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August 18, 2011

HRB 38 - Proposals on Exchanges, Premium Assistance and Uniform Benefit Summary

August 18, 2011 -- In recent days, the governing Agencies (HHS, DOL and IRS) responsible for implementing the Patient Protection and Affordable Care Act (referenced as the “Affordable Care Act” or “ACA”) have been busy.  A number of proposed guidance have been issued, specifically relating to Exchanges, premium assistance (“Health Insurance Premium Tax Credit”), and perhaps of most interest to employers, the uniform benefits summary, now dubbed the Summary of Benefits and Coverage (SBC). 

August 8, 2011

New York Imposes New Dependent Reporting Requirements on Employers

Presumably, in an effort to augment dependent health coverage, the State of New York has recently passed a law requiring that employers report both for new hires, and on a quarterly basis, the availability of dependent coverage. This applies to employers who have employees who work or reside in New York.

August 8, 2011

Extension for Self-Reporting of Welfare Benefit Plan Violations

For the past two years, it has been incumbent upon employers sponsoring group health plans, as well as certain other responsible entities, such as insurers or third party administrators, to self-report certain welfare benefit plan violations (see Welfare Benefit Plan Violations: Self-Reporting Required from the November 2009 Benefit Beat).  Such violations would include those relating to:

August 8, 2011

San Francisco HCSO Expenditure Rates for 2012

Covered employers who are subject to San Francisco’s Ordinance are required to make health care expenditures (HCE) to, or on behalf of, their covered employees.  These expenditure amounts are adjusted annually, in accordance with the San Francisco Ordinance.  Nonprofit entities with fewer than 50 employees, and small employers (those with fewer than 20 employees) are exempt from these provisions. 

August 8, 2011

Service Provider and Participant Fee Disclosure Final Regulation Issued

The DOL’s Employee Benefit Security Administration (EBSA) has issued a final rule that provides for an extension of the applicability dates relating to service provider fee disclosure to plan sponsors, and the participant level fee disclosure rules.  According to the final rule:

August 8, 2011

Expiration of FUTA Surcharge Tax

The federal unemployment tax (FUTA) empowers the IRS to tax employers in all states to fund unemployment benefits for involuntarily terminated workers.  For the past 23 years, FUTA included a 0.2% surcharge. This additional 0.2% surcharge provision expired on June 30, 2011.  Therefore, unless extended by law, the FUTA rate has decreased from 6.2% to 6.0% of gross payroll, beginning July 1, 2011.

August 3, 2011

HRB 37 - Preventive Care Coverage Expanded to include Women’s Health Services

August 3, 2011 -- The Patient Protection and Affordable Care Act (PPACA) requires individual and group health plans to provide preventive coverage, without imposing any cost-sharing requirements (co-payment, co-insurance, or deductible), when such services are delivered by in-network providers. These rules apply to both non-grandfathered individual and group health plans, including both insured and self-funded plans; the rules do not apply to grandfathered plans. About a year ago, the governing Agencies issued interim final rules defining the parameters of certain preventive services (see CBIZ Health Reform Bulletin,

August 2, 2011

Budget Control Act of 2011

With an August 2, 2011 deadline looming, President Obama and Congressional leaders have reached an eleventh hour agreement to raise the federal debt limit. The two-part debt deal includes creation of a joint select committee of Congress to determine additional deficit reduction measures before year-end.

July 11, 2011

HRB 36 - Modifications to Claims and Appeals, and External Review

July 11, 2011 -- The Patient Protection and Affordable Care Act (PPACA) includes rules relating to health claims and appeals, and the right to an external review.  These rules, applicable to non-grandfathered plans, are effective for plan years beginning on or after September 23, 2010; however, the Agencies provide for non-enforcement periods applicable to certain provisions (see CBIZ Health Reform Bulletin, 
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