HR & Compliance

  • Proposed Regulations Issued on Summary of Benefits and Coverage by

    Posted on: January 12, 2015Categories: HR & Compliance

    On Dec. 22, 2014, the U.S. Departments of Health and Human Services, Labor and the Treasury (Departments) released proposed regulations regarding the summary of benefits and coverage (SBC) and uniform glossary. The proposed regulations would amend the final SBC regulations from Feb. 14, 2012 (2012 regulations), and would revise the SBC template, instructions guides and uniform glossary. According to the Departments, the proposed changes are designed to improve consumers’ access to important h ...

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  • FAQS on Affordable Care Act Implementation (Part II) by

    Posted on: January 8, 2015Categories: HR & Compliance

    Claims, Internal Appeals, and External Review Q7: My plan already provided an external review process before the Affordable Care Act was enacted. Can my already-existing external review process be deemed to comply with Public Health Service Act (PHS Act) section 2719(b)? If your plan existed prior to enactment of the Affordable Care Act, you should first check to see if your plan is a grandfathered health plan. If it is, the new external review provisions of PHS Act section 2719(b) do not appl ...

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  • FAQS on Affordable Care Act Implementation (Part I) by

    Posted on: January 6, 2015Categories: HR & Compliance

    The initial FAQs cover issues related to general compliance, grandfathered plans, appeals process requirements, dependent coverage of adult children, out-of-network emergency services and discrimination in favor of highly-compensated employees. Compliance Q1: Under the Affordable Care Act, there are various provisions that apply to group health plans and health insurance issuers and various protections and benefits for consumers that are beginning to take effect or that will become effective v ...

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