On-Site Medical Clinics

in HIPAA Privacy & Security

Martha Sewell, one of my partners at KS, reminded me of a growing issue for on-site medical clinics.  Currently, on-site medical clinics are a HIPAA excepted benefit and the clinic itself is excepted from HIPAA privacy.  However, HHS has never formally defined an on-site medical clinic.  Many of us have thought that the exception may only apply to traditional on-site clinics, and not the large on-site clinics that are established by employers today that are close to fully functional...Continue Reading

ERRP Reporting Now Live

in Affordable Care Act

I have spent the last few days speaking at the JCEB National Health and Welfare Institute here in DC and have unfortunately not been keeping up with recent events.  One such recent event is that there is much happening with the ERRP right now.  Currently, the cost reporting and reimbursement request features are now live for plan sponsors with approved applications.  If you are waiting for your application to be approved, you should review the requirements so that you are ready to submit...Continue Reading

NAIC Finalizes MLR Rules

in Affordable Care Act

Today, the NAIC finalized its controversial MLR regulations, and have sent them to HHS.  In turn, HHS will turn the MLR rules into regulations under the Affordable Care Act.  In the process, HHS can certainly revise or tweak the MLR rules, including, for example, to make it easier for mini-med plans to pass the requirements.  A few weeks ago we posted a news release by HHS stating that they understood the challenges that mini-med plans face and they intended to revise the MLR rules as...Continue Reading

All Quiet in DC this Week

in Health Benefits, Retiree Benefits, Welfare Benefits

Now that the set of Transformers 3 has moved out of DC, it is fairly quite this week.  It appears that everyone is digging out from the avalanche of Affordable Care Act guidance, and waiting for the elections in two weeks.  As you are updating your enrollment guides and summary plan descriptions, and drafting plan document amendments, keep in mind that plaintiffs lawyers love obscurity and inconsistency.  The best way to draft any plan language is to be clear and consistent among your...Continue Reading

Retiree Health Plans – Beware of What you Wish for

in Affordable Care Act, Retiree Benefits

Our September 28th blog entry discussed retiree-only plans and that to solidify their exemption from the ACA employers should put those benefits into separate ERISA plans.  For months, some attorneys have been hammering away at the Departments regarding this issue (but I'm not sure why).  Well, now the Departments have addressed the issue, and while it is still inconclusive, I don't think the end result looks pretty.

Today, the Departments issued another round of guidance - called Part III...Continue Reading