Health Care Reform News and Events

USI provides up to date information regarding The Health Care Reform Act to keep you informed of legislative changes as they occur.

March, 2013

Proposed Guidance Issued on 90-day Waiting Period Limit

For plan years beginning on or after Jan. 1, 2014, the Affordable Care Act (ACA) prohibits group health plans and group health insurance issuers from applying any waiting period that exceeds 90 days. ACA’s 90-day waiting period limit applies to both non-grandfathered and grandfathered group health plans and health insurance coverage.

HHS Proposes Delay to Key Aspect of SHOP Exchanges

Beginning in 2014, individuals and small employers will be able to purchase health insurance through online competitive marketplaces, or Exchanges. The Affordable Care Act (ACA) directs each state that chooses to operate an Exchange to also establish a Small Business Health Options Program (SHOP). According to the Department of Health and Human Services (HHS), the SHOP will assist eligible small employers in providing health insurance for their employees. In addition, ACA directs HHS to establish and operate the federally-facilitated Exchange (FFE) in each state that does not establish its own Exchange. The FFE will include both individual market and SHOP components.

‘Pay or ‘Play’ – Transition Relief for Fiscal Year Plans

Effective Jan. 1, 2014, the Affordable Care Act (ACA) imposes a shared responsibility penalty on large employers that do not offer minimum essential coverage to substantially all full-time employees and their dependents. Large employers that offer coverage may still be liable for a penalty if the coverage is unaffordable or does not provide minimum value.

HHS Releases Final Minimum Value Guidance and Calculator

Beginning in 2014, to avoid penalties under the Affordable Care Act (ACA), large employers must provide health coverage to their full-time employees (and dependents) that is affordable and provides minimum value. An employer-sponsored plan provides minimum value under ACA if the percentage of the total allowed costs of benefits provided under the plan is no less than 60 percent.

February, 2013

The Individual Mandate
“Pay or Play” Penalty – Identifying Full-time Employees
Exchange Notice Requirements Delayed

January, 2013

Proposed Rule Issued on Health Insurance Exchanges
Proposed Rules Released on Employer Penalties
Determining Minimum Value of Health Plan Coverage

December, 2012

HHS Provides Guidance on Methods for De-Identifying PHI
Final Guidance Released on Research Fees
What is the Fiscal Cliff?

November, 2012

Proposed Rules on Workplace Wellness Programs
Washington, D.C. - Health Care Reform
Obama Wins Re-election – Health Care Reform Law Here to Stay

October, 2012

Employer Penalties – IRS Examples for Determining Full-Time Status
2013 Compliance Checklist
Eleventh Circuit Rules Wellness Program Complies with the ADA

September, 2012

Temporary High-Risk Pool Q&A - Updated
Temporary Guidance Issued on 90-day Waiting Period Limit
IRS Issues Guidance on Employer Penalties – Full-Time Status and Using W-2 Wages
HHS Adopts Final HIPAA Standard for Health Plan Identifier

August, 2012

Temporary Contraceptive Coverage Delay for Religious Employers
Supreme Court Reform - What it Means for Employers
MLR Rebates-Compliance Steps for ERISA Plan Sponsors

July, 2012

Federal Court Temporarily Blocks Contraceptive Mandate
How Employers Should Handle MLR Rebates
DOL Starts Auditing ACA Compliance

June, 2012

Supreme Court Upholds Health Care Reform
Mental Health Parity - Compliance Overview FAQs
Insurers to Retain Some Health Care Reforms
Final MLR Rule Creates New Notice Requirements for Issuers
IRS Provides Guidance on $2,500 Health FSA Limit
Individual Tax Credits to Trigger Employer Penalties

May, 2012

More FAQs Issued on Summary of Benefits and Coverage
Q & A on Medical Loss Ratio Rules
IRS Requests Comments on Determining Minimum Value and Related Reporting Requirements
HSA Limits Will Increase in 2013