COMPLIANCE ACA: May 2014 Updates
COMPLIANCE: May 2 2014 update of FAQs Related to ACA Implementation
The Treasury and the Departments of Labor (DOL) and Health and Human Services (HHS) (collectively referred to as the “Departments”) recently released frequently asked questions (FAQs) to help people understand and implement various provisions of the Affordable Care Act (ACA). These FAQs focus on:
• Updated model notices from the DOL (see details below) including new COBRA notices
• Cost-sharing limitations proposed (raised to $6,350 per individual and $13,200 per family in 2015)
• Coverage of preventive services (specified more services and indicates does not apply to grandfathered plans)
• Health FSA carryover and excepted benefits (see details below, but “use or lose” rule modification good news)
• Summary of benefits and coverage (safe harbor provisions; templates)
Updated Model Notices
The DOL has model notices that group health plans may use to comply with COBRA regulations requiring the provision of a General Notice and an Election Notice as well as a Premium Assistance Notice required under the Children’s Health Insurance Program Reauthorization Act (CHIPRA). While the COBRA Election Notice was updated in 2013, it has been revised with a better description of special enrollment rights since the Marketplace is now open. Similar updates have been made to the CHIPRA notice.
Click the linked documents below to obtain model notices:
• COBRA General Notice
• COBRA Election Notice
• CHIPRA Premium Assistance Notice
In addition, the DOL released proposed regulations which would eliminate the model COBRA Election Notice and General Notice from the appendices of DOL COBRA regulations and allow the DOL to publish all subsequent updates to these notices directly to the DOL website.
The use of the DOL model notices is not mandatory. However, a plan administrator’s use of the model notice (appropriately completed and adjusted) is considered a “safe harbor” and good faith compliance standard.