Additional Guidance on Essential Health Benefits

The Departments of Health & Human Services and the Centers for Medicare & Medicaid Services issue additional guidance on essential health benefits under the Affordable Care Act. Document Excerpt  On December 16, 2011, the Department of Health and Human Services (HHS) released a Bulletini describing the approach it intends to take in future rulemaking to define […]

Additional Guidance on Waivers from Annual Limits

The HHS Center for Consumer Information and Insurance Oversight has released additional Qs and As on waivers from the annual limits under the Afordable Care Act. Document Excerpt Q:  A health insurance issuer has received from HHS a waiver of the annual dollar limit requirements pursuant to section 2711 of the PHS Act for a group […]

March Lum Sums

The PBGC releases the interest rates for valuing lump sums payable in March. Document Excerpt The immediate interest rate for valuing lump sum payments for the month of March 2012 is 1.25%. The deferred interest rate I1 is 4.00%, I2 is 4.00%, and I3 is 4.00%. (The immediate interest rate for February 2012 was 1.25% […]

Final Rule Exempting Certain Religious Employers from Provision of Reproductive Preventive Services

The agencies have finalized their interim regulations exempting certain religious employers from the obligation to provide certain reproductive preventive services by their group health plans under the Affordable Care Act. Document Excerpt These regulations finalize, without change, interim final regulations authorizing the exemption of group health plans and group health insurance coverage sponsored by certain religious […]

Uniform Glossary

The agencies release a Uniform Glossary of Coverage and Medical terms. Document Excerpt This glossary has many commonly used terms, but it isn’t a full list. These are not contract terms. Those can be found in your insurance policy or certificate. You can get a copy of the policy at [] or you may […]

Technical Release 12-01

The agencies release a FAQ dealing with automatic enrollment, shared responsibility and waiting periods. Document Excerpt This Technical Release, which is being issued in substantially identical form by the other two Departments, provides information on questions from employers and other stakeholders regarding the provisions of the Affordable Care Act governing automatic enrollment, employer shared responsibility, […]

Sample Completed SBC

The agencies release a Sample Completed SBC. Document Excerpt Link

Summary of Coverage Templates

The agencies release a template for the Summary of Coverage. Document Excerpt Link

Compliance Guide for Summary of Benefits and Coverage

The agencies issue a compliance guide Document Excerpt SUMMARY: The Departments of Health and Human Services, Labor, and the Treasury are simultaneously publishing in the Federal Register this guidance document and final regulations under the Patient Protection and Affordable Care Act to implement the disclosure for group health plans and health insurance issuers of the […]

Summary of Benefits and Coverage

The agencies released a final rule governing the requirements of the Summary of Benefits and Coverage. Document Excerpt Paragraph (a) of the final regulations implements the general disclosure requirement and sets forth the standards for who provides an SBC, to whom, and when. The regulations outline three different scenarios under which an SBC will be […]

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