United Benefit Advisors Insight and Analysis Blog

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 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

Is Your Wellness Program Compliant with the ACA, GINA and EEOC?

Posted by: Valeria S. Tivnan, MPH, M.Ed.    May 9, 2017 9:30:00 AM

Workplace wellness programs have increased popularity through the years. According to the most recent UBA Health Plan Survey, 49 percent of firms with 200+ employees offering health benefits in 2016 offered wellness programs. Workplace wellness programs’ popularity also brought controversy and hefty discussions about what works to improve population health and which programs comply with the complex legal standards of multiple institutions that have not really “talked” to each other in the past. To “add wood to the fire,” the Equal Employment Opportunity Commission (EEOC) made public some legal actions that shook the core of the wellness industry, such as EEOC vs. Honeywell International, and EEOC vs. Orion Energy Systems.

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Topics: wellness, ACA, employee benefits, workplace wellness, GINA

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

An Employer’s Guide to Navigating the ACA’s Strong Headwinds

Posted by: Michael Weiskirch    Apr 13, 2017 9:30:00 AM

One might describe the series of events leading to the death of the American Health Care Act (Congress’s bill to repeal and replace the Affordable Care Act) as something like a ballistic missile exploding at launch. The Patient Protection and Affordable Care Act (ACA) repeal debate began nearly a decade ago with former President Barack Obama’s first day in office and reemerged as a serious topic during the 2016 presidential election. Even following the retraction of the House bill, repeal of the ACA remains a possibility as the politicians consider alternatives to the recent bill. The possibility of pending legislation has caused some clients to question the need to complete their obligation for ACA reporting on a timely basis this year. The legislative process has produced a great deal of uncertainty which is one thing employers do not like, especially during the busy year end.

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Topics: ACA, employer shared responsibility, Affordable Care Act, ACA reporting, independent employee benefits advisors

CMS Allows States to Extend Life of "Grandmothered" or Transitional Health Insurance Policies

Posted by: Danielle Capilla    Mar 21, 2017 9:30:00 AM

On February 23, 2017, the Department of Health and Human Services' Centers for Medicare & Medicaid Services (CMS) released its Insurance Standards Bulletin Series, in which it re-extended its transitional policy for non-grandfathered coverage in the small group and individual health insurance markets.

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Topics: ACA, health plan benchmarking, UBA Health Plan Survey, Danielle Capilla, Affordable Care Act, grandmothering, transitional relief, transitional health insurance policy

Tax Treatment of Fixed Indemnity Health Plans

Posted by: Danielle Capilla    Mar 9, 2017 9:30:00 AM

A fixed indemnity health plan pays a specific amount of cash for certain health-related events (for example, $40 per office visit or $100 per hospital day). The amount paid is neither related to the medical expense incurred, nor coordinated with other health coverage. Further, a fixed indemnity health plan is considered an "excepted benefit."

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Topics: ACA, HIPAA, excepted benefits, Danielle Capilla, Affordable Care Act, fixed indemnity health plan, fixed dollar indemnity plans, taxation of health benefits

The “Line 22” Question: Which Box(es) Do I Check?

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

Under the Patient Protection and Affordable Care Act (ACA), individuals are required to have health insurance while applicable large employers (ALEs) are required to offer health benefits to their full-time employees.

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Topics: ACA, employer shared responsibility, Danielle Capilla, Affordable Care Act, play or pay requirements, applicable large employers, IRS Form 1094-C

Top Five Compliance Assessment Surprises

Posted by: Bob Bentley    Feb 23, 2017 9:30:00 AM

Our Firm is making a big push to provide compliance assessments for our clients and using them as a marketing tool with prospects. Since the U.S. Department of Labor (DOL) began its Health Benefits Security Project in October 2012, there has been increased scrutiny. While none of our clients have been audited yet, we expect it is only a matter of time and we want to make sure they are prepared.

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Topics: compliance, ACA, COBRA, Affordable Care Act, Albers & Company, benefits compliance, Department of Labor audit, USERRA, life insurance, compliance assessment, Bob Bentley, benefits notices