EBIA Weekly Newsletter

Court Requires Health Plan to Cover Residential Treatment Expenses Incurred Before Mental Health Parity Final Rules


   February 22, 2018

B.D. and S.D. v. Blue Cross Blue Shield of Ga., 2018 WL 671213 (D. Utah 2018) Another court has held that a health plan must cover a participant’s expenses for residential mental health treatment services, even though they were incurred before final mental health parity regulations specifically required such services to be covered in parity … Read More


Are the Section 1557 Language-Assistance Requirements the Same as the Requirements for SBCs and Claims?


   February 22, 2018

QUESTION: We are an employer sponsor of an insured major medical plan, and we have heard that Section 1557 of the Affordable Care Act (ACA) imposes language-assistance requirements on our plan. Are the language-assistance requirements under the Section 1557 nondiscrimination rule different from the “culturally and linguistically appropriate manner” standard that applies to the summary … Read More


EBIA Seminars Are Coming to a City Near You!


   February 15, 2018

These full- and half-day intermediate-level courses cover ERISA, the ACA, cafeteria plans, HRAs & HSAs, HIPAA, COBRA—and a brand-new course on wellness programs! Join us in Boston (May 8–11), Minneapolis (May 15–18), Seattle (June 5–8), Dallas (June 12–15), or Chicago (June 19–22)! Our early bird discount is available through February 28, 2018. Read More


IRS Updates Guidance on Employer Shared Responsibility, Including 2018 Penalty Amounts


   February 15, 2018

Questions and Answers on Employer Shared Responsibility Provisions Under the Affordable Care Act Available at https://www.irs.gov/affordable-care-act/employers/questions-and-answers-on-employer-shared-responsibility-provisions-under-the-affordable-care-act The IRS has updated Q&A guidance on its webpage relating to Code § 4980H employer shared responsibility for applicable large employers (ALEs). Here are highlights: 2018 Adjusted Penalty Amounts. In Q/A-54, the IRS has announced … Read More


Updated MSP User Guide Addresses New Medicare Beneficiary Identifiers for Reporting


   February 15, 2018

MMSEA Section 111 MSP Mandatory Reporting GHP User Guide, Version 5.0 (Dec. 15, 2017) Available at https://www.cms.gov/Medicare/Coordination-of-Benefits-and-Recovery/Mandatory-Insurer-Reporting-For-Group-Health-Plans/Downloads/New-Downloads/MMSEA-Section-111-GHP-User-Guide-Version-50.pdf The most recent version of CMS’s Medicare Secondary Payer (MSP) User Guide provides guidance on using the new Medicare Beneficiary Identifier (MBI) for MSP mandatory reporting purposes. As background, CMS is in the process … Read More