Benefits Update – January 2011

From the editors of CCH’s BENE and BAN products, here are hot topics from recent Employee Benefits Management Directions newsletters as well as recent explanatory updates in Employee Benefits Management. Also included are recent explanatory updates to the Benefits Answers Now product.

If you have any comments/suggestions concerning the information provided or the format used, we’d like to hear from you. Please contact me at Tulay.Turan@wolterskluwer.com.

 

Hot Topics in Employee Benefits Management:

Medical loss ratio rules will affect 64 million covered by group plans, Employee Benefits Management Directions newsletter, Issue No. 481, December 7, 2010 – An interim final regulation implementing medical loss ratio (MLR) provisions in the Patient Protection and Affordable Care Act will affect almost 75 million individuals enrolled in comprehensive major medical coverage, including 24 million individuals covered by small employers and 40 million covered through large employer group health plans.

New health reform rules allow plans to change insurance coverage and keep grandfathered status, Employee Benefits Management Directions newsletter, Issue No. 481, December 7, 2010 – A group health plan will be allowed to enter into a new policy, certificate, or contract of insurance without ceasing to be a grandfathered health plan, according to amendments to existing rules issued jointly by the IRS, EBSA and HHS. 

IRS issues additional guidance on small employer health care tax credit, Employee Benefits Management Directions newsletter, Issue No. 482, December 21, 2010 – The IRS has released Notice 2010-82, which provides additional eligibility guidance for the small business health care tax credit provided under the Patient Protection and Affordable Care Act (ACA).

New rules for mini-med plans require insurers to notify consumers of low annual coverage limits, Employee Benefits Management Directions newsletter, Issue No. 482, December 21, 2010 – Two new sets of guidance issued b the Department of Health and Human Services (HHS) require that health insurers offering “mini-med” plans notify customers in plain language that their plan offers extremely limited benefits, and restrict the sale of new mini-med plans except under very limited circumstances.

What’s New in Employee Benefits Management:

Medical loss ratio regulations – The MLR regulations are discussed at ¶10,097 and ¶10,240.

 

Mini-med plan rules – The HHS guidance on mini-med plans is at ¶10,310. The model notice is at ¶226,119.

 

Grandfathered health plans – Amendments to regulations governing grandfathered plans are discussed at ¶10,140.

 

Small employer health care tax credit Notice 2010-82 is discussed at ¶10,505.

 

GINA regulations – The EEOC has published its long awaited final regulations implementing Title II of the Genetic Information Nondiscrimination Act (GINA). The regulations can be found at ¶700,060.

 

2011 mileage rates – The IRS has issued the 2011 optional standard mileage rates used to calculate the deductible costs of operating an automobile for business, charitable, medical or moving purposes. The rates are at ¶150,535, ¶150,565, ¶150,595, and ¶154,352.

 

Fiduciary duties – The Sixth Circuit’s ruling in DeLuca v. Blue Cross Blue Shield of Michigan, which found that a plan administrator’s rate negotiations were business decisions not subject to fiduciary standards, is discussed at ¶130,015.

 

What’s New in Benefits Answers Now (BAN):

Medical loss ratio rules will affect 64 million covered by group plans. An interim final regulation implementing medical loss ratio (MLR) provisions in the Patient Protection and Affordable Care Act (ACA) will affect almost 75 million individuals enrolled in comprehensive major medical coverage, including 24 million individuals covered by small employers and 40 million covered through large employer group health plans. The interim final regulation is effective Jan. 1, 2011, for health insurance issuers offering group or individual health insurance coverage. More information about the medical loss ratio requirements can be found at ¶20,059.

New health reform rules allow plans to change insurance coverage and keep grandfathered status. A group health plan will be allowed to enter into a new policy, certificate, or contract of insurance without ceasing to be a grandfathered health plan, according to amendments to existing rules issued jointly by the Internal Revenue Service, the Department of Labor’s Employee Benefits Security Administration (EBSA), and the Department of Health and Human Services’ Office of Consumer Information and Insurance Oversight (OCIIO). To find out more about grandfathered plans, see ¶20,053.

EEOC’s final GINA regulation clarifies some of the compliance issues faced by employers. The EEOC has published its long awaited final regulations implementing Title II of the Genetic Information Nondiscrimination Act (GINA). Signed into law in May 2008, GINA prohibits discrimination by health insurers and employers based on individuals’ genetic information. Genetic information includes the results of genetic tests to determine whether someone is at increased risk of acquiring a condition in the future, as well as an individual’s family medical history. To learn more about the requirements of GINA, see the discussion at ¶22,300.

IRS releases FAQs on small business health care tax credit. The IRS has released frequently asked questions addressing the small business health care tax credit provision under the ACA. The questions and answers provide information on the credit as it applies for 2010-2013, including information on transition relief for 2010. An enhanced version of the credit will be effective beginning in 2014. See the discussion at ¶60,310 for more information about the small employer tax credit.

Employers anticipate rising costs in outsourced health benefits administration. According to a study conducted by HighRoads, employers anticipate an increase in the cost of benefits administration outsourcing, while at the same time, those employers currently managing benefits in-house are increasingly looking to outsourcing to comply with provisions in the ACA. Find out more about outsourcing benefits administration at ¶50,490.