Reform Update


Issue 99 – New Proposed Regulations on Summary of Benefits and Coverage (SBC)
Issue 100 – New FAQs on Excepted Benefits and Premium Payment Plans
Issue 101 –  IRS Guidance on Cadillac Tax
Issue 102 – Final Notice of Benefits and Payment Parameters
Issue 103 – Delay in New SBC Template
Issue 104 – FAQs on Preventive Care Services
Issue 105 – FAQs on Out-of-Pocket Limits and Provider Nondiscrimination Rules
Issue 106 – Supreme Court Rules on Subsidies in Federally-Facilitated Exchanges
Issue 107 – External Review
Issue 108 – Increased Penalties for Failing to File a Form 1095C
Issue 109 – Updates on Reporting Requirements

2014Issue 79 – Excepted Benefits
Issue 80 – Reinsurance Updates and Marketplace Operations
Issue 81 – FAQs on a Variety of Issues
Issue 82 – More Details Regarding Individual Mandate
Issue 83 – Final “Play or Pay” Rules
Issue 84 – Final Reporting Requirement Regulations
Issue 85 – New Hire Waiting Periods
Issue 86 – Guidance on a Variety of Issues
Issue 87 – More FAQs
Issue 88 – Final Reinsurance Fee Rules
Issue 89 – Final Orientation Period Rules
Issue 90 – Supreme Court Ruling on Contraceptive Mandate
Issue 91 – Updated Affordability Percentage
Issue 92 – Changes in Look-Back Measurement Metrics
Issue 93 – Two New Permitted Mid-Year Changes under Section 125
Issue 94 – Annually Indexed PCORI Fee
Issue 95 – Final Regulations on “Excepted” Benefits
Issue 96 – Contraceptive Accommodations
Issue 97 – Minimum Value Plans Guidance
Issue 98 – More Details on the Employer Reporting Requirements
2013Issue 53 – Essential Health Benefit (EHBs) Updates, Actuarial Determinations
Issue 54 – Wellness Incentive Increase in 2014
Issue 55 – Rating Rule Changes for 2014
Issue 56 – Premium Stabilization Programs, Premium Assistance & Cost-Sharing Reductions, User Fees for Exchanges
Issue 57 – “Play or Pay” Details of Health Reform
Issue 58 – Final Regulations on Comparative Effectiveness Research Fees
Issue 59 – Frequently Asked Questions
Issue 60 – New Proposed Accommodations for Religious-Affiliated Organizations
Issue 61 – Individual Shared Responsibility Provision
Issue 62 – FAQs on Cost-Sharing Limitations and Preventive Care Services
Issue 63 – Changes to the SHOP Exchange; Whistleblower Protections
Issue 64 – New Hire Waiting Period Limit; Amendments to HIPAA
Issue 65 – FAQs on Summaries of Benefits and Coverage (SBCs), Various Issues
Issue 66 – Minimum Value Determination, Affordability Test, Individual Premium Tax Credits
Issue 67 – Exchange Notices
Issue 68 – Final Regulations on Non-Discriminatory Wellness Programs
Issue 69 – Delay of Employer Reporting Requirements & Employer Coverage Mandate
Issue 70 – IRS Notices Pertaining to Individual Mandate
Issue 71 – Religious Organizations and Coverage for Contraceptive Services
Issue 72 – Employer Reporting Requirements
Issue 73 – Account-Based Plans and Health Reform
Issue 74 – Individual Mandate Hardship Exemptions
Issue 75 – Clarifications for Non-Calendar Year 125 Plans
Issue 76 – Health Plan Terminations
Issue 77 – SHOP Delay
Issue 78 – Marketplace Operations and Qualified Health Plans
2012Issue 36 – More on Medical Loss Ratios
Issue 37 – Essential Benefits
Issue 38 – More Guidance
Issue 39 – Final Guidance on Summary of Benefits and Coverage
Issue 40 – Additional Guidance on Well Women Services Coverage
Issue 41 – Delayed Auto Enrollment, FAQs on Waiting Period and Play or Pay
Issue 42 – Actuarial Value Bulletin, FAQs on SBCs, and More on Coverage for Contraceptives
Issue 43 – Final Regulations on Exchanges
Issue 44 – Comparative Effectiveness Research Fees
Issue 45 – Calculating Minimum Value for Employer Health Plans, Reporting Requirements for Employer-Sponsored Health Plans, FAQs on SBCs
Issue 46 – Medical Flexible Spending Accounts (FSAs)
Issue 47 – Health Insurance Premium Tax Credit
Issue 48 – The Supreme Court Decision
Issue 49 – Increased Medicare Tax on High Wage Earners
Issue 50 – Enforcement Safe Harbor for Contraceptive Services Coverage for Religious-Affiliated Organizations
Issue 51 – The 30 Hour Full Time Measurement and the 90 Day Waiting Period
Issue 52 – Risk Adjustment Programs Associated with Health Reform
2011Issue 22 – Delay Non-Discrimination Rules, Prescribed OTC and Debit Cards, Waiver on Annual Restricted Limits, and FAQs #5
Issue 23 – Medical Loss Ratio Requirements
Issue 24 – State Tax Implications for Adult Children
Issue 25 – Additional Grace Period on Certain Internal Claim Appeal Requirements
Issue 26 – W-2 Reporting Guidance
Issue 27 – Elimination of Free Choice Vouchers
Issue 28 – Updates on Annual Maximum Waiver Process
Issue 29 – Amendments to Internal Claim Review and Appeals Process and External Review Process
Issue 30 – Expansion of Covered Preventive Care Services
Issue 31 – Summary of Benefits Requirement
Issue 32 – Calculation of Affordability and Premium Credits in Exchange
Issue 33 – Standalone HRAs and Lifetime Limits/Annual Restricted Limits
Issue 34 – Implementation of CLASS Act Halted
Issue 35 – ERRP Ends and New MEWA Enforcement Authority
2010Issue 1 – Overview of Patient Protection and Affordable Care act (PPACA)
Issue 2 – Health Care and Education Reconciliation Act of 2010 (HCERA) and Key Provisions and Overview of Changes to PPACA
Issue 3 – National High Risk Pool, Temporary Early Retiree Reinsurance Program, Small Busines Tax Credit, Change Tax-Favored Status of OTC Drugs and Non-Grandfathered Key Group Health Plan Mandates
Issue 4 – Grandfathering Discussion and Additional Group Health Plan Mandates, W-2 Reporting, Section 105(h) Non-Discrimination Rules on Self-Funded Plans and Increase to Excise Tax on Non-Medical HSA Distributions
Issue 5 – IRS Notice 2010-38 – Taxation of Coverage Provided to Age 26 Dependents; Section 125 Amendments – Pre-Tax Premium Deductions and Allowance of Expense Under Medical FSA for Adult Non-Dependent Children
Issue 6 – Employer Responsibilities for 2014 – “Pay or Play” Provisions and Additional Employer Administrative Requirements
Issue 7 – Early Retiree Reinsurance Program
Issue 8 – Extension of Coverage to Children Age 26
Issue 9 – Clinical Trials, Federal Rate Reviews and Minimum Loss Ratios, SIMPLE Cafeteria Plans, Web-based Information Portals, Health Plan Summary Communication Requirements and Important HSA Clarification
Issue 10 – Grandfathering Rules
Issue 11 – Pre-Exisiting Condition Limitations, No Annual Lifetime Limits, Restrictions on Annual Dollar Limits, Coverage Rescissions and Patient Protections
Issue 12 – Preventive Care Services
Issue 13 – Internal and External Claim Appeals
Issue 14 – Changes to Medicare Part D, Auto-Enrollment Rules for Large Employers, Government Studies on Large Group Market, National Voluntary Long-Term Care Program and Accommodations for Breast-Feeding Mothers
Issue 15 – More Guidance on Claim Reviews
Issue 16 – More Guidance on OTC Medication Exclusions
Issue 17 – Review of FSA Limits, RDS Tax Status, Quality Reporting, Comparative Effectiveness Tax, Comp Limits, and Medicare Tax Increase
Issue 18 – Q & A #1
Issue 19 – Q & A’s, Delay W-2, Notice of Exchange, Additional Plan Requirements, Requirement to Document Coverage, Cadillac Tax
Issue 20 – Department of Health and Human Services Insurance Standards Bulletin
Issue 21 – Amended Final Grandfathering Regulations

Our technical bulletins are written and produced by MMA Michigan staff and are intended to inform our clients and friends on general information relating to employee benefit plans. They are based on general information at the time they are prepared. They are not intended to provide either legal or tax advice. Before implementing any welfare or pension benefit program, employers are urged to consult with their benefits advisor and/or legal counsel for advice that is appropriate to their specific circumstances. This information cannot be used by any taxpayer to avoid tax penalties.

The fact that they only manage group benefits, that makes a difference.

— Indian Trails