Relief for Mini-Med Plans from Restrictive MLR Rules

in Affordable Care Act

Yesterday, many plan sponsors of mini-med plans publicly noted that the upcoming MLR regulations may force them to terminate their mini-med plans. Currently, the NAIC has published draft rules. Next month HHS is required to take that draft and turn it into proposed regulations on the medical loss ratio standards. Moments ago the Director of OCIIO released a statement saying in part that when OCIIO releases the proposed MLR regulations, it fully intends to exercise discretion under the new...Continue Reading

Retiree Only Plans – Time is Running Out

in Affordable Care Act, Retiree Benefits

The so-called "retiree-only" plan exception has been around since HIPAA was passed back in 1996.  However, it has taken on new importance now that a retiree-only plan can also be exempt from the provisions of the Affordable Care Act.  But, what is this amorphous being?  In the past some employers have claimed that this exception applies at the benefit option level even if retiree options are wrapped together with active employee options in the same ERISA plan.  This position is...Continue Reading

IROs – Relief or Confusion?

in Affordable Care Act

Late Tuesday, DOL released FAQs regarding various miscellaneous ACA issues.  DOL also released additional guidance on the claims and appeals procedures in Technical Release 2010-02.   THe FAQs can be seen here:

http://www.dol.gov/ebsa/faqs/faq-aca.html

The FAQs are a strange aggregation of items.  One of the FAQs states that with respect to IRO contracts that the earlier DOL guidance never required a contract between a plan and an IRO.  This is in direct contradiction with Technical...Continue Reading

Nondiscrimination for Insured Plans – Update

in Affordable Care Act

A few weeks ago we informed you of the delay in regulations regarding the insured plan nondiscrimination rules.  Yesterday, the IRS published Notice 2010-63, requesting information regarding how the new nondiscrimination rules should apply to insured plans and the interaction with 105(h).  Comments are due by November 4, 2010.  The IRS is likely looking at how it can combine nondiscrimination testing when a single sponsor has multiple insured options and/or multiple insured and...Continue Reading

GINA – More than an Interesting First Name

in Health Benefits

Just in time for annual enrollment, the DOL has issued a number of FAQs on the Genetic Information Nondiscrimination Act (GINA).  Remember, if you have health risk assessments for your medical plan, the questionnaires must be voluntary and you must decouple the genetic information questions from any monetary or other incentive that is paid to complete them.  You can still pay a monetary incentive but your health risk assessment must make it clear that the incentive is only paid for...Continue Reading