Have you been asleep for a while, like Rip Van Winkle, and just waking up to learn about health care reform? Or just not been interested in watching the minutiae of health care reform? Or have you just become responsible for health care reform compliance? We have plenty of posts about what you need to know, …
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 …
Annual Enrollment Materials and Welfare Notices
September 30, 2010 Leave a Comment
You may be preparing materials and notices for an upcoming annual enrollment period. Health care reform and other recent laws have added or changed several notices that are required before the next plan year starts (1/1/2011 for calendar-year plans). The agencies have provided several model notices to assist with …
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 …