Application of Market Reforms to HRAs, FSAs, and Certain Other Arrangements

The IRS, as well as the DOL and HHS, have issued guidance on the application of certain market reforms to HRAs, Health FSAs and other employer healthcare arrangements.

Document Excerpt

The market reforms specifically addressed in this notice are:to the extent that such limits are otherwise permitted under applicable law (the annual dollar limit prohibition); andLink

(a) PHS Act § 2711 which provides that a group health plan (or a health insurance issuer offering group health insurance coverage) may not establish any annual limit on the dollar amount of benefits for any individual—this rule does not prevent a group health plan, or a health insurance issuer offering group health insurance coverage, from placing an annual limit, with respect to any individual, on specific covered benefits that are not essential health benefits 

(b) PHS Act § 2713 which requires non-grandfathered group health plans (or health insurance issuers offering group health insurance plans) to provide certain preventive services without imposing any cost-sharing requirements for these services (the preventive services requirements).


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