Benefits Forward

Several states have filed an amicus brief with the Supreme Court supporting the individual mandate of the Affordable Care Act. Document Excerpt Does Congress have the power, under Article I of the Constitution, to enact the minimum-coverage provision of the Patient Protection and Affordable Care Act, 26 U.S.C. § 5000A, which requires nonexempt individuals to [...]

HHS has published a final rule implementing provisions regarding the reporting of gross covered retiree plan related prescription drug costs and retained rebates by Retiree Drug Subsidy sponsors. Document Excerpt This final rule implements and finalizes provisions regarding the reporting of gross covered retiree planrelated prescription drug costs (gross retiree costs) and retained rebates by [...]

The Departments release a completed Summary of Benefits and Coverage template. Document Excerpt Link http://www.dol.gov/ebsa/pdf/SBCtemplate.pdf

HHS releases proposd guidance on certain Exchange functions and determinations of eligibility. Document Excerpt This proposed rule would implement certain functions of the new Affordable Insurance Exchanges (‘‘Exchanges’’), consistent with title I of the Patient Protection and Affordable Care Act of 2010, as amended by the Health Care and Education Reconciliation Act of 2010, referred [...]

The Centers for Medicare & Medicaid Services has posted additional guidance on what plan sponsors who use Early Retiree Reinsurance Program (ERRP) reimbursements to reduce health benefit premiums must do to comply with prohibition on using ERRP reimbursement as general revenue. Document Excerpt  This guidance is intended to give plan sponsors some flexibility in applying [...]

The agencies have issued an amendment to the rules governing coverage of preventive services. Document Excerpt This document contains amendments to the interim final regulations implementing the rules for group health plans and health insurance coverage in the group and individual markets under provisions of the Patient Protection and Affordable Care Act regarding preventive health services. [...]

The agencies have released the text of the correcting amendment to the internal review and appeal and external review claims regulations. Document Excerpt Link http://www.gpo.gov/fdsys/pkg/FR-2011-07-26/pdf/2011-18820.pdf

HHS has issued regulations governing the establishment of Exchanges required under the Affordable Care Act. Document Excerpt This proposed rule would implement the new Affordable Insurance Exchanges     (“Exchanges”), consistent with title I of the Patient Protection and Affordable Care Act of 2010 (P.L. 111-148) as amended by the Health Care and Education Reconciliation [...]

The GAO’s internal study found that applications with a projected premium increase of 10 percent or more tended to be approved while applications with a projected premium increase of 6 percent or less tended to be denied. Applications with a premium increase between 7 and 9 percent warranted additional staff reviews Document Excerpt  CCIIO granted [...]

The Subcommittee on Health, Employment, Labor and Pensions of the House of Representatives Commitee on Education andthe Workforce held a hearing on the pressures of rising costs on employer provided health care.  Document Excerpt Link http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=112_house_hearings&docid=f:64941.pdf