EBIA Weekly Newsletter

HHS Halts Cost-Sharing Reduction Reimbursements to Insurers

   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

ERISA Preempts State Law Revoking Beneficiary Designation Upon Divorce

   October 19, 2017

Jackson v. Parks, 2017 WL 4077006 (D. Mont. 2017) This case arose following the death of an employee who had named his spouse as beneficiary under his employer’s life insurance plan. A year before his death, the employee and his spouse divorced, and, a few months later, the employee revised his will, leaving his entire … Read More

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

   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