On February 25th, 2013, final regulations implementing the essential health benefit (EHB) provisions of the Affordable Care Act were published in the Federal Register (78 Fed. Reg. 12834-12872). The EHB rules, which amend 45 C.F.R., apply to all non-grandfathered individual and small group health plans sold after January 1, 2014, as well as Medicaid benchmark and benchmark-equivalent health plans. The EHB rules also apply to...

This update to our March 2012 implementation brief reviews recent implementation efforts by the Administration in connection with coverage of contraceptives as a required element of required preventive services for all individual and (non-grandfathered) group health plans under the Affordable Care Act. The earlier brief reviewed the Administration’s final rules defining the scope of contraception coverage, as well as the scope of the religious exemption that would apply to employers that seek an exemption from this coverage requirement. Reflecting prior law on this matter, the final rule preserved...

The Affordable Care Act included a number of insurance market reforms designed to make health insurance more affordable and available. During consideration of the ACA, one criticism of the private insurance market was that the lack of standardization in descriptions of health insurance policies available made shopping for coverage both difficult and time consuming. The ACA included provisions designed to assist consumers in better understanding their health insurance coverage, and to assist in comparing their insurance policy with other available options. Among those provisions are requirements for plans offered in both the group and individual insurance markets to provide a summary of benefits and coverage and a uniform glossary of terms commonly used in health insurance policies.

Recent federal regulations requiring insurance coverage of contraception have generated controversy, especially as applied to religious employers. The requirement stems from an ACA provision requiring insurance coverage of preventive services. Section 2713 of the Public Health Service Act, as added by Section 1001 of the Patient Protection and Affordable Care Act (ACA), requires group health plans and health insurance issuers offering group or individual health insurance coverage to provide coverage without cost-sharing for certain preventive services, including preventive treatments and services for women recommended by The Health Resources and Services Administration (HRSA) in guidelines. The preventive services provisions of the Act...

On December 16, 2011, the HHS Center for Consumer Information and Insurance Oversight (CCIIO) released an Essential Health Benefits Bulletin, whose purpose is to “provide information and solicit comments on the regulatory approach that the Department of Health and Human Services (HHS) plans to propose to define essential health benefits under section 1302 of the Affordable Care Act.” Comments on the Bulletin can be sent directly to EssentialHealthBenefits@cms.hhs.gov and will be accepted until January 31, 2011