Health & Welfare Plans Newsletter

BULLETIN
Supplement to
October 23, 2015

BenefitsLink.com logo EmployeeBenefitsJobs.com logo LinkedIn logo Twitter logo Facebook logo
Get Retirement News | Advertise | Previous Issues | Search
 

[Official Guidance]

Text of Agency FAQs on ACA Implementation: (Part XXIX) and Mental Health Parity Implementation
13 Q&As. "Coverage of Preventive Services ... Are plans and issuers required to provide a list of the lactation counseling providers within the network?.... My non-grandfathered group health plan or coverage contains a general exclusion for weight management services for adult obesity. Is this permissible?... If a colonoscopy is scheduled and performed as a screening procedure pursuant to the USPSTF recommendation, is it permissible for a plan or issuer to impose cost sharing for the required specialist consultation prior to the screening procedure?... I am a qualifying non-profit or closely held for-profit employer who sponsors an ERISA-covered self-insured plan, and I have a sincerely held religious objection to providing coverage of contraceptive services. How do I effectuate the religious accommodation, relieving myself of any obligation to contract, arrange, pay, or refer for that coverage?...

"Coverage of BRCA Testing ... Which women must receive coverage without cost sharing for genetic counseling, and if indicated, testing for harmful BRCA mutations?...

"Wellness Programs ... My group health plan gives rewards in the form of non-financial (or in-kind) incentives (for example, gift cards, thermoses, and sports gear) to participants who adhere to a wellness program. Are these non-financial incentives subject to the wellness program regulations issued by the Departments? ...

"Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) and Disclosure ... I am a participant in a group health plan that provides treatment for anorexia as a mental health benefit. In accordance with the plan terms, my provider, on my behalf, requested prior authorization for a 30-day inpatient stay to treat my anorexia. The request was denied based on the plan's determination that a 30-day inpatient stay is not medically necessary under the plan terms.... Can my plan, upon request, provide a summary description of the medical necessity criteria for both [mental health and substance use disorder (MH/SUD)] benefits and medical/surgical benefits that is written to be understandable for a layperson?"

(Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]; U.S. Department of Health and Human Services [HHS]; and U.S. Treasury Department)  

Connect   LinkedIn logo   Twitter logo   Facebook logo

Additional useful links:

BenefitsLink.com, Inc.
1298 Minnesota Avenue, Suite H
Winter Park, Florida 32789
Phone (407) 644-4146
Fax (407) 644-2151

Lois Baker, J.D., President
David Rhett Baker, J.D., Editor and Publisher
Holly Horton, Business Manager

Copyright 2015 BenefitsLink.com, Inc. — but feel free to forward this newsletter without further permission from us, if you do not modify the newsletter in any way (including this lower portion).

All materials contained in this newsletter are protected by United States copyright law and may not be reproduced, distributed, transmitted, displayed, published or broadcast without the prior written permission of BenefitsLink.com, Inc., or in the case of third party materials, the owner of that content. You may not alter or remove any trademark, copyright or other notice from copies of the content.

Links to websites other than those owned by BenefitsLink.com, Inc. are offered as a service to readers. The editorial staff of BenefitsLink.com, Inc. was not involved in their production and is not responsible for their content.

We are proud of our Privacy Policy.

Thanks for reading this newsletter!