What Will the State Exchanges Look Like?

in Affordable Care Act

Although many plan sponsors are still trying to digest the 2011 changes, some are looking toward the future when the exchanges are scheduled to come on line in 2014.  HHS is planning on issuing proposed regulations starting in the Spring of 2011 addressing the basic exchange requirements.  However, for now HHS has issued a general statement to the states seeking to establish an exchange.  This guidance was posted late last week at the following address:

Continue Reading

Annual Limit Waiver Applications – Update

in Affordable Care Act

I recently talked to HHS regarding an annual limit waiver (i.e., mini-med waiver) that i filed on behalf of a client.  HHS requested additional information, which is not new.  But, what is new, is that one of the additional pieces of requested information is a hypothetical calculation of premiums for the next year, assuming that the plan sponsor had to raise the annual limit to $750,000.  Theoretically, this sounds like good information for HHS to request.  But, this information takes...Continue Reading

Agencies Amend Grandfather Plan Rules

in Affordable Care Act

Today, the agencies amended the grandfather plan rules to allow employers to change insurers without losing grandfather status.  Under the prior interim final rules, one of the ways an employer group health plan could lose its grandfather status was if the employer changed insurers.  However, as amended, employers can now change insurers without losing grandfather status, so long as the structure of the coverage doesn’t violate one of the other rules for maintaining grandfathered plan...Continue Reading

Annual Limit Waiver Guidance Updated

in Affordable Care Act

In previous posts I discussed the annual limit waiver process for mini-med plans as well as the upcoming MLR rules regarding mini-med plans.  Today, OCIIO amended the annual limit waiver application process for mini-med plans, including adding a participant notice requirement.  This notice is yet to be posted to the website, but it is required to be sent to participants in a plan that has obtained an annual limit waiver.  OCIIO also announced its intention to provide a special...Continue Reading


in Affordable Care Act

This morning the DOL released three more FAQs dealing with grandfathered plans.  These additional FAQs are referred to as Part IV on the website and linked here: 


I certainly hope at one point DOL combines all these FAQs into a single guidance document or includes the guidance in the regulations when the interim final regulations are finalized.