Mini-Med Plans – Round 2

in Affordable Care Act

As I previously discussed, HHS has indicated a willingness to make an exception in the upcoming MLR regulations for mini-med plans.  However, currently, it is unclear how and to what extent that exception will apply.  Unfortunately, employers need to make decisions now for annual enrollment materials.  Because no one knows what the MLR exception will look like, one solution to this issue is to simply self-insure your mini-med option.  A self-insured mini-med option is not subject to the...Continue Reading

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