Only a few months remain to comply with the legal mandates of the Health Insurance Portability and Accountability Act (HIPAA), the Affordable Care Act (ACA), and other laws that affect your plans.
Look to Us for Help
The complicated laws of the ACA are our specialty, so let us help. Below are just a few of the issues you need to know and address to comply with the ACA and HIPPA.
Affordable Care Act
Waiting periods: The ACA limits waiting periods under group health plans to 90 days. Plans can require as many as 1,200 cumulative hours for eligibility and can include an orientation period of one month. It is especially important that employers with high rates of employee turnover refine their policies to address this.
Cost-sharing limits: The ACA set up limits on in-network out-of-pocket expenses that must be paid before the plan reimburses at 100%. The limits are $6,350 (single) and $12,700 (family) in 2014, increasing to $6,600 and $13,200 in 2015. By 2015, employers must be sure their vendors can share data correctly to track and coordinate expenses against these limits.
Excepted benefits: Dental, vision, employee assistance, and wrap-around plans will not be subject to ACA requirements and will not disqualify individuals from getting a subsidy for coverage bought through a health insurance exchange. Employers may consider whether they wish to take advantage of any of these new rules.
Health plan ID numbers: Larger employer health plans (those with receipts of at least $5 million) must have the new federally-mandated unique ID number by November 5, 2014. The process for obtaining this involves many complicated steps, so there is not much time left. Smaller plans have another year to get the ID number.
As always, we are here to help you navigate these complicated compliance issues, with your company's specific needs and interests in mind. Time is quickly running out to take care of these items and remain compliant with the many government regulations. Contact us
with any questions to see how we can help.