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Business Insights, Research & Perspectives

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May 5, 2010

HRB 2 - Early Retiree Reinsurance Program

May 5, 2010 -- The Department of Health and Human Services (HHS) has just issued interim final regulations, and a Fact Sheet, relating to the Early Retiree Reinsurance Program.  This temporary program, established by way of the health care reform laws, provides reimbursement of certain expenses to plan sponsors of group health plans that provide retiree coverage to early retirees, and their eligible spouses and dependents.

May 4, 2010

COBRA Subsidy Extension: Revised Model COBRA Notices and Other Updated Information

In its ongoing effort to assist with COBRA subsidy compliance, the Department of Labor has just issued several documents that have been updated to reflect the extension of the COBRA subsidy eligibly period through May 31, 2010 (seeCOBRA Subsidy Extended….Again!  from the April ’10 Benefit Beat).  Included among these documents are new model notices, discussed below, Application for Expedited Review of Denial of COBRA Premium Reduction, Fact Sheet, and Frequently Asked Questions.

May 4, 2010

Medicare Part D – 2011 Benefit Limits

The Centers for Medicare and Medicaid Services have released the 2011 cost of living adjustments for Medicare Part D prescription drug benefits.  The following are selected modified limits relating to the standard drug benefit and the retiree drug subsidy.

May 4, 2010

TRICARE Secondary Payor Rules: Final Regulations Issued

The Department of Defense issued final regulations relating to TRICARE secondary payor rules (seeEmployer Coverage? TRICARE? Beware! from the April ’08 Benefit Beat, andNew TRICARE Provisions Affect Group Health Plans from Nov. ’06 Benefit Beat). In summary, these rules are similar to the Medicare secondary payor rules.  If an individual entitled to TRICARE is actively working, the employer cannot do anything to incent the individual to choose TRICARE over the employer’s sponsored health plan.  In other words, the employer cannot, in any way, incent the employee to choose TRICARE, rather than the employer’s plan.  This choice strictly rests with the individual.  Furthermore, an employer is prohibited from paying for a TRICARE supplemental plan.

May 4, 2010

A Confidentiality Reminder

It is of upmost importance to ensure the protection of an individual’s medical information.  Several laws address the need to ensure this confidentiality.  HIPAA, for example, addresses protected health information derived from covered entities.  The Rehabilitation Act, the Americans with Disabilities Act (ADA), as well as the Family and Medical Leave Act, also require that medical information be handled with the upmost care.  This issue was highlighted in a recent informal Letter issued by the Equal Employment Opportunity Commission.  The Letter specifically relates to the Rehabilitation Act, but is equally applicable for ADA purposes. 

April 28, 2010

HRB 1 - IRS Guidance: Tax-Favored Status of Dependent Coverage

April 28, 2010 -- As promised, the government is feverishly attempting to issue guidance on the new health care reform law.  Yesterday, the IRS issued guidance relating to the tax-favored status of dependent coverage (IRS Notice 2010-38).  Part of the Reconciliation law (enacted March 30th) provides that reimbursement of health expenses for dependent children who have not attained age 27 by the end of the taxable year (calendar year) is excludable from the employee’s income.  For this purpose, a dependent includes:

April 16, 2010

COBRA Subsidy Extended….Again!

The COBRA subsidy law has been temporarily extended, once again (H.R. 4851, signed by President Obama on April 15, 2010). This is the law that allows individuals involuntarily terminated from employment to pay 35% of the COBRA premium for up to 15 months.

April 15, 2010

Dependent Coverage: A Bit of Tax Relief

Effective March 30, 2010, the cost of employer-provided health coverage for dependent children who have not reached their 27th birthday by the end of the calendar year, will not be imputed into the parent’s income.  For 2010, this means that the cost for providing health coverage to a child, who does not meet the definition of qualifying child or qualifying relative, is includible in their employee-parent’s income for the first 3 months of the year, and is excluded from the employee-parent’s income for the balance of the year.

April 15, 2010

Reminder: Triennial HIPAA Privacy Notice Obligation

The sixth anniversary of the HIPAA privacy rules, applicable to small group health plans, is upon us. This means that the requirement for notifying covered individual regarding the availability of the Notice of Privacy Practices and how to obtain one, must be met no later than April 14, 2010.

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