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Final Regulations Issued on Exemption for Limited-Scope Dental/Vision Benefits and EAPs

Final regulations issued by the Departments of Treasury, Labor, and Health and Human Services modify the excepted benefit exemption for limited-scope vision and dental benefits, as well as employee assistance programs (?Ç£EAPs?Ç¥). Consistent with the proposed regulations issued in December 2013, the final regulations add an exemption for standalone limited-scope dental or vision coverage and coverage for long-term care that otherwise are not ?Ç£an integral part?Ç¥ of the employer?ÇÖs group health plan. Coverage that satisfies the exemption is not subject to some of the requirements imposed by the Health Insurance Portability and Accountability Act (HIPAA) and the Patient Protection and Affordable Care Act (PPACA). Consistent with the proposed regulations, the final regulations eliminate the additional employee contribution requirement for a self-insured limited-scope dental or vision plan to be considered an excepted benefit and provide that EAPs must satisfy four requirements to be considered excepted benefits. The final regulations are available… Continue Reading

CMS FAQ: Insurer is Required to Obtain HPID for Fully Insured Health Plan

The Centers for Medicare & Medicaid Services (?Ç£CMS?Ç¥) issued a FAQ and quick reference guide outlining the process for a health plan to obtain a health plan identifier (?Ç£HPID?Ç¥). Among its guidance, CMS explains that for fully-insured plans, the insurer is treated as offering a controlling health plan (?Ç£CHP?Ç¥) and thus must obtain the HPID. The individual employer plans are sub health plans (?Ç£SHPs?Ç¥) to the fully-insured CHPs. The SHPs may obtain HPIDs, but are not required to. The CMS FAQ can be found here. The CMS quick reference guide can be found here.

October 2014