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Employee Assistance Programs under the ACA
Spencer Fane
[Guidance Overview] Oct. 1, 2013
"Through at least the end of 2014, the agencies will view any EAP that does not provide significant medical benefits as an 'excepted benefit' -- and therefore exempt from most of the ACA rules. Thus, such an EAP need not comply with the prohibition on annual or lifetime limits, need not provide first-dollar coverage for preventive-care services, and need not issue an SBC.... An EAP's status as an excepted benefit also has implications under both the individual mandate and the employer play-or-pay rules.... [An] employee who is covered by an EAP that constitutes an excepted benefit may still qualify for a federal tax subsidy to purchase coverage on an Exchange[.]"
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