Category Archives: Health Care Reform

Groups say HIPAA transaction rules would unduly tax self-funded plans

Government requirements for certifying compliance with HIPAA’s transaction standards would impose a significant, unwarranted burden on self-funded group health plans that do not perform these transactions directly, employer groups warned in written comments to the U.S. Department of Health and…

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Law Eliminates Reform Caps on Small-business Deductibles

Congress removed health care reform’s $2,000/$4,000 deductible limits as part of the annual Medicare physician payment bill that President Obama signed on April 1. Section 213 of the Protecting Access to Medicare Act of 2014 removes deductible limits for small-business…

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Organization Strategy Must Underlie Health Reform Decisions

How a company complies with health care reform should be determined by what kind of employer it is, how exclusive its workforce is, and how important its benefit package is seen as an aid to recruitment and retention. Only after…

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SIIA Chief Testifies on Pro-reform Threats to Self-funding

On Feb. 26, SIIA’s CEO and president Mike Ferguson testified before a House panel to make it clear that skirting the ACA is not the reason companies and institutions self-insure, contrary to what pro-reform elements in the federal government may…

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Notre Dame University Denied Contraception Injunction

The 7th Circuit in a 2-1 ruling refused to grant a preliminary injunction to Notre Dame University, which would have freed the university from participating in reform’s requirement to provide contraceptives at no cost to all women. In so doing the court criticized…

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Agencies Add Safe Harbors to 90-day Rule for Health Plan Enrollment

Generally, waiting periods to enroll in health coverage cannot exceed 90 days, and eligibility conditions based solely on the lapse of a time period are permissible for no more than 90 days, under new final rules issued by the U.S….

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ACA Pay-or-play Mandate Loosened Again

Companies with 50-99 employees that do not offer health insurance to their workers will not be subject to fines for failing to provide coverage until 2016. This gives such mid-sized firms an additional year to prepare health coverage for workers,…

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Health Care Reform: Individual Mandate Penalties Further Refined

In proposed rules issued Jan. 27, the IRS clarifies how participants in employer-sponsored plans are to count employer contributions to HRAs and wellness program incentives when calculating their contributions to employer-sponsored coverage. In those rules, the IRS also allows temporary…

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Wellness Plans Discriminate, Union Official Says

Wellness benefits have exploded in the past decade because they purportedly make employees healthier and save employers money, but they have found a detractor in at least one labor union.  John Borsos, secretary-treasurer of the National Union of Healthcare Workers,…

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Reform Agencies Clarify Cost Sharing and Essential Services

A series of agency Q&As resolves a few questions relating to complying with federal health care reform, such as correctly counting participants’ out-of-pocket expenditures; wellness program reward administration; and the status of “carved-out” benefits. In latest set of Frequently Asked…

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