United Benefit Advisors Insight and Analysis Blog

Danielle Capilla

Chief Compliance Officer at United Benefit Advisors

Recent Posts

DOL Asks for MHPAEA Related Comments; Clarifies Eating Disorder Benefit Requirements

Posted by: Danielle Capilla    Jun 28, 2017 9:30:00 AM

Earlier this month, the Department of Labor (DOL) provided an informational FAQ relating to the Mental Health Parity and Addiction Equity Act (MHPAEA) and the 21st Century Cures Act (Cures Act). This is the DOL's 38th FAQ on implementing the Patient Protection and Affordable Care Act (ACA) provisions and related regulations. The DOL is requesting comments on a draft model form for participants to use to request information regarding nonquantitative treatment limitations, and confirms that benefits for eating disorders must comply with the MHPAEA. Comments are due by September 13, 2017.

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Topics: ACA, Affordable Care Act, Mental Health Parity and Addiction Act, mental health, 21st Century Cures Act

What Employers Need to Know about the Senate Proposed Healthcare Bill

Posted by: Danielle Capilla    Jun 26, 2017 9:30:00 AM

On June 22, 2017, the United States Senate released a "Discussion Draft" of the "Better Care Reconciliation Act of 2017" (BCRA), which would substitute the House's House Resolution 1628, a reconciliation bill aimed at "repealing and replacing" the Patient Protection and Affordable Care Act (ACA). The House bill was titled the "American Health Care Act of 2017" (AHCA). Employers with group health plans should continue to monitor the progress in Washington, D.C., and should not stop adhering to any provisions of the ACA in the interim, or begin planning to comply with provisions in either the BCRA or the AHCA.

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Topics: ACA, health care reform, Better Care Reconciliation Act of 2017, American Health Care Act of 2017

What Qualifying Events Trigger COBRA?

Posted by: Danielle Capilla    Jun 20, 2017 11:25:55 AM

The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) requires employers to offer covered employees who lose their health benefits due to a qualifying event to continue group health benefits for a limited time at the employee’s own cost. Per regulation, qualifying events are specific events that cause or trigger an individual to lose health coverage. The type of qualifying event determines who the qualified beneficiaries are and the maximum length of time a plan must offer continuation coverage. A group health plan may provide longer periods of continuation coverage beyond the maximum 18 or 36 months required by law.

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Topics: change in status event, COBRA continuation coverage, health care coverage

What Happens to Coverage When Employees Reduce Their Hours?

Posted by: Danielle Capilla    Jun 13, 2017 9:30:00 AM

The Section 125 cafeteria plan regulations and the Patient Protection and Affordable Care Act (ACA) require employers to take certain actions when an employee reduces hours.

Consider this scenario: An employer has an employee who is reducing hours below 30 hours per week. The employee is performing the same job and duties. The employee was determined to be full-time during the most recent measurement period. The employee is currently in a stability period.

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Topics: ACA, cafeteria plan, Affordable Care Act, Section 125 plan, reduction in hours

2018 Amounts for HSAs; Retroactive Medicare Coverage Effect on Contributions

Posted by: Danielle Capilla    Jun 8, 2017 9:30:00 AM

IRS Releases 2018 Amounts for HSAs

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Topics: HDHPs, health savings accounts, UBA Health Plan Survey, HSAs, Medicare coverage

Answers to the Top 4 Questions about Section 105(h) Nondiscrimination Testing

Posted by: Danielle Capilla    Jun 6, 2017 9:30:00 AM

Under Internal Revenue Code Section 105(h), a self-insured medical reimbursement plan must pass two nondiscrimination tests. Failure to pass either test means that the favorable tax treatment for highly compensated individuals who participate in the plan will be lost. The Section 105(h) rules only affect whether reimbursement (including payments to health care providers) under a self-insured plan is taxable.

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Topics: employee benefits, nondiscrimination testing, IRS Code Section 105(h), self-insured medical plan

Qualified Small Employer Health Reimbursement Arrangements and ERISA

Posted by: Danielle Capilla    Jun 1, 2017 9:30:00 AM

Certain small employers have the option to reimburse individual health coverage premiums up to a dollar limit through Qualified Small Employer Health Reimbursement Arrangements (QSE HRAs) under the 21st Century Cures Act (Cures Act).

The Cures Act amends the Employee Retirement Income Security Act of 1974 (ERISA) to exclude QSE HRAs from the ERISA definition of group health plan; however, the Cures Act does not specifically exclude QSE HRAs from the rest of ERISA.

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Topics: health reimbursement arrangements, 21st Century Cures Act, Qualified Small Employer HRA, QSE HRA

House Passes AHCA Bill in First Step to Repeal and Replace the ACA

Posted by: Danielle Capilla    May 5, 2017 10:27:15 PM

On May 4, 2017, the U.S. House of Representatives passed House Resolution 1628, a reconciliation bill aimed at "repealing and replacing" the Patient Protection and Affordable Care Act (ACA). The bill, titled the "American Health Care Act of 2017" or "AHCA," will now be sent to the Senate for debate, where amendments can be made, prior to the Senate voting on the bill.

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Topics: ACA, Affordable Care Act, American Health Care Act

Man-in-the-Middle Attacks on ePHI, HIPAA Enforcement in the News

Posted by: Danielle Capilla    May 4, 2017 12:57:07 PM

The U.S. Department of Health and Human Services Office for Civil Rights (OCR) issued its Man-in-the Middle Attacks and "HTTPS Inspection Products" guidance. The OCR warns organizations that have implemented end-to-end connection security on their internet connections using Secure Hypertext Transport Protocol (HTTPS) about using HTTPS interception products to detect malware over an HTTPS connection because the HTTPS interception products may leave the organization vulnerable to man-in-the-middle (MITM) attacks. In an MITM attack, a third party intercepts internet communications between two parties; in some instances, the third party may modify the information or alter the communication by injecting malicious code.

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Topics: HIPAA, protected health information, internet security, ePHI

ACA Market Stabilization Final Rule

Posted by: Danielle Capilla    Apr 27, 2017 9:30:00 AM

On April 18, 2017, the Department of Health and Human Services’ (HHS) Centers for Medicare & Medicaid Services (CMS) published its final rule regarding Patient Protection and Affordable Care Act (ACA) market stabilization.

The rule amends standards relating to special enrollment periods, guaranteed availability, and the timing of the annual open enrollment period in the individual market for the 2018 plan year, standards related to network adequacy and essential community providers for qualified health plans, and the rules around actuarial value requirements.

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Topics: Affordable Care Act, benefits enrollment, guaranteed availability policy, continuous coverage, open enrollment periods