United Benefit Advisors Insight and Analysis Blog

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

Regulations Regarding Short-Term Limited-Duration Insurance, Excepted Benefits, and Lifetime/Annual Limits

Posted by: Danielle Capilla    Dec 27, 2016 10:30:00 AM

Recently, the U.S. Department of the Treasury, Department of Labor (DOL), and Department of Health and Human Services (HHS) (collectively the Departments) issued final regulations regarding the definition of short-term, limited-duration insurance, standards for travel insurance and supplemental health insurance coverage to be considered excepted benefits, and an amendment relating to the prohibition on lifetime and annual dollar limits.

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Topics: group health insurance, excepted benefits, supplemental health coverage, Danielle Capilla, travel insurance, short-term insurance

Wraparound Excepted Benefits to Launch with Two Pilot Programs

Posted by: Danielle Capilla    Apr 21, 2015 12:00:00 PM

Health plan sponsors would be permitted to offer wraparound coverage to employees purchasing individual health insurance in the private market, including the Marketplace, in limited circumstances, under a new Final Rule issued by the Department of Labor (DOL) and other federal agencies. The Final Rule, published March 18, 2015, sets forth two narrow pilot programs for the limited wraparound coverage. One pilot program allows wraparound benefits only for multi-state plans (MSPs) in the Health Insurance Marketplace. The second pilot program allows wraparound benefits for part-time workers who enroll in an individual policy or in Basic Health Plan (BHP) coverage for low-income individuals, which was established under the Patient Protection and Affordable Care Act (PPACA). The wraparound coverage would be an excepted benefit. Excepted benefits are generally exempt from certain requirements of federal laws, including ERISA, the IRS Code, and parts of PPACA.

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Topics: individual plans, excepted benefits, multi-state plans, part-time employee insurance, wraparound coverage, Health Insurance Marketplace

Agencies Provide Guidance on Single Benefit Products and Excepted Benefits

Posted by: Linda Rowings    Mar 12, 2015 12:00:00 PM

On February 13, 2015, the regulatory agencies issued an FAQ on whether supplemental health insurance coverage that provides additional categories of benefits may qualify as supplemental excepted benefits. Many provisions of PPACA do not apply to excepted health benefits. Supplemental excepted benefits are those that are provided under a separate policy, certificate, or contract of insurance and are Medicare supplement insurance (Medigap), Tricare supplemental programs, or “similar” supplemental coverage.

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Topics: ACA, health care reform, PPACA, excepted benefits, supplemental health coverage