Telemedicine - ACA?

[Catsby]

Several of our clients have been approached by vendors to offer telemedicine products outside of their group health plans (e.g., to part-time employee groups who are not eligible for medical coverage). It has always been my understanding that telemedicine benefits would constitute a group health plan and be subject to Affordable Care Act requirements (preventive services, etc.) that would be functionally impossible for a telemedicine benefit to meet (e.g., the requirement to offer immunizations). I have seen some vendors make the argument that the telemedicine benefits could fall under the excepted benefits rules, as EAPs. However, in order for an EAP to be an excepted benefit, it cannot offer significant benefits in the nature of medical care. I find it hard to believe a telemedicine benefit could meet that requirement. 

Are you guys also seeing these products becoming very common? Is there some rule I am missing that is allowing employers to offer standalone telemedicine benefits to their employees? TIA for any thoughts!

[leevena]

Catsby, there is more to this issue than ACA.  Telemedicine can be impacted by ACA, ERISA, and COBRA.  There may even be state law issues to deal with, but I am not an expert on each state.  

Generally speaking, when a telemedicine program is integrated into the group plan these issues are satisfied because of its inclusion in the plan.  When offered as a stand-alone it is viewed as a separate plan and the employer needs to satisfy ERISA requirements, create a separate COBRA process, and abide by ACA.  Abiding by ERISA and COBRA is not very difficult, nor expensive.  The ACA excepted benefit piece may be because of the requirements.  To meet this threshold, the plan must;  not provide significant medical care benefits, not be coordinated with the group plan, be cost free to the participants, and does not have any cost sharing.