Health Care Reform

Health care reform is complicated. Our resources help employers stay informed and manage changes in benefits compliance and labor laws.

Senate Releases Proposed Healthcare Bill

On June 22, 2017, the U.S. Senate released a “Discussion Draft” of the “Better Care Reconciliation Act of 2017” (BCRA), aimed at "repealing and replacing" the Patient Protection and Affordable Care Act (ACA).

DOL Asks for MHPAEA Related Comments

The Department of Labor is requesting comment on a draft model form to request information regarding nonquantitative treatment limitations.

ACA Market Stabilization Final Rule

The rule amends standards relating to special enrollment periods, guaranteed availability, and the timing of the annual open enrollment period in the individual market.

SBC Template and REquired Addendums for Covered Entities under ACA SEction 1557

A Summary of Benefits and Coverage (SBC) is four page (double-sided) communication required by the federal government. It must contain specific information, in a specific order, and with a minimum size type, about a group health benefit's coverage and limitations.

Medicare Part D: Creditable Coverage Disclosures

Entities such as employers with group health plans that provide prescription drug coverage to individuals that are eligible for Medicare Part D have two major disclosure requirements that they must meet at least annually.

CMS' Proposed Rule on ACA Market Stabilization

On February 17, 2017, the Department of Health and Human Services’ Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to stabilize the health insurance market and address risks to the individual and small group markets.

IRS Reporting Tip 1 - 2016 Form 1094-C, Line 22

Under the Patient Protection and Affordable Care Act (ACA), individuals are required to have health insurance while applicable large employers (ALEs) are required to offer health benefits to their full-time employees.

FAQs on ACA Implementation

On December 20, 2016, the Department of Labor, Department of Health and Human Services, and the Treasury issued FAQs About Affordable Care Act Implementation Part 35. The FAQ covers a new HIPAA special enrollment period, an update on women’s preventive services that must be covered, and clarifying information on qualifying small employer health reimbursement arrangements.

Short-Term Insurance, Excepted Benefits, Annual Limits

On October 31, 2016, the U.S. Department of the Treasury, Department of Labor, and Department of Health and Human Services issued final regulations regarding the definition of short-term, limited-duration insurance, standards for travel insurance and supplemental health insurance coverage to be considered excepted benefits, and an amendment relating to the prohibition on lifetime and annual dollar limits.

Final Summary of Benefits and Coverage Template and Updates

A Summary of Benefits and Coverage (SBC) is two-and-a-half page (double-sided) communication required by the federal government. It must contain specific information, in a specific order, and with a minimum size type, about a group health benefit’s coverage and limitations.