New FAQs (Part 31) have been issued highlighting various compliance issues and can be found at http://www.dol.gov/ebsa/faqs/faq-aca31.html. The questions address a wide range of issues, including preventive care, coverage for clinical trials, required disclosures, the Women’s Health and Cancer Rights Act, rescissions, reference pricing and mental health parity requirements. Here are a few highlights from these new FAQs:
-- Preventive care coverage, with no cost-sharing, includes...Continue Reading
Recently, we summarized the proposed revisions to the Summary of Benefits and Coverage template. This week, the agencies issued the final SBCs and related documents that must be used beginning on the first day of the first open enrollment period that begins on or after April 1, 2017 with respect to coverage for plan years beginning on or after that date. In other words, for calendar year plans, these revised forms must be used during the open enrollment associated with the 2018 plan...Continue Reading
On April 6, 2016, the Department of Labor released the final version of the new fiduciary rule. The new rule followed a long and extended comment period for the 2015 proposed rule, with much lobbying on both sides. The final rule is substantially revised from the proposed rule which was issued in 2015. The Department also released a chart which highlights changes from the proposed rule to the final rule.
The Department of Labor has issued a new FAQ (Part 30) stating that after March 28, 2016 (the end of the comment period for the proposed changes to the Summary of Benefits and Coverage template and related documents), the Departments will finalize the SBC template and associated documents “expeditiously.” The intent is for the new template to be used beginning on: the first day of the first open enrollment period that begins on or after April 1, 2017, for plan years beginning on or...Continue Reading
Many states have recently enacted laws requiring insurers, and self-funded health plans, to report detailed medical information to state databases, including eligibility and medical claims data. The purpose of collecting this information in what are known as “all payer claim databases” is to find ways to control health care costs and improve outcomes. Today, in a case challenging Vermont’s law requiring self-funded health plans subject to ERISA to disclose this information, the...Continue Reading