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UPDATED GUIDANCE ON PREVENTIVE CARE REQUIREMENTS
UPDATED GUIDANCE ON PREVENTIVE CARE REQUIREMENTS The United States Preventive Services Task Force ("USPSTF") has revised several of its recommendations concerning preventive care services that must be covered by non-grandfathered group health plans subject to PPACA's preventive care requirements. The minimum preventive care coverage requirements under these revised recommendations are described below. Hepatitis C (HCV) screening for persons at high risk for infection, and a one-time screening for hepatitis C infection in adults [...]
AGENCY ANNOUNCEMENT: WASHINGTON STATE LAW REQUIRES SELF-INSURED ERISA PLANS COVER SAME-SEX SPOUSES
On June 5, 2014, the Washington State Attorney General, Office of the Insurance Commissioner, and Human Rights Commission (the "Agencies") jointly issued an announcement clarifying that under Washington State law (which recognizes same-sex marriages and prohibits discrimination on the basis of sexual orientation), all group health plans providing coverage to opposite-sex spouses must extend that coverage to same-sex spouses as well. The Agencies' clarification was the result of its investigation of O'Reilly [...]
UPDATE ON HIPAA ELECTRONIC TRANSACTIONS
HPIDs Generally Required by November 5, 2014 A health plan identifier ("HPID") is a numeric code that will be used to identify a health planFor purposes of the HIPAA electronic transaction rules, "health plan" is broadly defined and includes insurers as well as employer-sponsored group health plans. See 45 CFR § 160.103. in HIPAA electronic transactions. Per final HHS regulations,The final regulations are available at: <a href=" href=" mce_href=">http://www.gpo.gov/fdsys/pkg/FR-2012-09-05/pdf/2012-21238.pdf. health [...]
GUIDANCE FOR RETIREMENT PLANS ON RETROACTIVITY OF WINDSOR
In April 2014, the IRS issued new guidance (Notice 2014-19 and website FAQs) on applicability of the Windsor decision to retirement plans.Notice 2014-19 is available at http://www.irs.gov/pub/irs-drop/n-14-19.pdf and the FAQs are available at http://www.irs.gov/Retirement-Plans/Answers-to-Frequently-Asked-Questions-Regarding-the-Application-of-the-Windsor-Decision-and-Post-Windsor-Published-Guidance-to-Qualified-Retirement-Plans. In short, the guidance provides that plans must operationally comply with Windsor effective June 26, 2013, and plan sponsors have at least until December 31, 2014 to adopt any required plan amendments. Background The Defense of Marriage Act (DOMA) was signed into law in [...]
HEALTH CARE REFORM: SUMMARY OF FINAL “PLAY OR PAY” REGULATIONS APRIL 2014
In February 2014, the Treasury Department issued final regulations under Internal Revenue Code ("Code") Section 4980H, more commonly known as PPACA's "Play or Pay" or "Employer Shared Responsibility" rules. This bulletin provides a summary of the final regulations and the Play or Pay rules generally. 1. What is the Effective Date of the Play or Pay Rules? The Play or Pay rules were originally scheduled to go into effect on January 1, 2014. [...]
HEALTH CARE REFORM: NEW 90-DAY WAITING PERIOD REGULATIONS ISSUED
In February 2014, the DOL, IRS and HHS issued final regulationsFor the 2014-15 plan year, plans can rely on either the final waiting period regulations or the proposed regulations that were issued in 2013. This Bulletin focuses only on the final regulations, as they are generally more favorable to plans. The final regulations are available at: http://www.dol.gov/opa/media/press/ebsa/20140220-redfeg1.pdf. on the Affordable Care Act's 90-day waiting period rule, as well as proposed regulations [...]
2013 YEAR END UPDATE: EMPLOYEE BENEFIT PLAN CONTRACTS
For general contracting tips, see our older article. The final HIPAA/HITECH regulations required new business associate contracts by, at the latest, September 23, 2014. Read more here. We’ve seen business associates request changes in the new contracts that go beyond updates required by the final regulations, for example: Adding that they may de-identify protected health information (PHI) This is permitted by the final HIPAA/HITECH regulations. See 45 CFR § 164.514. – respond by [...]
2013 YEAR END UPDATE: LEGAL DEVELOPMENTS IMPACTING RETIREMENT PLANS
The DOL's two significant retirement plan fee and investment disclosure regulations issued in 2010 became applicable in 2012. First, most retirement plans should have received fee disclosures from covered service providers before July 1, 2012. 29 CFR § 2550.408b-2(c). After that, covered service providers must deliver fee disclosures before contracting with a plan (or updating an existing contract with the plan). Second, administrators of participant-directed individual account plans should have first delivered disclosures [...]
2013 YEAR END UPDATE: LEGAL DEVELOPMENTS IMPACTING HEALTH PLANS (OTHER THAN HEALTH CARE REFORM (“PPACA”))
In June 2013 the Supreme Court issued a decision invalidating a section of DOMA, the law which limited federal recognition of marriages to opposite-sex couples. U.S. v. Windsor, 133 S. Ct. 2675 (2013). And so, applicable state law now determines the marital status of same-sex couples for federal purposes. Several federal agencies, including the IRS for purposes of the Tax CodeSee Rev. Rul. 2013-17. and the DOL for purposes of ERISA, DOL Technical [...]
2013 YEAR END UPDATE: HEALTH CARE REFORM (“PPACA”) LEGAL DEVELOPMENTS
In 2012 the USPTF updated its recommendation describing the preventive health services plans must provide for obesity under the "preventive care" requirements of PPACA. Non-grandfathered plans must provide preventive care without cost-sharing. Significantly, preventive care for obesity does not include weight-loss or weight-management medications or weight-loss surgeries.http://www.uspreventiveservicestaskforce.org/uspstf11/obeseadult/obesers.htm. The updated recommendation is effective for plan years beginning on or after June 30, 2013. PPACA's preventive care requirements also mandate that plans provide contraceptives without cost-sharing. The [...]