HHS Halts Cost-Sharing Reduction Reimbursements to Insurers

EBIA Newsletter October 19, 2017

HHS Memorandum: Payments to Issuers for Cost-Sharing Reductions (Oct. 12, 2017) Available at https://www.hhs.gov/sites/default/files/csr-payment-memo.pdf The Acting Secretary of HHS has notified CMS via a Memorandum that cost-sharing reduction payments to insurers are prohibited and must stop effective immediately. As background, under the Affordable Care Act (ACA), insurers are required to reduce … Read More

Executive Order Directs Agencies to Consider Expanding Health Coverage Options, Including HRAs

EBIA Newsletter October 19, 2017

Presidential Executive Order 13813: Promoting Healthcare Choice and Competition Across the United States (Oct. 12, 2017); White House News Release: President Donald J. Trump is Taking Action to Improve Access, Increase Choices, and Lower Costs for Healthcare (Oct. 12, 2017) Executive Order News Release Citing concerns about choice and competition under … Read More

Are HIPAA Special Enrollment Periods Required for Loss of Individual Coverage?

EBIA Newsletter October 19, 2017

QUESTION: Our company sponsors a self-insured major medical plan for our employees and their dependents. If an employee or dependent loses eligibility under an individual health insurance policy, must we offer a special enrollment period under our plan? ANSWER: Generally, yes. Under HIPAA portability rules, group health plans are required to provide special enrollment periods … Read More