United States Department of Health and Human Services
Agency officials were busy last week releasing updated forms and publications while also proposing new rules that would generally impact health plans in 2020. Here are three important releases which are now available:
The Department of Labor (DoL), Department of Treasury (DoT) and the Department of Health and Human Services (HHS) have jointly proposed new rules that would impact Health Reimbursement Arrangements (HRAs) effective January 1, 2020.
The public insurance exchanges are expected to introduce a new way for individuals to obtain health insurance coverage next year. However, with the introduction of these exchanges comes a number of complexities and nuances. That includes the topic of premium payment processing and late payments.
Individuals that qualify for Advanced Premium Tax Credits (APTC) through the exchanges will have a portion of their premium subsidized by the federal government, but the balance of the premium will be their responsibility.
The U.S. Department of Health and Human Services (HHS) released final regulations on March 1, 2013 about the Transitional Reinsurance Program. This new program will require insurance companies and some employers to fund a program that will provide partial reimbursements to commercial insurers that provide coverage to high risk individuals.
The U.S. Department of Health and Human Services (HHS) released final regulations on February 22, 2013 in regards to various health insurance market rules. The new guidance includes information about minimum participation requirements in the small employer marketplace. In most states, small employers are defined as those with 50 or fewer employees.
Insurance companies today require a minimum percentage of employees to enroll in coverage. This is referred to as the participation requirements and helps insurance companies avoid adverse selection. Minimum participation requirements can be up to 75% today.
The U.S. Department of Health and Human Services (HHS) posted final regulations about the deductible and out-of-pocket limitations to the Federal Registrar on February 25, 2013. Section 1302(c) of the Affordable Care Act (ACA) specifies that the maximum deductible for a qualified insurance plan cannot exceed $2,000 for single coverage and $4,000 for family coverage.
The U.S. Department of Health and Human Services (HHS) released the final regulations about Essential Health Benefits (EHB) on February 20, 2013. The guidance defines the benefits that must be included with all fully insured plans sold inside and outside of the public exchanges in 2014. This will impact all individual health plans and most small group health plans. Grandfathered plans and self-insured plans are exempt from the EHB requirements; however, self-insured plans that cover any EHB must provide coverage without any annual or lifetime dollar limits.
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