New regulations delay ACA’s ‘play or pay’ provision for some employers

February 11, 2014 - by: Jessica Webb-Ayer 0 COMMENTS

In yet another unexpected turn in the implementation of the Affordable Care Act (ACA), the Obama administration announced Monday that it is delaying the application of the law’s employer responsibility provision (also commonly referred to as the “play or pay” provision) for some small employers until 2016. The administration let the public know about the delay when the U.S. Department of the Treasury and the IRS released final regulations addressing the much-publicized provision.

Under the play-or-pay provision, employers with 50 or more employees face penalties if they don’t offer health insurance coverage or if the coverage they offer is insufficient. The provision was originally supposed to take effect on January 1, 2014, but last summer the administration delayed implementation until 2015.

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Certain religious employers get a reprieve from ACA’s contraceptive mandate from Supreme Court

January 02, 2014 - by: Jessica Webb-Ayer 0 COMMENTS

On New Year’s Eve, just hours before the healthcare reform (also known as the Affordable Care Act or ACA) contraceptive mandate requirement was supposed to go into effect, Supreme Court Justice Sonia Sotomayor issued a stay and gave the federal government until Friday to respond to the Court.

The stay applies to a limited group of employers. More specifically, it applies to an order of nuns called the Little Sisters of the Poor and certain other Roman Catholic nonprofit groups that use the same health insurance plan offered by the Christian Brothers Employee Benefit Trust.

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Mental health parity regulations take effect January 13

January 02, 2014 - by: Tammy Binford 0 COMMENTS

The final regulations implementing the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 will become effective January 13.

The Act requires group health plans that offer mental health or substance use disorder benefits to ensure that those benefits are equivalent to the medical and surgical benefits offered by the plans.

The new final regulations apply to group health plans and health insurance issuers for plan years beginning on or after July 1, 2014. The final regulations define the law’s basic terms and outline the general parity requirement and classification of benefits.

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Supreme Court agrees to hear ACA contraception coverage cases

November 26, 2013 - by: Jessica Webb-Ayer 0 COMMENTS

Although the Affordable Care Act (ACA) overcame a large hurdle when the U.S. Supreme Court upheld its provisions (including the individual mandate) last year, the Court announced today that it would take another look at the law. This time, it will be reviewing another one of the law’s controversial mandates—the contraceptive mandate.

Under the ACA, many health insurance plans must cover certain preventive services for women without cost sharing (e.g., coinsurance, copayments, and deductibles). These preventive services include contraceptive methods and counseling—or more specifically, “all Food and Drug Administration approved contraceptive methods, sterilization procedures, and patient education and counseling for all women with reproductive capacity.” However, there are exceptions to the mandate. For example, the requirement to cover such preventive services doesn’t apply to grandfathered health plans or to certain religious employers.

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Walgreens to provide employees with healthcare subsidy while ACA public exchange deadline looms

September 18, 2013 - by: HR Hero Alerts 0 COMMENTS

Walgreens has announced it will provide eligible employees with employer-sponsored health insurance coverage in 2014 through its proprietary “Live Well Benefits Store,” a marketplace that is an outsourced solution through Aon Hewitt Corporate Health Exchange.

The new program allows Walgreens to continue offering health insurance and wellness benefits to its employees as the plan administrator while providing tools and resources that help employees personalize coverage for themselves and their dependents.

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Obama administration delays another ACA provision

August 13, 2013 - by: Jessica Webb-Ayer 0 COMMENTS

The Obama administration has delayed another Affordable Care Act (ACA) provision. The administration has postponed a consumer protection provision that limits out-of-pocket costs until 2015. Under the provision, the limit on out-of-pocket costs was not to exceed $6,350 for an individual and $12,700 for a family.

According to the New York Times, the one-year grace period was announced in February on the U.S. Department of Labor’s (DOL) website in guidance titled “FAQs about Affordable Care Act Implementation Part XII.” However, the language outlining the grace period largely flew under the radar until DOL officials recently confirmed what the language means.

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Obama administration delays implementation of ACA “play or pay” provision

July 03, 2013 - by: Jessica Webb-Ayer 0 COMMENTS

In a surprising move yesterday, the Obama administration announced on the U.S. Department of the Treasury’s website that it is delaying the implementation of the Affordable Care Act’s (ACA) employer responsibility provision. Now employers won’t have to worry about compliance with the provision, commonly referred to as the “play or pay” provision, until 2015.

The play or pay provision has been one of the most publicized provisions affecting employers, and many employers have been nervous about its 2014 effective date. Under this particular part of the ACA, employers with 50 or more employees face penalties if they don’t offer health insurance coverage or if the coverage they offer is insufficient.

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New regulations change details on workplace wellness programs

May 30, 2013 - by: Tammy Binford 1 COMMENTS

Final rules from the U.S. Department of Health and Human Services on employment-based wellness programs raise the maximum reward that may be offered by certain wellness programs and expand nondiscrimination protections for sick employees.

The final rules under President Barack Obama’s Patient Protection and Affordable Care Act were issued May 29 and will be effective for plan years beginning on or after January 1, 2014.

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Obama unveils compromise on health reform contraception rule

February 01, 2013 - by: Tammy Binford 0 COMMENTS

The Obama administration released a compromise plan February 1 on how contraception is covered under the healthcare reform law, but it’s not clear whether foes of the original requirement will approve.

Under President Barack Obama’s Affordable Care Act, contraception is included as a free preventive service. The original rule exempted religious groups that employ mostly people of their own faith, but groups such as religious universities and Catholic hospitals weren’t included in the exemption.

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Healthcare reform provisions move forward: preexisting condition exclusions

November 20, 2012 - by: HR Hero Alerts 0 COMMENTS

On November 20, the Obama administration announced it is moving forward with certain provisions in the Affordable Care Act (ACA), including banning insurance companies from discriminating against people with preexisting conditions. The administration issued the following:

  • A proposed rule that, beginning in 2014, prohibits health insurance companies from discriminating against individuals because of a preexisting or chronic condition. Under the rule, insurance companies would be allowed to vary premiums within limits based only on age, tobacco use, family size, and geography. Health insurance companies would be prohibited from denying coverage to a person because of a preexisting condition or from charging higher premiums to certain enrollees because of their  current  or past health problems, gender, occupation, and small employer size or industry.

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