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BenefitsLink Health & Welfare Plans Newsletter

Supplement to
December 20, 2013
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Supplement to December 20, 2013

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[Official Guidance]

Text of DOL, HHS and Treasury Department Proposed Regs: Amendments to Excepted Benefit (PDF)
43 pages. Excerpt: "In response to [employer] concerns, and to level the playing field between insured and self- insured coverage, these proposed regulations would eliminate the requirement under the HIPAA regulations that participants pay an additional premium or contribution for limited-scope vision or dental benefits to qualify as benefits that are not an integral part of a plan (and therefore as excepted benefits). The Departments invite comments on this approach.... the Departments have developed these proposed regulations to treat certain wraparound coverage provided under a group health pl an as excepted benefits when it is offered to individuals who could receive such benefits through their group health plan if they could afford the premiums, but who do not enroll in the employer-sponsored plan because the premium is unaffordable under the law. As excepted benefits, the coverage would generally be exempt from the HIPAA and Affordable Care Act market reform requirements of ERISA, the PHS Act, and the Code. Wraparound coverage would only qualify as excepted benefits under limited circumstances ... these proposed regulations set forth criteria for an EAP to qualify as excepted benefits beginning in 2015. Under these proposed regulations, benefits provided under EAPs are excepted if four criteria are met." (U.S. Department of the Treasury, U.S. Department of Labor, and U.S. Department of Health and Human Services)  

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