Department of Labor
Department of Labor releases FAQs on mental health parity compliance
Posted on May 10, 2012
The Department of Labor’s Employee Benefits Security Administration published a set of frequently asked questions (FAQs) regarding implementation of the Mental Health Parity and Addiction Equity Act of 2008.
Amongst other topics, the FAQs address…
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Three federal agencies release request for information on stop-loss coverage
Posted on April 30, 2012
On April 27, 2012, the Department of the Treasury’s Internal Revenue Service (IRS), the Department of Labor’s Employee Benefits Security Administration, and the Department of Health and Human Services’ (HHS) Centers for Medicare & Medicaid Services (CMS) issued a request for information (RFI) regarding the use of stop loss insurance by group health plans and their plan sponsors, with a focus on the prevalence and consequences of stop loss insurance at low attachment points, or the point at which excess insurance or reinsurance limits apply.
Concerns have circulated that the practice could lead to higher costs in small group health insurance exchanges. Stop-loss insurance protects self-insured companies against claims above the attachment point. Employers and plans that purchase stop-loss insurance generally are not subject to state health insurance laws regarding coverage, rating policies, and other state and federal consumer protections, and thus could prove financially risky in the exchange market. Specifically, if the practice is widespread, it could worsen the risk pool and increase premiums in the insured small group market, including the Small Business Health Options Program (SHOP) exchanges.
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IRS and Treasury release FAQs about ACA automatic enrollment, employer shared responsibility, and waiting periods
Posted on February 10, 2012
The Internal Revenue Service answered frequently asked questions related to automatic enrollment, employer shared responsibility payments, and waiting periods under the Affordable Care Act (ACA). The notice addressed employers’ questions and invited comments on proposals that the Treasury, Labor, and Health and Human Services departments expect to include in future guidance or rulemaking under the ACA.
The notice included the following information…
Final rule released requiring insurers to use plain language in describing benefits, coverage
Posted on February 9, 2012
Today the Department of Health and Human Services, the Department of Treasury, and the Department of Labor released a final rule requiring insurers to use plain language in describing health plan benefits and coverage under the Affordable Care Act (ACA). The regulations mandate health insurers and group health plans to provide concise and comprehensible information about health plan benefits and coverage to Americans with private health coverage. The new rules will also facilitate easier plan comparison for individuals and employers. The new explanations, available on or soon after September 23, 2012, will be a critical resource for the roughly 150 million Americans with private health insurance. Specifically, these rules will ensure consumers have access to two key documents that will help them understand and evaluate their health insurance choices…
Departments release FAQs on ACA, Mental Health Parity
Posted on November 22, 2011
According to a set of frequently asked questions (FAQs) recently released by the Departments of Health and Human Services (HHS), Treasury (DOT), and Labor (DOL), the final rule under an Affordable Care Act (ACA) provision, which requires health care insurers and group health plans to make available to consumers a standardized summary of the benefits and coverage for each plan they offer, will be released “as soon as possible.” The FAQs pertain to implementation of ACA market reform provisions and mental health parity requirements. Until this final rule is released, plans are not required to comply with the proposed rule’s provisions. The ACA requires plans to provide consumers with a standardized form containing definitions of benefits and information on coverage. Along with the benefits and coverage summary, the departments also included several FAQs addressing the implementation of the Mental Health Parity and Addiction Equity Act of 2008, which mandates equal treatment for medical and surgical care and mental health and substance use disorder care in areas such as out-of-pocket costs and benefit limits and practices.
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Treasury, DOL, HHS issue new rules on providing insurance information to consumers
Posted on August 17, 2011
The Internal Revenue Service (IRS) of the U.S. Department of Treasury (Treasury), The Employee Benefits Security Administration (EBSA) of the U.S. Department of Labor (DOL), and the U.S. Department of Health and Human Services (HHS) have jointly-released two Notices of Proposed Rulemaking (NPRMs) covering the disclosure of the Summary of Benefits and Coverage and the Uniform Glossary to insurance consumers, aimed at providing clear, consistent, and comparable information about their health plan. The rules apply to group health plans and health insurance coverage in the group and individual markets under the Affordable Care Act (ACA), and include not only what must be disclosed to consumers, but also examples of the templates on which the information will be disclosed.
HHS issues amended preventive services IFR
Posted on August 1, 2011
The U.S. Department of Health and Human Services (HHS) has issued an amended version of the previous Interim Final Rule on the coverage of preventive services by group health plans and health insurance issuers under the Affordable Care Act (ACA). The amended rule reflects recent recommendations by the Institute of Medicine (IOM) regarding particular preventive services for women that should be covered at no cost by insurance companies. Services include screening and counseling for certain sexually transmitted infections, screening for gestational diabetes, and among others, counseling and contraception to prevent unintended pregnancies. The Internal Revenue Service has also issued an amended rule that reflects the coverage of these preventive services.
*** On August 3, 2011, HHS issued an amendment to the amended IFR, further clarifying the expemption of religious organizations from the contraception coverage requirement.
For more information on prevention, click here.
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DOL/IRS issue amendments to IFR on claims appeals
Posted on June 22, 2011
The US Department of Labor (DOL) and the Internal Revenue Service (IRS) have issued separate amendments to the July 23, 2010 Interim Final Rule (IFR) on internal claims and appeals and external review processes for group health plans and health insurance issuers offering coverage in the group and individual markets. The Employee Benefits Security Administration (EBSA) of the Department of Labor has also issued new guidance on the subject.
The IFR, recent amendments, and recent guidance do not apply to grandfathered plans.
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Sebelius, other Cabinet members send letter to House Speaker, updating Congress on ACA status
Posted on January 5, 2011
Health and Human Services Secretary Kathleen Sebelius, Treasury Secretary Tim Geithner, and Labor Secretary Hilda Solis sent a letter to Speaker of the House John Boehner, outlining the successes of the Affordable Care Act (ACA) to date. The letter also warned Congress that millions of Americans would lose the protections the ACA currently provides in the event of any attempts to dismantle or repeal the law.
Agency Profile: Department of Labor
Posted on December 13, 2010
The responsibilities for implementing the Affordable Care Act are spread across several federal departments and the offices within them. This is the latest in a series of briefs developed by HealthReformGPS describing the implementing agencies and their roles.
Though the Affordable Care Act (ACA) left the basic framework of ERISA unchanged, it introduced many new requirements on employer-sponsored insurance (ESI) to strengthen the rights of beneficiaries. DOL is the lead agency responsible for implementing these new requirements.
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- Contraception Coverage under the ACA’s Preventive Services Coverage Requirements, and Employer Implementation: An Update posted on April 20, 2012
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- State Health Insurance Exchange Navigators posted on February 28, 2011
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