[Guidance Overview] Chart of State Domestic Partner and Same-Sex Marriage Laws as of May 10, 2012
Jurisdictions covered are CA, CO, CT, DC, DE, HI, IA, IL, MD, ME, MA, NH, NJ, NV, NY, OR, RI, VT and WA. Issues described in this nicely done 3-page chart include: type of relationship addressed, whether or not health insurance coverage is mandated; whether a leave law applies; scope of state tax exclusion for health coverage; scope of rights (same as opposite sex vs. limited); and recognition of out-of-state relationships. (Mercer)
HHS Finalizes Requirement to Notify Consumers When MLR Spending Targets Met
"The final rule said that requiring the notices to be sent when MLRs are met 'will ensure that all consumers, not just those owed a rebate, are informed whether their issuer meets the minimum MLR standards established by the Affordable Care Act,' and it will 'reduce confusion as to why certain individuals receive rebates, while others, such as coworkers or family members with different plans, do not.'" (Bloomberg BNA)
How Does Health Reform Affect Rural America?
"The Rural Health Panel analyzed federal health reform proposals,[ACA], and related government papers and documents and produced nine reports for federal policy-makers and stakeholders. The reports analyzed the impacts of the various coverage proposals and of the ACA on rural people, places, and providers. The project informed the ideas in the ACA through discussions of its provisions and ways to implement the law." (Robert Wood Johnson Foundation)
Proskauer ERISA Litigation Newsletter, May 2012
Articles include: Health Care Reform Remains Alive and Well as DOL Enforces ACA through Plan Audits; Class Warfare -- ERISA Class Litigation in Light of Wal-Mart v. Dukes; and Rulings, Filings, and Settlements of Interest. (Proskauer Rose LLP)
DOL Begins Enforcing the ACA Through Plan Audits
"Generally, plan sponsors and administrators must be able to demonstrate that their plans comply with the ACA, which requires documentary evidence -- from plans, record keepers, and/or service providers. Written records of the steps taken to comply with the ACA since September 23, 2010, including detailed records of participation information and communications with participants about enrollment periods and coverage, should be retained in a readily accessible fashion. For example, plans should keep and be able to produce notices of coverage for children up to 26 years of age, and evidence of distribution. Likewise,any plan amendments or written policies that were adopted to implement the ACA mandates discussed above should be ready for production." (Proskauer Rose LLP)
[Official Guidance] Text of CCIIO Announcement on Medical Loss Ratio Annual Reporting Form Reminding Health Insurers of June 1 Deadline (PDF)
"[The final regs require] an issuer to submit an annual report to the Secretary by June 1 of the year following the end of an MLR reporting year. The first annual report must be submitted to the Secretary by June 1, 2012.... Please refer to the Medical Loss Ratio (MLR) Annual Reporting Form Instructions at: http://www.cciio.cms.gov/resources/other/index.html#mlr for the complete set of instructions." (Centers for Medicare & Medicaid Services, Center for Consumer Information and Insurance Oversight)
[Official Guidance] Text of CCIIO Announcement on Medical Loss Ratio Rebate Notices, Reminding Health Insurers of August 1 Deadline (PDF)
"[The final regs require] an issuer to provide information in the form of a rebate notice to enrollees who are owed rebates, regardless of the form in which the rebate payment is made (e.g., check or future premium credit).... CMS has developed a standard form for the rebate notice that each issuer must send by August 1 of the following year to enrollees entitled to a rebate based upon the prior MLR reporting year. For example, notice of rebates based on the 2011 MLR reporting year must be provided by August 1, 2012.... Please refer to the Medical Loss Ratio (MLR) Rebate Notice Instructions at http://www.cciio.cms.gov/resources/other/index.html#mlr for the complete set of instructions." (Centers for Medicare & Medicaid Services, Center for Consumer Information and Insurance Oversight)
[Official Guidance] Text of General CCIIO Guidance on Federally-Facilitated Health Exchanges (PDF)
"This document outlines the [HHS] approach to implementing a Federally-facilitated Exchange (FFE) in any State where a State-based Exchange is not operating. In addition to describing [the] high-level operational approach, [the document discusses]: 1. How States can partner with HHS to implement selected functions in an FFE, 2. Key policies organized by Exchange function, and 3. How HHS will consult with a variety of stakeholders to implement an FFE. Subsequent guidance documents will include additional policy and operational details intended to inform State decision-making and preparation for Exchange participation, roles and responsibilities, and potential areas of collaboration." (Center for Consumer Information and Insurance Oversight)
More States Working to Implement Health Insurance Exchanges, HHS Announces
"[Illinois, Nevada, Oregon, South Dakota, Tennessee and Washington will receive more than $181 million in grants to help implement the new health care law by helping] states establish Affordable Insurance Exchanges. Starting in 2014, [the Exchanges will help consumers and small businesses in every state] choose a private health insurance plan. These comprehensive health plans will ensure consumers have the same kinds of insurance choices as members of Congress. [34] states and the District of Columbia have received Establishment grants to fund their progress toward building Exchanges." (Department of Health & Human Services)
[Official Guidance] Text of Official Corrections to Final HHS Regs on Standards for Reinsurance, Risk Corridors, and Risk Adjustment (PDF)
"This document merely corrects technical and typographic errors in the Health Insurance Premium Stabilization final rule that was published on March 23, 2012 and becomes effective on May 22, 2012. The changes are not substantive changes to the standards set forth in the final rule." (U.S. Department of Health and Human Services)
[Guidance Overview] HHS Notice Addresses Rules for Insurers That Meet or Exceed Medical Loss Ratio Standards
"The extended notice requirement will hopefully reduce confusion that may have otherwise occurred when some individuals received rebates and others, in different insurance plans, did not. Importantly, the electronic disclosure rules for providing SBCs, which are referenced in the extended notice requirements for MLRs, were recently addressed in DOL frequently-asked-questions[.]" (Practical Law Company)
[Guidance Overview] Recent Case Highlights Split of Authority on Whether Corporate Agreements Can Amend Employee Benefit Plans
"In Sterling Chemicals v. Evans, the U.S. Court of Appeals for the Fifth Circuit found that a paragraph in an asset purchase agreement satisfied the technical requirements for an employee benefit plan amendment, [and even though] it did not state it was intended to amend the plan....[the language] did, in fact, serve to amend the benefit plan.... [T]he First and Sixth Circuits have held that a corporate agreement cannot amend an employee benefit plan without explicitly setting forth the intent to do so. Last month, the Supreme Court of the United States declined to review the Sterling decision, so the question of whether and how a corporate agreement may amend an employee benefit plan will continue to be an issue that employers must consider when drafting and reviewing corporate agreements." (McDermott Will & Emery)
Resource Page on Implementation of Health Insurance Medical Loss Ratios by the States, Updated May 11, 2012
"The N.H. insurance department released its first health insurance premium rate report in April 2012, a study mandated by legislation enacted two years ago. According to the report, premiums grew 14 percent between 2009 and 2010, driven primarily by claims costs, as well as new medical technologies and the growth in outpatient facility costs." (National Conference of State Legislatures)
[Official Guidance] Text of Official Corrections to Interim Final CMS Regs for Health Insurance Issuers Implementing Medical Loss Ratio Requirements (PDF)
8 pages; the clarifications are more than typographical errors. "This document corrects technical errors that appeared in the interim final rule published in the Federal Register on December 1, 2010, entitled 'Health Insurance Issuers Implementing Medical Loss Ratio ... Requirements under the [PPACA]' and in the correction notice published in the Federal Register on December 30, 2010, entitled 'Health Insurance Issuers Implementing Medical Loss Ratio ... Requirements Under the [PPACA]; Corrections to the Medical Loss Ratio Interim Final Rule With Request for Comments.' ... We believe that it is unnecessary to provide for a public comment period or to delay implementing these corrections, as they clarify provisions of a final rule that has been subjected to notice and comment procedures and do not make any substantive changes to it." (Centers for Medicare & Medicaid Services)
New Online Resource Page by HHS: the 'Health System Measurement Project'
"The web-based tool ... will allow policymakers, providers, and the public to develop consistent data-driven views of changes in critical U.S. health system indicators.... The Health System Measurement Project brings together datasets from across the federal government that span topical areas, such as access to care, cost and affordability, prevention and health information technology. It presents these indicators by population characteristics, such as age, sex, income level, insurance coverage, and geography." (U.S. Department of Health and Human Services)
[Official Guidance] Eighth Circuit Addresses Standard of Review in Long-Term Disability Insurance Dispute (PDF)
"Standard's [disability insurance] policy language reserving the power to 'resolve all questions . . . [of] interpretation' indicates the administrator has discretionary power to construe ambiguous terms. Thus, our standard of review is for abuse of discretion.' (Hankins v. Standard Insurance Company, 8th Cir., May 14, 2012). (Justia.com)
ML Strategies Health Care Reform Update, May 14, 2012 (PDF)
Weekly update on federal and state health care reform legislation, regulations and initiatives. (ML Strategies)
Federal Guidance and Regulation of State Health Benefit Exchanges
"[Information on the Final Rule which i]mplements standards for states related to reinsurance and risk adjustment, and for health insurance issuers related to reinsurance, risk corridors, and risk adjustments consistent with the ACA. These programs will lessen the impact of potential adverse selection and stabilize premiums in the individual and small group markets as insurance reforms exchanges are implemented, starting in 2014. The rule becomes effective May 23, 2012." (National Conference of State Legislatures)
Reinhart Employee Benefits Update, May 2012 (PDF)
Items include: Summary of Description of Material Modifications for Calendar-Year Plans; HHS Announces Proposed Regulations to Establish Health Plan Identifiers for Health Plans; IRS Publishes Proposed Regulations Imposing Fees to Fund Patient-Centered Outcomes Research; CMS Releases Guidance on Medical Loss Ratio Regulations; Ninth Circuit Rejects Claim for Equitable Relief Following SPD and Plan Document Discrepancies. (Reinhart)
[Opinion] Health Care Reform: What Employers Should Be Considering Now
"As employers anxiously await the Supreme Court's decision on health care reform (expected by late June), there are many things employers should be thinking about now. The Supreme Court will most likely make one of four decisions on health care reform. [This article describes] how each of those possible decisions may affect employers." (Faegre Baker Daniels)
[Guidance Overview] Connecticut's Group Health Plan Would Lose Governmental Plan Status by Covering Employees of Non-Profit Contractors
"[T]he DOL concluded that a group health plan sponsored by the State of Connecticut for state employees, retirees, and dependents would lose its ERISA exception as a governmental plan if it extended eligibility to employees of nonprofit entities providing public services through state contracts or funding.... [T]he 175,000 nonprofit employees estimated to become eligible under the new law (compared to 100,000 state employees and retirees currently in the plan) would far exceed the 'de minimis' number of private employees permitted under prior DOL guidance addressing the governmental plan exception." (Thomson Reuters/EBIA)
The Small Business Tax Credit in the ACA Is Good Business Sense
"[The] analysis found that more than 3.2 million small businesses, employing 19.3 million workers across the nation, will be eligible for this tax credit when they file their 2011 taxes. In total, these small businesses are eligible for more than $15.4 billion in credits for the 2011 tax year alone, an average of $800 per employee." (Families USA)
New Jersey Governor Vetoes Health Insurance Exchange
"Democrats in the Legislature had billed the exchange as one-stop shopping for people or businesses seeking health insurance, allowing consumers to compare the benefits and the costs of participating plans. The Web site it proposed would have also allowed people to apply for tax credits or other subsidies toward the cost of insurance. In his veto message, the governor said he was concerned about the potential costs of the exchange." (The New York Times; free registration required)
Plan Management Issues for State, Partnership and Federally Facilitated Health Insurance Exchanges (PDF)
"Based on [their findings, the authors] conclude that exchanges' plan management responsibilities represent a considerable expansion of states' oversight of insurers. The law requires oversight that in some cases expands on what states currently do and in other cases represents a wholly new activity. However, to fulfill their responsibilities, state exchanges can leverage the authority and skills of multiple state agencies, including departments of insurance, departments of health, and Medicaid agencies." (National Academy of Social Insurance / The Center on Health Insurance Reforms)
Restricted Health Insurance Enrollment Periods As an Alternative to Individual Mandates
"[Healthcare Town Hall] recently ran a poll on the best course of action to reduce adverse selection if the PPACA individual mandate is struck down by the Supreme Court. The number one answer was 'use limited enrollment windows to reduce the occurrence of people joining a plan only when they become sick.'" (Healthcare Town Hall)
[Guidance Overview] Proposed IRS Regs Address the PPACA Comparative Effectiveness Fee (PDF)
"The proposed regulations provide very practical alternatives for determining the number of covered lives for the purpose of determining the [Patient-Centered Outcomes Research Institute] fee. Plan sponsors should review the options available for determining the fee to determine the most effective approach for their plans." (Buck Consultants)
North Carolina Voters Approve Same-sex Marriage Ban
"North Carolina voters on Tuesday approved a state constitutional amendment that bans same-sex marriage and civil unions ... North Carolina law already blocks gay and lesbian couples from marrying, but the state now joins the rest of the Southeast states in adding the prohibition to its constitution." (Yahoo! News)
Benefits Administration: To Outsource or Manage In-House?
"The goal of the survey was to gain insight into what employers views are on the topic of benefits administration to include: What employers are thinking about the various trade-offs inherent to insourcing and outsourcing benefits administration? What employers are actually doing -- what functions are they outsourcing and which are insourced? What employers are planning on doing -- in light of the changing technological and legal landscape, are employers planning on insourcing or outsourcing more functionality?" (ADP; free registration required)
[Guidance Overview] ML Strategies Health Care Reform Update, May 7, 2012
Weekly update on federal and state health care reform legislation, regulations and initiatives. (Mintz Levin)
Reinhart Employee Benefits Update, April 2012 (PDF)
Articles include: Clarification on Reasonable Interest Rate for Participant Loans; Final Interim Rule on Health Insurance Exchanges; Adoption of Preapproved Defined Benefit Plans; and Departments Issue New FAQs on SBC Requirements. (Reinhart)
Health Care Reform Timeline for Employers
Timeline of employer action items having effective dates during 2010-2018. (Mercer)
Health Care Reform: What If They Throw the Whole Thing Out?
"[If the Supreme Court finds the individual mandate is not constitutional and that it is not severable from the rest of PPACA, it] would mean that the entire law would be voided and employers would no longer have to continue to comply.... [The situation would then be that] employers will no longer have to comply with any of the PPACA mandates, and various PPACA provisions that affect employers will no longer apply. This includes portions of PPACA that are already effective, as well as those that are becoming effective over the next several years." (Jones Day)
Deloitte Health Care Reform Memo, May 7, 2012
Describes recent developments in various health plan and health insurance matters at the federal and state levels. This issue includes a discussion of the Senate Committee on Finance announcement of a bipartisan effort to combat waste and fraud. (Deloitte)
[Guidance Overview] IRS Guidance Addresses Upcoming Research Fees on Many Health Plans and Insurers
"These research fees are scheduled to start with the first plan or policy year ending on or after October 1, 2012, and will affect the health plans of many employers. Although the regulations currently are in proposed form, health insurance issuers and plan sponsors may rely on the proposed regulations for guidance pending the issuance of final regulations." (Bond, Schoeneck & King)
DOL Reports to Congress on Self-Insured Health Plans; Agencies Seek Information on Stop-Loss Coverage
"Will health care reform's insurance mandates (which indirectly burden plan sponsors ... prompt more employers to consider self-insurance? It's too soon to tell -- particularly from a report based on 2009 data. But employers considering a change to a self-insured plan should understand both the risks and the advantages." (Thomson Reuters/EBIA)
[Guidance Overview] IRS Proposed Regs Address Comparative Effectiveness Research Fee on Group Health Plans
"Insurers and plan sponsors must report and pay these fees annually on IRS Form 720, which will be due by July 31 of each year. The first due date is July 31, 2013. A return will generally cover policy or plan years that end during the preceding calendar year. In other words, fees for a plan year are due by July 31 of the calendar year following the calendar year containing the plan year end. Form 720 may be filed electronically. The IRS has not yet updated Form 720 to reflect the reporting of these fees." (Proskauer)
[Guidance Overview] Proposed IRS Regs Address Fees to Be Paid by Health Insurers and Sponsors of Self-Insured Health Plans
"If the Supreme Court agrees that the individual mandate is unconstitutional and cannot be severed from the rest of the Act, the Section 4375 and 4376 fees [on health insurers and plan sponsors for the Patient-Centered Outcomes Research Trust Fund] would be invalidated along with the PCORI. The Court's decision is expected this June." (McGuireWoods)
[Opinion] Text of Comments by American Academy of Actuaries to CMS on Revised MLR Annual Reporting Form (PDF)
"The Medical Loss Ratio Work Group sent a letter to CMS offering comments on the revised annual reporting form, specifically on the definition of premiums, contract reserves, and the definition of pre-tax underwriting gain/(loss)." (American Academy of Actuaries)
[Guidance Overview] CMS Guidance Addresses Medical Loss Ratio Requirement
"In response to [a] question about whether 'premium holidays' are permissible in lieu of providing rebates if an issuer finds that its MLR is lower than the standard required, the guidance explains that this is a state regulatory issue not addressed by the MLR regulations." (Littler)
[Guidance Overview] HHS Guidance Addresses 'Minimum Value' Calculation by Employer-Sponsored Health Plans and Reporting Requirements
"After considering stakeholder comments, HHS proposes to provide a standardized way for employees and employers to voluntarily collect and communicate employer-sponsored coverage information needed to complete an Exchange application. HHS proposes to allow Exchanges to verify employer-sponsored coverage for the 2014 and 2015 plan years through use of limited pre-enrollment verification based on data sources available to an Exchange and a post-enrollment verification screening process where data sources are not available during the eligibility determination process." (Littler)
[Guidance Overview] IRS Proposes Methods for Valuing Employer Health Coverage
"The IRS has just issued three notices concerning key aspects of the 2010 Affordable Care Act ('ACA'). Notice 2012-31 proposes three different methods by which sponsors of self-funded health plans could value the coverage they provide to plan participants and their dependents. Notice 2012-32 and Notice 2012-33 then solicit comments on two related employer reporting requirements.... All three of these Notices solicit comments. Unfortunately, the deadline for submitting those comments is June 11, 2012. This is likely to be before the Supreme Court has issued its ruling on the constitutionality of the individual mandate - and perhaps the entire ACA." (Spencer Fane)
[Guidance Overview] Employers Sponsoring Health Plans Must Pay New Annual Health Plan Fee
"Plan sponsors of self-insured group health plans covering individuals residing in the U.S. must pay the fee. Governmental entities, including federally-recognized Indian tribal governments, must also pay the fee unless they operate certain exempt governmental programs." (McKenna Long & Aldridge LLP)
[Official Guidance] Text of EBSA Advisory Opinion 2012-01A on Allowing Private Employers Into Connecticut's Group Health Plan
"[The state of Connecticut asked w]hether the status of the Group Health Plan for Employees of the State of Connecticut as a 'governmental plan' within the meaning of section 3(32) of ERISA would be adversely affected if the State permitted participation by certain private nonprofit employers who perform public service functions under contract with the State or receive substantial funding from governmental sources.... [T]he Department would view the participation of private nonprofit employers in the Connecticut State Plan described in your letter as more than de minimis, and, therefore, such participation would adversely affect the status of the State Plan as governmental under ERISA section 3(32)." (Employee Benefits Security Administration)
[Guidance Overview] Research Fees to Be Imposed on Self-Insured Health Plans Beginning October 2012
"New proposed regulations identify the plans and policies that are subject to the fee, specify how the fees will be calculated, and prescribe the filing and payment requirements. The proposed regulations explicitly provide that plan sponsors and issuers are entitled to rely on their terms until final regulations are issued." (Deloitte)
DOL Updates Interactive Health Plan Compliance Website for Laws Other than Health Care Reform
"While the Advisor provides useful information, employers will need to exercise caution when using it. Because health care reform is not integrated into the information provided in the Advisor or used in its evaluation of whether a plan is in compliance, users should not rely on the results of the interactive tool without first checking to see if health care reform affects the analysis." (Thomson Reuters/EBIA)
[Opinion] Employers Rolling Up Sleeves on Health Care Cost Containment
"The primary employer challenge becomes, and the genius lies in, execution. In brief, the employer community needs a combination of bold leadership and disciplined, evidence-based intervention strategies in both population health management and in value-based purchasing to accomplish their bold aims. In addition, employers must understand that their leadership and actions need to be exerted not only within their own organizations, but also in communities where they do business and where their current and future workforce resides." (Human Resource Executive Online)
[Guidance Overview] IRS Mulls Meaning of 'Minimum Value' Coverage
"[M]ost large employers that don't provide plans offering 'minimum value' (thereby sending their employees to an Exchange to seek coverage) may be liable for a penalty payment under Code Sec. 4980H. So, for the IRS to determine which individuals are eligible for the tax credit or not, and which employers will get socked with the penalty, it must get a handle on what it means under the ACA to provide minimum value." (Wolters Kluwer Law & Business / CCH)
[Guidance Overview] IRS Requests Comments on Calculation of 'Minimum Value' and Associated Reporting Requirements
"On April 26, 2012, the [IRS] issued three notices in connection with health care reform employer penalty and reporting requirements. Notices 2012-31, 2012-32 and 2012-33 invite comments on potential approaches to determining whether an employer-sponsored plan provides minimum value, and reporting requirements under [IRC] Sections 6055 and 6056." (Practical Law Company)
Federal Agencies Investigate Self-Funded Health Plans and Stop-Loss Insurance
"Helping to push this inquiry have been the states, working through the National Association of Insurance Commissioners.... They've been looking for a way to regulate self-insured ERISA plans (which do not have to abide by state insurance laws), in a potential bid to strengthen regulatory power over employer plans, self-funding proponents say." (Thompson Smart HR Manager)
Preparing for the U.S. Supreme Court's Health Care Decision
"By taking a number of interim steps, employer group health plans can position themselves to respond quickly and appropriately -- whether healthcare reform is upheld, partially upheld, or struck down.... These interim steps take into account the full range of possibilities and should position employer group health plans to react to the possible outcomes, respond to inquiries and requests from internal stakeholders, and consider administrative and design issues presented by the eventual Supreme Court decisions." (Morgan Lewis)
[Guidance Overview] Final Regulations on Health Exchanges (PDF)
"The framework proposed in these final rules is complex. The federal government intends to create a streamlined, single-point enrollment stop for Medicaid, CHIP, Exchange coverage, premium assistance and cost-sharing subsidies. This single stop will require tremendous coordination among a number of governmental agencies and insurance carriers. Hopefully, many of the requirements will be successfully automated." (McGraw Wentworth)
Deloitte Health Care Reform Memo, April 30, 2012
Describes recent developments in various health plan and health insurance matters at the federal and state levels. This issue includes a discussion of health policy and costs. (Deloitte)
[Guidance Overview] HHS Issues Additional Questions and Answers Guidance on Medical Loss Ratio Requirements
"Insurers are required to make the first round of rebates by August 2012 based on their 2011 MLR. While many details in the guidance relate to the actual calculation and reporting of MLRs by insurers, these rules also affect employers (e.g., in terms of handling any rebates provided)." (Thomson Reuters/EBIA)
[Guidance Overview] New Guidance on Computing Taxes Payable by Health Plan Sponsors and Insurers
"The Research Tax generally will apply to major medical benefits. Many other benefits -- such as a dental plan, vision plan and health flexible spending arrangement -- will often be an 'excepted benefit' and not subject to the tax. [The chart in this article] discusses how the Research Tax applies to various benefits that may be offered by an employer. See [also a description of] an important 'non-duplication' rule, which can reduce the tax owed by an employer." (Quarles & Brady LLP)
[Guidance Overview] IRS Describes New Fees Coming Next Year for Group Health Plans
"The Patient Protection and Affordable Care Act (PPACA) created the [Patient Centered Outcomes Research Institute] fee to promote research to evaluate and compare health outcomes and the clinical effectiveness. It will apply to some, but not all, health plans with years ending on or after Sept. 30, 2012. The excise tax will be $1 times the average number of covered lives for the plan year. The tax increases to $2 per covered life for plan years ending on or after Oct. 1, 2013[.]" (Thompson / SmartHR Manager)
[Official Guidance] Text of Request by IRS, DOL, HHS for Information on Stop Loss Insurance (PDF)
"This document is a request for information regarding the use of stop loss insurance by group health plans and their plan sponsors, with a focus on the prevalence and consequences of stop loss insurance at low attachment points.... Employers and plans that purchase stop loss insurance generally are not subject to State health insurance laws including coverage laws, rating policies, and other State and Federal consumer protections applicable to health insurance, including certain patient protections under the Patient Protection and Affordable Care Act.... It has been suggested that some small employers with healthier employees may self-insure and purchase stop loss insurance policies with relatively low attachment points to avoid being subject to these requirements while exposing themselves to little risk. This practice, if widespread, could worsen the risk pool and increase premiums in the fully insured small group market[.]" (Internal Revenue Service)
Clickable Cross-Reference Table for ERISA and United States Code Title 29
When ERISA became law in 1974, it was codified as part of Title 29 of the United States Code. By that time Title 29 already contained the codified version of many other labor laws. (Title 29 section 1 was already "taken,' for example.) So the Title 29 section numbers assigned to the provisions of ERISA do not line up with the section numbering in the original Act. For example, the fiduciary duty provisions of ERISA section 404 are found in Title 29 section 1104. The table on the linked page shows the ERISA sections and their corresponding Title 29 section numbers, with clickable links to the text of each section. (BenefitsLink.com)
Text of EBSA's Annual Report on Self-Insured Group Health Plans, April 2012 Issue (PDF)
"Along with this second annual Report, [DOL] is submitting two detailed appendices produced under contract. Appendix A, Group Health Plans Report: Abstract of 2009 Form 5500 Annual Reports Reflecting Statistical Year Filings, provides detailed statistics describing group health plans that file a Form 5500. Appendix B, Self-Insured Health Benefit Plans 2012, presents a study that explores statistical issues associated with Form 5500 health plan data and analyzes available data on the financial status of employers that sponsor group health plans filing the Form 5500." (Employee Benefits Security Administration)
[Official Guidance] Text of Proposed IRS Regulations Pertaining to the Disclosure of Return Information to Carry Out Eligibility Requirements for Health Insurance Affordability Programs (PDF)
"This document contains proposed regulations relating to the disclosure of return information under section 6103(l)(21) of the Internal Revenue Code, as enacted by the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010. The regulations define certain terms and prescribe certain items of return information in addition to those items prescribed by statute that will be disclosed, upon written request, under section 6103(l)(21) of the Internal Revenue Code." (Internal Revenue Service)
Estimating the 2012 Health Insurance Rebates Under the Medical Loss Ratio Rules
"This analysis looks at the latest estimates provided by insurers to state insurance commissioners. The analysis finds that consumers and businesses are expected to receive an estimated $1.3 billion by this August in rebates from health insurers who spent more on administrative expenses and profits than allowed by the ACA. The rebates include $541 million in the large employer market, $377 million in the small business market, and $426 million for those buying insurance on their own." (The Henry J. Kaiser Family Foundation)
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