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Business Insights, Research & Perspectives

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August 19, 2010

HRB 14 - Pre-existing Condition Insurance Plan (“PCIP”)

August 19, 2010 -- The Patient Protection and Affordable Care Act (PPACA) provides for the establishment of a federal temporary high risk pool to assist individuals who have been denied insurance coverage due to a preexisting condition.  Further, the PPACA prohibits individual and group health plans from imposing preexisting condition exclusions on children younger than 19 (for plan years beginning on or after September 23, 2010), and can no longer impose such exclusion on anyone beginning in 2014.  The Department of Health and Human Services (HHS) has developed a health insurance program to assist such individuals in obtaining insurance coverage through a Pre-existing Condition Insurance Plan (“PCIP”).  The purpose of the PCIP program is to bridge the gap between now and 2014, when the preexisting condition standards are in place in all health plans.

August 6, 2010

Mandatory Medicare Reporting for HRAs Clarified

As mentioned in the June Benefit Beat (Updated Information: Mandatory Medicare Reporting for HRAs), the rules relating to the Mandatory Medicare Reporting for health reimbursement arrangements (HRAs) have been clarified.  TheCMS Group Health Plan User Guide has been updated to reflect this.  Of particular note, both “free-standing” and “imbedded” HRAs must comply with the mandatory reporting. 

August 5, 2010

More HIPAA Privacy Rules Proposed

The American Recovery and Reinvestment Act of 2009 (ARRA) included a law known as the Health Information Technology for Economic and Clinical Health (HITECH) Act.   The HITECH Act made several changes to the HIPAA privacy and security rules. 

August 5, 2010

Retirement Plan Fee Disclosure Continuum

The DOL’s Employee Benefit Security Administration has been working on a multi-faceted approach to ensure adequate fee disclosures payable by retirement plans.  The first prong came in the form of Schedule C reporting requirement; these requirements took effect for the 2009 plan year.  The second prong relates to fee disclosure to plan sponsors.  On July 16, 2010, the DOL issued interim final regulations addressing fee disclosure matters by service providers.  Later this year, the DOL is expected to issue regulations relating to disclosure to participants. 

August 5, 2010

COBRA Subsidy Expired

The COBRA premium assistance subsidy, enacted as part of the American Recovery and Reinvestment Act (“ARRA”) in February, 2009, ended May 31, 2010, and has not been reinstated.  Therefore, individuals who are involuntarily terminated after May 31, 2010, do not qualify for the subsidy.  However, individuals who qualified for the subsidy on or before May 31, 2010 may continue to pay reduced premiums for the full subsidy period (15 months), as long as they are not eligible for another group health plan or Medicare.

August 3, 2010

HRB 13 - Expanded 1099 Reporting Requirements for 2012 and Call for Public Comment

August 3, 2010 -- Beginning in 2012, payments of $600 or more in any taxable year for goods as well as services, and made to any person or entity, including corporations, will be subject to Form 1099 reporting.  The new reporting requirements were introduced as part of the health care reform legislation enacted on March 23, 2010, which amends Section 6041 of the Internal Revenue Code (the “Code”).    Prior to the amendment, Section 6041 required information returns to be filed by every person engaged in a trade or business who makes payments to another person of rent, salaries, wages and other enumerated amounts that total $600 or more in a taxable year.  The amendment significantly expands this reporting requirement to include payments “of amounts in consideration for property” and includes corporations not tax-exempt under Section 501(a) of the Code as “persons” subject to the reporting.  Note that certain business purchases made with credit or debit cards are exempted from the Section 6041 reporting requirement under previously issued proposed regulations (REG-139255-08),1because such purchases will already be reported by banks and other payment processors. 

August 3, 2010

HRB 12 - Break Time for Nursing Mothers

August 3, 2010 -- As part of the Patient Protection and Affordable Care Act, a federal law was enacted, effective March 23, 2010, that provides for a reasonable break time for nursing mothers to express milk.  Specifically, this law requires employers to provide a private place, other than a bathroom, for nursing mothers to express milk during the first year of the child’s life.  The designated private place must be shielded from view, and free from intrusion from coworkers and the public.

July 26, 2010

HRB 11 - Internal Claims and Appeals, and External Review Process

July 26, 2010 --On July 23, 2010, the Departments of HHS, Labor, and Treasury issued interim final regulations relating to the internal claims and appeal, and external review process provisions of the health reform law (PPACA).  These rules provide for both a standardized internal process, as well as an external process, that individuals can use to appeal decisions made by their health plan.

July 15, 2010

HRB 10 - Preventive Health Services

July 15, 2010 -- On July 14, 2010, the Departments of HHS, Labor, and Treasury issued interim final regulations relating to the preventive care provisions of the health reform law (PPACA).  These rules require health plans to cover certain preventive services, without imposing any cost-sharing requirements (co-pay, co-insurance, or deductible), when such services are delivered by in-network providers. 

July 12, 2010

HRB 9 - New Model Notices Issued

July 12, 2010 -- In response to several notice requirements contained in recently issued regulations implementing the new health reform law, the DOL’s Employee Benefit Security Administration (EBSA) issued four new model notices, as follows:
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