Health Reform
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HMS Dependent Eligibility Under Health Care Reform
Cost-Containment Strategies Employers Should Take From The Signing of the Bill to Beyond 2014. Learn about the two types of plans and important factors to consider as employers formulate a cost-containment strategy.
Recent Posts
Retroactive Termination & Health Reform
From the language in health care legislation, “…plans and issuers cannot rescind coverage unless an individual was involved in fraud or made an intentional misrepresentation of material fact.” A group health plan must provide at least 30 days advance written notice to each participant who would be affected before coverage can be rescinded. This applies to both self-funded or fully-insured groups. Read more.
Adult Dependent Coverage Options for Grandfathered Plans
In an era of Health Care Reform, your organization may be adding adult dependents onto your plans. HCR mandates allow children to maintain benefit coverage up to age 26 without regard to dependency, marriage or student status. One way for employers to ease the added dependent burden, for those plans maintaining their grandfathered status, is to implement a working child affidavit program. Read more.
Proposed HHS Rules Regarding What is Required to Maintain a Plan’s Grandfathered Status
Upon initial review of the document here are a few items that should be noted by employers. 1. Elimination of Benefits – The elimination of all or substantially all benefits to diagnose or treat a particular condition causes a group health plan or health insurance coverage to cease to be a grandfathered health plan. For this purpose, the elimination of benefits for any necessary element to diagnose or treat a condition is… Read more.
HHS Issues Interim Final Regulations on Dependent Eligibility Definition Under Health Care Reform
The Department of Health and Human Services (HHS) issued interim final rules regarding how dependent eligibility can be defined under health care reform. The rules (excerpted and linked below) reinforce how critical it is to maintain the grandfathered status of a group health plan. Read more.
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