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June 22, 2011

HRB 35 - Update: Mini-Med Plan Waivers

June 22, 2011 --  One of the requirements of health care reform contained in the Patient Protection and Affordable Care Act (PPACA) is that health plans, both grandfathered and non-grandfathered, can impose no annual or lifetime limits on essential benefits.  While the law requires no annual limits, there is a phase-in period for compliance with this requirement between now and 2014.  During this time, a plan can impose limits in accordance with the following schedule:

June 7, 2011

Fee Disclosure Applicability Date Modification Proposed

In July, 2010 and October, 2010, respectively, the DOL issued service provider and participant level fee disclosure rules.  The Department indicated, informally, that it was considering delaying the applicability date of these regulations in order to give service providers and plan administrators time to comply with the regulations. 

June 7, 2011

Medicare Part D Notices – Corrected Links

It’s come to our attention that the links to the model Medicare Part D disclosure notices contained in last month’s Benefit Beat article, Medicare Part D Updates, were changed following release of our publication.  We‘ve since revised the links contained in this article.

June 7, 2011

Accountings for PHI Disclosure: Rules Proposed

HHS’ Office of Civil Rights has recently proposed rules relating to accounting of disclosures.  The HIPAA law, as modified by the Health Information Technology for Economic and Clinical Health Act (HITECH), requires certain accounting of disclosures of protected health information (PHI) maintained in a designated record set.  These rules propose to clarify the types of accounting that are required.  Of particular note, the proposal would limit the accounting to the past 3 years. 

June 7, 2011

Health Savings Accounts: 2012 Cost of Living Adjustments

In Rev Proc 2011-32, the IRS released the 2012 cost of living adjustments (COLA) for health savings accounts.  Note, the statutory high deductible health plan (HDHP) minimum deductibles remain unchanged from the 2011 limits.  The HDHP out-of pocket limits, and the statutory HSA contribution amounts, have increased slightly.

June 7, 2011

Plan….Summary Plan Description…Which One Governs?

The U.S. Supreme Court has recently rendered an important opinion relating to the role of a summary plan description (SPD).  In CIGNA Corp. v. Amara, 2011 WL 1832824 (U.S. 2011), the Supreme Court ruled that the SPD is not part of the plan document.  Of particular note, the terms of the SPD that may be in conflict with the plan document, cannot, in effect, amend the terms of the plan.  In other words, the terms of the plan govern.  This is a departure from some lower court decisions. 

May 12, 2011

Update: Wellness Program – ADA Class Action Case

In the April Benefit Beat, a class action lawsuit (Bradley Seff v. Broward County) was mentioned relating to an employer offering financial incentives for participating in a group wellness program.  This case addresses the applicability of the Americans with Disabilities Act (ADA) to wellness programs.  Specifically, a group of employees challenged the employer’s imposition of a wellness program that requires completion of a health risk assessment (HRA).  Failure to complete the HRA would result in a financial penalty.  The complainant alleged that this was a violation of the ADA because it impermissibly requested medical information.  Generally, the ADA permits the collection of medical information as long as it is voluntary.  The “voluntary” nature of the medical information collection was in question. 

May 12, 2011

Revised National Medical Child Support Notice Issued

On occasion, an employer may receive a court order directing the employer and/or plan administrator to enroll an employee’s child(ren) listed in the Order in one or more of its benefit programs, including medical, dental, vision, prescription drug, mental health and other benefit programs.  An Order can be received directly from a Court, or by way of a National Medical Support Notice (NMSN) form issued by a State Child Support Agency authorized to enforce medical child support orders. 

May 12, 2011

Medicare Part D Updates

Change in Medicare Part D Annual Enrollment Period plus New Model Notices of Creditable and Non-Creditable Coverage

May 11, 2011

The Outlook for Major Tax Reform: What You Need to Know

A bruising budget battle, near-government shutdown, lightening-rod speech by President Obama, and threatened downgrade in the AAA rating of US debt all added to the momentum for major tax reform in the first few weeks of April 2011. At this point, the calls for tax reform are intertwined with efforts to reduce the federal deficit, and some of the proposals in process are more sweeping than we have seen in decades.
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