Benefits Forward

Guidance Making Obsolete Rev. Rul. 2003-102

administrator — Fri, 03 Sep 2010 19:12:19 +0000

As a result of the enactment of the Affordable Care Act, guidance is now issued making Rev. Rul. 2003-102 obsolete.

Document Excerpt

Revenue ruling obsoleted. This ruling obsoletes Rev. Rul. 2003-102, 2003-2 C.B. 559, which provides guidance on employer reimbursements of amounts paid by an employee to purchase nonprescription medicines or drugs.

Link http://www.irs.gov/pub/irs-drop/rr-10-23.pdf

Guidance On Reimbursement of Over-the-Counter Drugs under FSAs

administrator — Fri, 03 Sep 2010 19:07:07 +0000

Notice 2010-59 provides guidance on new section 106(f) of the Internal Revenue Code, added by section 9003 of the Affordable Care Act. That section sets forth a new standard, effective Jan. 1, 2011, for reimbursement of expenses for over-the-counter drugs from all workplace health plans, including flexible spending arrangements (FSA), health reimbursement arrangements (HRA), Health Savings Accounts (HSA) and Archer Medical Savings Accounts (Archer MSA).

Document Excerpt

This Notice provides guidance on § 9003 of the Patient Protection and Affordable Care Act (Affordable Care Act), Pub. L. No. 111-148, enacted March 23, 2010, which revises the definition of medical expenses as it relates to over-the-counter drugs. Section 9003 generally applies after December 31, 2010.

Link http://www.irs.gov/pub/irs-drop/n-10-59.pdf

Updated FAQs on COBRA Premium Reduction

administrator — Tue, 31 Aug 2010 14:11:56 +0000

The DOL has updated its COBRA page to include an update to its FAQs on the COBRA premium reduction.

Document Excerpt

FAQs on the COBRA Premium Reduction Extension Provisions Related To The Continuing Extension Act Of 2010.

Link http://www.dol.gov/ebsa/faqs/faq-cobra-premiumreductionEE.html

Fact Sheet on Maintaining COBRA After the Premium Reduction Ends

administrator — Tue, 31 Aug 2010 14:07:02 +0000

The DOL has released a Fact Sheet on maintaining COBRA coverage after the premium reduction ends.

Document Excerpt

The American Recovery and Reinvestment Act (ARRA) provided a COBRA premium reduction for eligible individuals who were involuntarily terminated from employment through May 31, 2010. Individuals who qualified on or before May 31, 2010 may continue to pay reduced premiums for up to 15 months, as long as they are not eligible for another group health plan or Medicare. Those individuals who qualified for the premium reduction were only required to pay 35 percent of the COBRA premium otherwise due to the plan. If your COBRA continuation coverage lasts for more than 15 months, you will need to pay the full amount to continue your COBRA continuation coverage.

Link http://www.dol.gov/ebsa/newsroom/fsExpiringSubsidy.html

Proposed Rule on Prohibited Transaction Exemption Procedures

administrator — Tue, 31 Aug 2010 13:58:45 +0000

The DOL has issued a proposed rule amending and restating its rules on obtaining prohibited transaction exemption relief.

Document Excerpt

This document contains a proposed rule that, if adopted, would supersede the existing procedure governing the filing and processing of applications for administrative exemptions from the prohibited transaction provisions of the Employee Retirement Income Security Act of 1974 (ERISA), the Internal Revenue Code of 1986 (the Code), and the Federal Employees’ Retirement System Act of 1986 (FERSA). The Secretary of Labor is authorized to grant exemptions from the prohibited transaction provisions of ERISA, the Code, and FERSA and to establish an exemption procedure to provide for such relief. The proposed rule would clarify and consolidate the Department of Labor’s exemption procedures and provide the public with a more comprehensive description of the prohibited transaction exemption process.

Link http://edocket.access.gpo.gov/2010/pdf/2010-21073.pdf

Model Notice of Final External Review Decision

administrator — Wed, 25 Aug 2010 14:47:12 +0000

The agencies issue a Model Notice which may be used to advise as to the external review decision regarding a claim under the Affordable Care Act.

Document Excerpt

This document serves as notice of a final external review decision. We have [upheld/overturned/modified] the denial of your request for the provision of, or payment for, a health care service or course of treatment.

Link iabdmodelnotice3

Model Notice of Adverse Benefit Determination

administrator — Wed, 25 Aug 2010 14:42:26 +0000

The agencies release a Model Notice that can be used to advise of the denial of benefits under the Affordable Care Act.

Document Excerpt

This document serves as notice of an adverse benefit determination. We have declined to provide benefits, in whole or in part, for the requested treatment or service described below. If you think this determination was made in error, you have the right to appeal (see the back of this page for information about your appeal rights).

Link iabdmodelnotice2

Model Notice of Final Adverse Benefit Determination

administrator — Wed, 25 Aug 2010 14:36:55 +0000

The agencies have issued a Model Notice which may be used by plans when denying a claim after internal review under the claims and review requirements of the Affordable Care Act.

Document Excerpt

This document serves as notice of a final internal adverse benefit determination. We have declined to provide benefits, in whole or in part, for the requested treatment or service described below. If you think this determination was made in error, you may have the right to appeal (see the back of this page for information about your appeal rights).

Link iabdmodelnotice1

VCP Submission Kit For Pre-approved Plans Missing EGTRRA Deadline

administrator — Wed, 25 Aug 2010 14:03:48 +0000

The IRS has issued a Voluntary Correction Program submission kit for those plans that missed the April 30, 2010 deadline for amending to comply with EGTRRA.

Document Excerpt

This kit is designed for plan sponsors who failed to restate their retirement plan documents for EGTRRA by the April 30, 2010 deadline. Retirement plan sponsors who use pre-approved plan documents (i.e., documents that are pre-approved by the IRS and sold to plan sponsors through law firms, banks, brokers, other financial institutions, or plan administrative firms) were generally required to sign new plan documents, amended to reflect the Economic Growth and Tax Relief Reconciliation Act of 2001 (commonly referred to as “EGTRRA”), by April 30, 2010. For some plan sponsors, this deadline may have been extended.*

Link http://www.irs.gov/pub/irs-tege/0430_nonamender_submission_kit.pdf

Interim Guidance on External Review for Self-Insured Non-Grandfathered Plans

administrator — Tue, 24 Aug 2010 14:10:23 +0000

Technical Release 2010-01 provides interim guidance on the Federal external review process for self-insured non-grandfathered plans not subject to State external review procedure.

Document Excerpt

The preamble to the interim final regulations provided that the Departments would issue additional guidance on the Federal external review process. This technical release provides guidance on the interim Federal external review process for self-insured group health plans.

Link http://www.dol.gov/ebsa/pdf/ACATechnicalRelease2010-01.pdf