HHS has already granted waivers from the new restricted annual dollar limits to 30 companies—and some members of Congress want an explanation why, according to a recent letter to HHS from the House Committee on Energy and Commerce. As previously discussed, HHS has regulatory authority to waive the restricted …
Just Released: HHS Application Procedure for Annual Dollar Limit Waivers
September 8, 2010 Leave a Comment
In an earlier post, we discussed the interim final regulations issued relating to the prohibition of annual dollar limits on essential health benefits. Those regulations also provided that these restricted annual limits could be waived by the Secretary of HHS if compliance with the regulations would result in a …
When are annual and lifetime limits allowed?
July 17, 2010 1 Comment
Recent regulations confirm that the general prohibition on annual and lifetime limits applies only to "essential health benefits." That is, annual and lifetime limits are permissible for "non-essential" health benefits. In addition, for plan years beginning before January 1, 2014, group health plans may establish …
What is an “essential health benefit”?
July 15, 2010 Leave a Comment
The health care reform statute provides that "essential health benefits" must be defined to include the following categories of services: Ambulatory patient services; Emergency services; Hospitalization; Maternity and newborn care; Mental health and substance use disorder services, including behavioral …
What health care reform changes should employers be thinking about right now?
April 19, 2010 Leave a Comment
The following health care reform changes are already effective for 2010: For federal tax purposes, imputation of income no longer required for health coverage of children age 26 or younger Breaks required for nursing mothers Adoption assistance program limit can be increased Early Retiree Reinsurance Program …