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DOL posts third health reform FAQ

Posted on October 12, 2010 | No Comments

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Implementation Briefs

The Department of Labor has posted the third in a series ofFAQs on health reform implementation, this time addressing group health plan exemptions for firms with less than two current employees.

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According to a set of frequently asked questions (FAQs) recently released by the Departments of Health and Human Services (HHS), Treasury (DOT), and Labor (DOL), the final rule under an Affordable Care Act (ACA) provision, which requires health care insurers and group health plans to make available to consumers a standardized summary of the benefits and coverage for each plan they offer, will be released "as soon as possible." The FAQs pertain to implementation of ACA market reform provisions and mental health parity requirements. Until this final rule is released, plans are not required to comply with the proposed rule's provisions. The ACA requires plans to provide consumers with a standardized form containing definitions of benefits and information on coverage. Along with the benefits and coverage summary, the departments also included several FAQs addressing the implementation of the Mental Health Parity and Addiction Equity Act of 2008, which mandates equal treatment for medical and surgical care and mental health and substance use disorder care in areas such as out-of-pocket costs and benefit limits and practices.
The responsibilities for implementing the Affordable Care Act are spread across several federal departments and the offices within them. This is the latest in a series of briefs developed by HealthReformGPS describing the implementing agencies and their roles. Though the Affordable Care Act (ACA) left the basic framework of ERISA unchanged, it introduced many new requirements on employer-sponsored insurance (ESI) to strengthen the rights of beneficiaries. DOL is the lead agency responsible for implementing these new requirements.
The health reform law establishes minimum federal standards, preserving states’ ability to require more stringent standards for insured plans.