Benefits Forward

Final Medical Loss Ratio Rules

administrator — Mon, 14 May 2012 14:02:46 +0000

The Centers for Medicare & Medicaid Services and HHS have published its final rule governing Medical Loss Ratio requirements.

Document Excerpt

This final rule amends the regulations implementing medical loss ratio (MLR) standards for health insurance issuers under the Public Health Service Act in order to establish notice requirements for issuers in the group and individual markets that meet or exceed the applicable MLR standard in the 2011 MLR reporting year.

Link http://www.ofr.gov/OFRUpload/OFRData/2012-11753_PI.pdf

Corrected Sample Completed SBC

administrator — Fri, 11 May 2012 21:58:03 +0000

The DOL’s website has been updated with a corrected sample completed Summary of Benefits and Coverage Template.

Document Excerpt

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

Affordable Care Act Implementation FAQs Part IX

administrator — Fri, 11 May 2012 21:53:21 +0000

The DOL has updated its website to include its most recent FAQ regarding implementation of the Affordable Care Act.

Document Excerpt

Set out below are additional Frequently Asked Questions (FAQs) regarding implementation of the summary of benefits and coverage (SBC) provisions of the Affordable Care Act. These FAQs have been prepared jointly by the Departments of Labor, Health and Human Services (HHS), and the Treasury (the Departments). Like previously issued FAQs (available at www.dol.gov/ebsa/healthreform/ and cciio.cms.gov/resources/factsheets), these FAQs answer questions from stakeholders to help people understand the new law and benefit from it, as intended.

Link http://www.dol.gov/ebsa/faqs/faq-aca9.html

FAQs on Mental Health Parity Act

administrator — Fri, 11 May 2012 14:48:58 +0000

The DOL has issued a list of Frequently Asked Questions on implementation of the Mental Health Parity Act.

Document Excerpt

The Departments of Labor, the Treasury, and Health and Human Services (HHS) (collectively, the Departments), administer MHPAEA together with the States. This document provides basic information about the Departments’ MHPAEA implementation efforts.

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

Proposed Regulations On ACA’s Comparative Effectiveness Fee

administrator — Thu, 10 May 2012 14:36:52 +0000

The IRS has issued proposed regulations regarding the Affordable Care Act’s comparative effectiveness fee.

Document Excerpt

This document contains proposed regulations that implement and provide guidance on the fees imposed by the Patient Protection and Affordable Care Act on issuers of certain health insurance policies and plan sponsors of certain self-insured health plans to fund the Patient-Centered Outcomes Research Trust Fund. These proposed regulations affect the issuers and plan sponsors that are directed to pay those fees. This document also contains a request for comments and provides notice of public hearing on these proposed regulations.

Link http://www.gpo.gov/fdsys/pkg/FR-2012-04-17/pdf/2012-9173.pdf

Update on Interest Rates

administrator — Thu, 10 May 2012 13:59:11 +0000

Notice 2012-36 provides guidance as to the corporate bond weighted average interest rate and permissible range under Section 412(b)(5)(B)(ii)(II) in effect for plan years beginning before 2008.

Document Excerpt

This notice provides guidance as to the corporate bond weighted average interest rate and the permissible range of interest rates specified under § 412(b)(5)(B)(ii)(II) of the Internal Revenue Code as in effect for plan years beginning before 2008. It also provides guidance on the corporate bond monthly yield curve (and the corresponding spot segment rates), and the 24-month average segment rates under § 430(h)(2). In addition, this notice provides guidance as to the interest rate on 30-year Treasury securities under § 417(e)(3)(A)(ii)(II) as in effect for plan years beginning before 2008, the 30-year Treasury weighted average rate under § 431(c)(6)(E)(ii)(I), and the minimum present value segment rates under § 417(e)(3)(D) as in effect for plan years beginning after 2007.

Link http://www.irs.gov/pub/irs-drop/n-12-36.pdf

Field Assistance Bulletin On Fee Disclosure

administrator — Mon, 07 May 2012 20:56:20 +0000

Field Assistance Bulletin 2012-02 provides additional guidance on the requirements to comply with the participant-level disclosure. It also serves as additional guidance under 408(b)(2).

Document Excerpt

On October 20, 2010, the Department of Labor (Department) published a final regulation⁽¹⁾ requiring plan administrators to disclose certain plan and investment-related information, including fee and expense information, to participants and beneficiaries in participant-directed individual account plans, e.g., 401(k) plans (the “participant-level disclosure regulation” codified at 29 CFR § 2550.404a-5). At the same time, the Department published conforming changes to 29 CFR § 2550.404c-1 (the “404(c) regulation”) relating to plans that allow participants to direct the investment of their individual accounts. This Bulletin supplements the participant-level disclosure regulation by providing guidance on some of the most frequently asked questions concerning the participant-level disclosure regulation and how it may be implemented. In addition, on February 3, 2012, the Department published a final regulation under section 408(b)(2) of the Employee Retirement Income Security Act of 1974 (ERISA). The 408(b)(2) regulation, in relevant part, requires certain covered service providers to furnish specified information to plan administrators so that they may comply with their disclosure obligations in the participant-level disclosure regulation. Consequently, the guidance in this Bulletin also serves as guidance concerning that specific requirement of the 408(b)(2) regulation.

Link http://www.dol.gov/ebsa/regs/fab2012-2.html

Request for Comments on Large Employer Reporting

administrator — Wed, 02 May 2012 14:46:12 +0000

Notice 2012-33 requests comments on the reporting requirements applicable to large employers under Section 6056 as added by the Affordable Care Act.

Document Excerpt

This notice invites comments on reporting under § 6056 of the Internal Revenue Code for applicable large employers (as defined in § 4980H(c)(2)) that are subject to § 4980H. Section 6056 was enacted by § 1514(a) of the Patient Protection and Affordable Care Act, Pub. L. 111-148 (enacted on March 23, 2010), which was amended by the Health Care and Education Reconciliation Act, Pub. L. 111-152 (enacted on March 30, 2010) (collectively, the Affordable Care Act).

Link http://www.irs.gov/pub/irs-drop/n-12-33.pdf

Request for Comments on Health Care Reporting

administrator — Wed, 02 May 2012 14:41:18 +0000

Notice 2012-32 requests comments on the reporting requirements for employers providing minimum essential coverage.

Document Excerpt

This notice invites comments concerning the reporting requirements under § 6055 of the Internal Revenue Code for health insurance issuers, government agencies, employers that sponsor self-insured plans, and other persons that provide minimum essential coverage to an individual.

Link http://www.irs.gov/pub/irs-drop/n-12-32.pdf

Possible Approaches to Determining Minimum Value

administrator — Wed, 02 May 2012 14:35:55 +0000

The IRS has released Notice 2012-31 which provides proposed methods that ultimate guidance may use to determine whether employer coverage constitutes minimum value under the Affordable Care Act.

Document Excerpt

This notice describes and requests comments on several possible approaches to determining whether health coverage under an eligible employer-sponsored plan, as defined in § 5000A of the Internal Revenue Code (“employer-sponsored plan”), provides minimum value within the meaning of § 36B(c)(2)(C)(ii).

Link http://www.irs.gov/pub/irs-drop/n-12-31.pdf