Proposed Regulations on Administrative Simplification: Certification of Compliance

HHS proposes regulations designed to provide a testing process to be able to demonstrate compliance with electronic transaction requirements. Document Excerpt This proposed rule would require a controlling health plan (CHP) to submit information and documentation demonstrating that it is compliant with certain standards and operating rules adopted by the Secretary of Health and Human […]

CCIIO Technical Guidance On MLR Reporting and Rebate

Technical Guidance 2013-0004, Q & A on Medical Loss Ratio and rebate calculations in the case of non-calendar year plans. Document Excerpt  For the 2013 MLR reporting year, issuers may defer including in their MLR and rebate calculations the portion of 2013 premiums collected for 2014 ACA assessments or fees on non-calendar year policies. Link […]

FINRA Notice 13-45 on Rollovers to IRAs

FINRA provides guidance in the form of a Notice to covered financial institutions on making recommendations for rollovers to IRAs. Document Excerpt FINRA is issuing this Notice to remind firsm of their responsibilities when (1) recommending a rollover or transfer of assets in an employer-sponsored retirement plan to an Individual Retirement Account (IRA) or (2) […]

Budget Agreement Includes Premium Increase

The Budget Agreement signed into law December 26 includes an increase in PBGC premiums. Document Excerpt Link http://beta.congress.gov/113/bills/hjres59/BILLS-113hjres59enr.pdf

Proposed Regulations on Excepted Benefits

The agencies issue proposed regulations to the rules governing excepted benefits including what qualifies as excepted benefits. Document Excerpt This document contains proposed rules that would amend the regulations regarding excepted benefits under the Employee Retirement Income Security Act of 1974, the Internal Revenue Code, and the Public Health Service Act. Excepted benefits are generally […]

Options for Those with Cancelled Policies

CMS releases a letter to consumers whose health insurance policies have been cancelled describing the options including catastropic coverage. Document Excerpt If you have been notified that your individual market policy will not be renewed, you will be eligible for a hardship exemption and will be able to enroll in catastrophic coverage. If you believe […]

Expansion of “Hardship” Exemption to Canceled Policy Holders

HHS issued a letter describing the expansion of the Affordable Care Act’s “Hardship” exemption to allow certain individuals affected by the cancellation of their individual health insurance to purchase catastrophic coverage. Document Excerpt Link http://www.hhs.gov/healthcare/facts/factsheets/2013/12/letter-to-senator.pdf

Tables of Covered Compensation

Revenue Ruling 2014-3  provides updated Tables of Compensation for purposes of permitted disparity. Document Excerpt This revenue ruling provides tables of covered compensation under § 401(l)(5)(E) of the Internal Revenue Code (the “Code”) and the Income Tax Regulations thereunder, for the 2014 plan year.   Link http://www.irs.gov/pub/irs-drop/rr-14-03.pdf

Application of Minimum Participation Rates in State SHOPs

CMS releases a Frequently Asked Question regarding the application of the minimum participation rates on delayed enrollment under State SHOPs. Document Excerpt No. The exception to guaranteed availability allowing issuers to restrict enrollment for small employers that fail to meet minimum participation requirements requires that enrollment be available to such employers from Nov. 15-Dec. 15 […]

CMS FAQ on Minimum Participation Rates for Renewal in FF-SHOP

CMS issues a Frequently Asked Question and response on application of the minimum participation rates upon renewals occurring during the period November 15-December 15. Document Excerpt No. For operational and consumer consideration reasons, employers will not have to meet the FF-SHOP’s minimum participation rate for renewals occurring during Nov. 15-Dec. 15. Because under guaranteed availability […]

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