transitional relief, an expatriate health plan is an insured group health plan with respect to which enrollment is limited to primary insureds who reside outside of their home country for at least six months of the plan year and any covered dependents, and its associated group health insurance coverage.

This definition is also the definition of “expatriate health coverage” under 45 CFR 153.400(a)(1)(iii) during this temporary transitional period (that is, for plans with plan years ending on or before December 31, 2015).

Expatriate health plans must, as a condition of this transitional relief, comply with the pre-Affordable Care Act version of Title XXVII of the PHS Act and other applicable law under ERISA and the Internal Revenue Code, including, for example, the mental health parity provisions, the HIPAA nondiscrimination provisions, the ERISA section 503 requirements for claims procedures, and any reporting and disclosure obligations under ERISA Part 1.

The Departments note that coverage provided under an expatriate group health plan is a form of minimum essential coverage under section 5000A of the Internal Revenue Code.

The Departments request comments on and information about the unique challenges that expatriate health plans may face in complying with provisions of the Affordable Care Act, including information about which particular types of plans face these challenges and with respect to which particular provisions of the Affordable Care Act. Please send comments by May 8, 2013 to e.ohpsca-expat.ebsa@dol.gov.