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The U.S. Chamber of Commerce (the “Chamber”) is submitting these comments in response to the Interim Final Rules for Group Health Plans and Health Insurance Coverage Relating to Status as a Grandfathered Health Plan under the Patient Protection and Affordable Care Act (“IFRs” or “regulations”), which were published in the Federal Register on June 17, 2010.

The IFRs provide guidance pursuant to the statutory language of the Patient Protection and Affordable Care Act (the “Affordable Care Act”) and the Health Care and Education Reconciliation Act (the “Reconciliation Act”). As with other guidance under these Acts, the IFRs were published jointly by the Department of the Treasury, the Department of Labor and the Department of Health and Human Services (the “Departments”)

Link

ttp://library.uschamber.com/sites/default/files/comments/100816grandfatherdhealthcomments.pdf

• Service provider disclosure on Form 5500 Schedule C is now required for both direct and indirect compensation.  This became effective with the 5500s for the 2009 plan years.
• Fee disclosure by service providers to responsible plan fiduciaries to show reasonableness of contract (required by service-provider exemption of ERISA § 408(b)(2)) as specified in interim final DOL regulations published in July of this year will become effective July 16, 2011.
• Fee disclosure by fiduciaries to participants for participant-directed 401(k) plans regarding investment options with a comparative chart of investment options and with the administrative expenses of each option would be required under proposed DOL regulations issued in July of 2008.  However, these regulations have to date not been finalized.
• Regulations regarding investment advice arrangements that are permitted by the Pension Protection Act where there is level-fee or computer model arrangements were issued in final form in January 2009, but was deferred several times and then withdrawn, and will apparently be the subject of new proposed regulations to be issued.

For further details see memo at
http://www.ebeclaw.com/ebeclaw/memos/EBEC_Law_Update_-_Fee_Disclosure_and_Investment_Advice_Guidance.pdf

Charlie Shulman
cshulman@ebeclaw.com

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The NAIC amended this model during the 2010 Spring National Meeting.

Link http://www.dol.gov/ebsa/pdf/externalreviewmodelact.pdf

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This document contains interim final regulations implementing the requirements regarding internal claims and appeals and external review processes for group health plans and health insurance coverage in the group and individual markets under the Patient Protection and Affordable Care Act. The regulations will generally affect health insurance issuers; group health plans; and participants, beneficiaries, and enrollees in health insurance coverage and in group health plans. The regulations provide plans and issuers with guidance necessary to comply with the law.

Link http://www.dol.gov/federalregister/HtmlDisplay.aspx?DocId=24056&AgencyId=8&DocumentType=2

Document Excerpt : The Department of Health and Human Services (HHS or ‘‘the Department ’’ ) is issuing this notice of proposed rulemaking to modify the Standards for Privacy of Individually Identifiable Health Information (Privacy Rule), the Security Standards for the Protection of Electronic Protected Health Information (Security Rule), and the rules pertaining to Compliance and Investigations, Imposition of Civil Money Penalties, and Procedures for Hearings (Enforcement Rule) issued under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The purpose of these modifications is to implement recent statutory amendments under the Health Information Technology for Economic and Clinical Health Act (‘‘the HITECH Act ’’ or ‘‘the Act’’), to strengthen the privacy and security protection of health information, and to improve the workability and effectiveness of these HIPAA Rules.

LInk http://edocket.access.gpo.gov/2010/pdf/2010-16718.pdf

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Link http://edocket.access.gpo.gov/2010/pdf/2010-14488.pdf

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Rising health costs will put tremendous pressure on the federal budget during the next few decades and beyond. In CBO’s judgment, the health legislation enacted earlier this year does not substantially diminish that pressure.

Link http://www.reginfo.gov/public/do/PRAViewDocument?ref_nbr=201005-0938-012

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As part of the Patient Protection and Affordable Care Act, P.L. 111-148, Congress enacted a provision that requires certain individuals to have a minimum level of health insurance. Covered individuals who fail to maintain sufficient coverage will be subject to a financial penalty beginning in 2014. Although the federal government provides health coverage for many individuals through federal programs such as Medicare, it had never before required individuals to purchase health insurance. There are various constitutional considerations relevant to the enactment of this provision. This report provides an analysis of constitutional issues raised by compelling individuals to purchase health insurance.

Link http://www.ncsl.org/documents/health/Constitutionality.pdf