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

FAQ on HIPAA Special Enrollment; QSE HRAs Released

Posted by: Danielle Capilla    Feb 8, 2017 9:53:35 AM

Recently, the Department of Labor (DOL), Department of Health and Human Services (HHS), and the Treasury (collectively, the Departments) issued FAQs About Affordable Care Act Implementation Part 35. The FAQ covers a new HIPAA special enrollment period, an update on women's preventive services that must be covered, and clarifying information on qualifying small employer health reimbursement arrangements (QSE HRAs).

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Topics: HIPAA, group health insurance, health reimbursement arrangements, HRA, Danielle Capilla, 21st Century Cures Act, Qualified Small Employer HRA, benefits enrollment, women's preventive services

Interim Final Regulation on Maximum Civil Monetary Penalties

Posted by: Danielle Capilla    Dec 29, 2016 10:30:00 AM

The Department of Health and Human Services (HHS) recently issued interim final regulations that adjust for inflation the maximum civil monetary penalties (CMP) that fall under HHS's jurisdiction. The regulations reflect changes required by the Federal Civil Penalties Inflation Adjustment Act Improvements Act of 2015 (the Act).

Adjustments under the Act were effective on August 1, 2016, and HHS's CMP adjustment regulations were effective on September 6, 2016. HHS issued its regulations for immediate implementation, without the notice and comment procedures that normally accompany new regulations.

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Topics: compliance, ACA, HIPAA, group health insurance, Danielle Capilla, Affordable Care Act, monetary penalties

HIPAA Phase 2 Audits

Posted by: Danielle Capilla    Oct 4, 2016 10:30:00 AM

The U.S. Department of Health and Human Services’ (HHS) Office for Civil Rights (OCR) began a pilot program in 2012 to assess the procedures implemented by covered entities to ensure compliance with the Health Insurance Portability and Accountability Act (HIPAA). OCR evaluated the effectiveness of the pilot program and then announced Phase 2 of the program on March 21, 2016. Phase 2 Audits focus on the policies and procedures adopted by both covered entities and business associates to ensure they meet selected standards and implementation specifications of the Privacy, Security, and Breach Notification Rules. Covered entities include health plans, health care clearinghouses, and health care providers; whereas, business associates include anyone handling health information on behalf of a covered entity.

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Topics: HIPAA, covered entities, HIPAA audit, business associates, HIPAA privacy

HIPAA Phase 1 Audits

Posted by: Danielle Capilla    Aug 26, 2016 10:30:00 AM

The Health Insurance Portability and Accountability Act (HIPAA) established national standards to secure and protect the privacy of health information. The Health Information Technology for Economic and Clinical Health Act (HITECH) requires the Department of Health and Human Services’ (HHS) Office for Civil Rights (OCR) to conduct audits of covered entities and business associates in order to ensure compliance with the HIPAA Privacy, Security, and Breach Notification Rules.

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Topics: compliance, HIPAA, Danielle Capilla, covered entities, HIPAA audit, business associates

Shining a Light on HIPAA Compliance for Health and Welfare Plans

Posted by: Elizabeth Kay    Jun 7, 2016 5:43:27 PM

With the passage of the Affordable Care Act (ACA), the federal government became much more involved in what had always been a heavily regulated, but predominately private industry. What many people have forgotten is that the ACA was not the first legislation to be passed that involved private and employer-sponsored health and welfare plans.

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Topics: compliance, HIPAA, health plan compliance, Elizabeth Kay, PHI, health and welfare plans, protected health information, business associate agreement

A To-Do List for Sponsors of Self-Funded Group Health Plans

Posted by: Jennifer Stanley    Oct 9, 2014 2:17:00 PM

Below are some to-dos for sponsors of self-funded group health plans.  The information is limited generally to the “what” and the “when.”  For a summary of the PPACA provisions that apply to group health plans and whether the provision applies to self-funded plans, request PPACA Decision Guide for Self-funded Plans.   

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Topics: Self-Funded, HPID, HIPAA, Sponsors, BAA, TRF, 6055 Reporting, 6056 Reporting

Regulatory Agencies Propose Expansion of “Excepted Benefits”

Posted by: Linda Rowings    Jan 13, 2014 8:49:00 AM

By Linda Rowings
Chief Compliance Officer
United Benefit Advisors 

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Topics: ACA, HRAs, health care reform, EAPs, Employee Assistance Programs, HIPAA, ERISA, Internal Revenue Code, Group health plans