This post will provide an overview of the new guidance on PPACA’s out-of-pocket maximum issued jointly by the HHS, the DOL, and IRS. This guidance is particularly important for plan sponsors who provide essential health benefits (EHBs) through multiple vendors. While previous guidance provided transitional …
Update on Essential Health Benefits
February 27, 2012 Leave a Comment
We previously posted on the difficulties that state by state essential health benefits determinations could present for self-funded health plan sponsors. CMS recently issued some guidance that could help. The guidance provides that to determine which benefits are essential health benefits for purposes of …
Essential Health Benefits Guidance Could Be Problematic for Self-funded Health Plan Sponsors
January 16, 2012 Leave a Comment
On December 16th, 2011, the Center for Consumer Information and Insurance Oversight proposed a benchmark standard to define essential health benefits. Under the proposal, states would choose a benchmark plan from: The largest plan by enrollment in any of the three largest small group insurance products in the …
Glossary of Important Health Care Reform Terms
September 22, 2011 Leave a Comment
Health care reform has coined several new terms that are confusing, and often used interchangeably – minimum essential coverage, qualified health plans, and essential benefits and essential health benefits package, among others. This post is designed to assist self-funded health plan sponsors in determining …
Top 5 Health Care Reform Issues Employers Should Focus on Today
March 3, 2011 Leave a Comment
It has now been almost a year since health care reform was first enacted. The first year involved many compliance challenges, not the least of which was keeping up with the many pieces of guidance issued by the Department of Labor, Internal Revenue Service and Health and Human Services. But now that the first …
Waiting For Guidance
February 22, 2011 Leave a Comment
Employers are waiting for agency guidance on many pieces of the health care reform puzzle. Here are some of the big issues for which guidance has been promised but not yet issued: Form W-2 Reporting. The IRS was expected to release additional guidance by the end of 2010 on the new Form W-2 requirement to …