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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 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, 

July 7, 2011

IRS Increases Mileage Rate for Medical Expense Reimbursement

Due to the increased cost of gasoline, the IRS revised the optional standard mileage rates for purposes of computing the deductible costs of operating an automobile for medical expense reimbursements, as well as for business and moving expense purposes. Below are the reimbursement rates for the first and second six-month periods in 2011.

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

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

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. 

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