August 2010
From the editors of CCH's BENE and BAN products, here are hot topics from
recent Employee Benefits Management Directions newsletters as well as
recent explanatory updates in Employee Benefits Management. Also included
are recent explanatory updates to the Benefits Answers Now product.
If you have any comments/suggestions concerning the information provided or the format used, we'd like to hear from you. Please contact me at tulay.turan@wolterskluwer.com.
Hot Topics in Employee Benefits Management:
DOL, IRS, HHS issue interim final rules on grandfathered health plans, Employee Benefits Management Directions newsletter, Issue No. 471, July 6, 2010 – The Departments of Labor, Treasury, and Health and Human Services have issued interim final regulations relating to grandfathered health plan status under the Patient Protection and Affordable Care Act (PPACA; P.L. 111-148). PPACA Sec. 1251 provides that certain group health plans and health insurance coverage existing as of March 23, 2010, (the date of enactment of the PPACA), are subject only to certain provisions of the PPACA.
New health reform rules specify minimum annual limits, provide model language for patient protections, Employee Benefits Management Directions newsletter, Issue No. 471, July 6, 2010 – Minimum annual dollar limits for health plans in 2010 through 2013 were established in interim final regulations announced on June 23, 2010, by the Internal Revenue Service, the Employee Benefits Security Administration (EBSA), and the Department of Health and Human Services.
Proposed HIPAA rules seek to strengthen health information privacy and security, Employee Benefits Management Directions newsletter, Issue No. 472, July 27, 2010 – The Department of Health and Human Services Secretary Kathleen Sebelius has announced proposed regulations and resources regarding the privacy of health information. The proposed rules, published July 14, 2010, would strengthen and expand enforcement of privacy, security, and enforcement rules in HIPAA and the HITECH Act.
ACA regs issued by IRS, HHS, EBSA clarify preventive services that must be covered by health insurers, Employee Benefits Management Directions newsletter, Issue No. 472, July 27, 2010 – The IRS has announced the issuance of proposed regulations by cross reference to IRS, EBSA, and HHS temporary and interim final rules on requirements that group health plans and health insurance issuers must meet for coverage of preventive services under the Patient Protection and Affordable Care Act (ACA).
What's New in Employee Benefits Management:
Health care reform – Several provisions of the Patient Protection and Affordable Care Act (PPACA; P.L. 111-148), as amended by the Health Care and Education Reconciliation Act of 2010 (P.L. 111-152), have been reflected in Explanations as follows: ¶10,140 (grandfathered health plans); ¶2040 (itemized deduction for medical expenses); and ¶20,030 (wellness programs).
Retiree health benefits – A claim by retirees against their former employer for a breach of promise to provide lifetime free health care is barred under Tennessee’s six-year statute of limitations, the Sixth Circuit Court of Appeals (CA-6) has ruled in Winnett v. Caterpillar. The case is discussed at ¶26,050.
State health laws – Various state laws have been updated at ¶10,760.
Patient protection regulations – PPACA-related regulations regarding patient protections are discussed at ¶10,100, ¶10,140, ¶10,310 and ¶10,420.
Model notices – PPACA-related model notices can be found at ¶226,111 through ¶226,114.
What's New in Benefits Answers Now (BAN):
DOL, IRS, HHS issue interim final rules on grandfathered health plans. The Departments of Labor, Treasury, and Health and Human Services have issued interim final regulations relating to grandfathered health plan status under the Patient Protection and Affordable Care Act (PPACA). PPACA provides that certain group health plans and health insurance coverage existing as of March 23, 2010, (the date of enactment of the PPACA), are subject only to certain provisions of the PPACA. The statute and the interim final regulations refer to these plans and health insurance coverage as grandfathered health plans. To learn more about grandfathered health plans, see the discussion at ¶20,057.
Proposed HIPAA rules seek to strengthen health information privacy and security. HHS Secretary Kathleen Sebelius has announced proposed regulations and resources regarding the privacy of health information. The proposed rules, published July 14, 2010, would strengthen and expand enforcement of privacy, security, and enforcement rules in the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the subsequently issued Health Information Technology for Economic and Clinical Health Act (HITECH Act). Find out more about these proposed rules at ¶22,087.
DOL clarifies FMLA definition of "son and daughter." The US Department of Labor, in an Administrator's Interpretation, clarified the definition of "son and daughter" under the FMLA to ensure that an employee who assumes the role of caring for a child receives parental rights to family leave regardless of the employee's legal or biological relationship to the child. Significantly, the revised interpretation extends parental leave rights to same-sex couples who have children. More information about this FMLA definition can be found at ¶31,040.
New health reform rules specify minimum annual limits, provide model language for patient protections. Minimum annual dollar limits for health plans in 2010 through 2013 were established in interim final regulations announced on June 23, 2010, by the Internal Revenue Service, the Employee Benefits Security Administration (EBSA), and the Department of Health and Human Services. The interim final regulations provide detailed guidance on four separate health insurance provisions in the Patient Protection and Affordable Care Act (PPACA), as follows: Prohibition of preexisting condition exclusions; No lifetime or annual limits; Prohibition on rescissions; and Patient protections. See the discussion at ¶20,059 for more information about theses PPACA requirements.
EBRI says early retiree reinsurance funds likely will be exhausted in 2012. A $5 billion temporary reinsurance program designed to help employers maintain health benefits for early retirees likely will be exhausted within two years --well before the 2014 termination date for the program, according to a study released by the Employee Benefit Research Institute (EBRI). The program is part of the Patient Protection and Affordable Care Act (PPACA). One goal of the program is to provide an incentive for employers to maintain retiree health benefits and assist retirees with their costs for health coverage. To find out more about the early retiree reinsurance program, see ¶22,875.