Final Rule on Eligibility and Exemption from Exchanges and Minimum Essential Coverage

The final rule provides standards that Exchanges will use to determine eligibility for, and grant certificates of exemption from, the individual responsibility payment as well as procedures plan sponsors should use to have a plan identified as minimum essential coverage. Document Excerpt This final rule sets forth standards and processes under which the Exchange will […]

Transition Relief for Employees Eligible Under Non-Calendar Year Plans

Notice 2013-42 provides transition relief from the shared responsibility payment penalty for certain employees and related parties who are eligible to enroll in certain non-calendar year plans. Document Excerpt  This notice provides relief from the § 5000A shared responsibility payment for specified individuals who are eligible to enroll in certain eligible employer-sponsored health plans with […]

Guidance on Minimum Essential Coverage under Medicaid and Medicare

Notice 2013-41 provides guidance on when, for purposes of ACA’s premium tax credit, an individual is eligible for minimum essential coverage under Medicaid, Medicare or TRICARE or under student health plan. Document Excerpt Link

Proposed Amendments to Class Exemptions to Remove Credit Ratings

Post Dodd-Frank, agencies are told not to rely upon credit ratings. The DOL has proposed amendments to various Class Exemptions to remove reliance on credit ratings for financial strength. Document Excerpt This document contains a notice of pendency before the Department of Labor (the Department) of Proposed Amendments to Prohibited Transaction Exemption (PTE) 75-1 (40 […]

Missing Participant Program

The PBGC is soliciting comments on the establishment of a missing participant program for defined contribution plans. Document Excerpt PBGC is soliciting information from the public to assist it in making decisions about implementing a new program to deal with benefits of missing participants in terminating individual account plans. PBGC is interested in stakeholders’ views […]

July Lump Sum Rates

The PBGC releases the interest rate applicable for July lump sum payments. Document Excerpt The immediate interest rate for valuing lump sum payments for the month of July 2013 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 June 2013 was 0.75% for lump […]

Fact Sheet on Exchange Integrity Rules

Along with releasing the financial integrity and oversight proposed rules governing Exchanges, HHS also releases a Fact Sheet. Document Excerpt On June 14, 2013, HHS released a Notice of Proposed Rulemaking – Opens in a new window (NPRM) that proposes a number of policies related to the implementation of the Affordable Care Act, including provisions […]

Proposed Rule on Exchange Integrity

HHS released proposed rules governing ACA Exchange integrity. Document Excerpt This proposed rule sets forth financial integrity and oversight standards with respect to Affordable Insurance Exchanges; Qualified Health Plan (QHP) issuers in Federallyfacilitated Exchanges (FFEs); and States with regard to the operation of risk adjustment and reinsurance programs. It also proposes additional standards with respect […]

IRS Chief Counsel Memorandum on Deductibility of PCOR Fees

Chief Counsel Memorandum concludes that PCOR fees (Patient-Centered Outcomes Research Trust fees) are deductible by the issurer as ordinary and necessary business expenses under Section 162. Document Excerpt This memo addresses whether fees paid by issuers of certain health insurance policies and plan sponsors of certain self-insured health plans to fund the Patient-Centered Outcomes Research Trust […]

Technical Corrections to HIPAA

HHS releases technical corrections to the HIPAA privacy, enforcement and security rules. Document Excerpt As explained below, with one exception, the errors and omissions are related to the modifications made in the final rule published on January 25, 2013. This final rule contains technical corrections to the HIPAA Rules to revise these errors and omissions, […]

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