Transitional Relief Provided For Expatriate Health Plans Under ACA

The Departments of Labor, Health and Human Services (HHS), and the Treasury (the Departments) have issued a frequently asked question (FAQ) regarding the extent to which expatriate group health insurance coverage is subject to the provisions of the Patient Protection and Affordable Care Act (ACA). The FAQ indicates that for expatriate health plans with plan years ending on or before Dec. 31, 2015, the Departments will consider the requirements of subtitles A and C of Title I of the ACA satisfied if the plan and issuer comply with the pre-ACA version of Title XXVII of the Public Health Service Act (PHSA).

References to subtitles A and C of Title I of the ACA also include the corresponding provisions imported into ERISA Sec. 715 and IRC Sec. 9815.

Definition of expatriate health coverage. For purposes of this temporary transitional relief, an expatriate health plan is an insured group health plan with respect to which enrollment is limited to primary insureds who reside outside of their home country for at least six months of the plan year and any covered dependents, and its associated group health insurance coverage.

This definition also is the definition of “expatriate health coverage” under 45 CFR 153.400(a)(1)(iii) during this temporary transitional period (that is, for plans with plan years ending on or before Dec. 31, 2015).

Expatriate health plans must, as a condition of this transitional relief, comply with the pre-ACA version of Title XXVII of the PHSA and other applicable law under ERISA and the IRC, including, for example, the mental health parity provisions, the HIPAA nondiscrimination provisions, the ERISA Sec. 503 requirements for claims procedures, and any reporting and disclosure obligations under ERISA Part 1.

The Departments indicated that coverage provided under an expatriate group health plan is a form of minimum essential coverage under IRC Sec. 5000A.

Comments requested. The Departments have requested comments on and information about the unique challenges that expatriate health plans may face in complying with provisions of the ACA, including information about which particular types of plans face these challenges and with respect to which particular provisions of the ACA. Comments should be sent by May 8, 2013, to e.ohpsca-expat.ebsa@dol.gov.

For more information, visit http://www.dol.gov/ebsa/faqs/faq-aca13.html.

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