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must provide at least 30 days advance written notice to each participant who would be affected before coverage can be rescinded.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.
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.
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.
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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