ACA Regulations Roundup (and Free Resources)
By Danielle Capilla
Chief Compliance Officer
United Benefit Advisors
The government was busy recently, issuing the massive Benefit Payment and Parameters rule in addition to numerous other updates. Our recent blog reviews the updates to the Benefit Payment and Parameters rule; for more detailed information as it relates to standardized plans, small employer definition, reinsurance fees, rating areas, guaranteed availability, exemptions, and more, download UBA’s ACA Advisor, “Benefit and Payment Parameters Rule and HIP FAQ”.
The IRS has also added filing errors relating to Form 5500 to its project list, and multiple federal agencies confirmed that the just-announced templates relating to the Summary of Benefits and Coverage will not go into effect until the first day of the first plan year beginning on or after April 1, 2017. To plan ahead for the changes, download UBA’s ACA Advisor, “Proposed Summary of Benefits and Coverage Template and Updates” for a summary of all the changes, including how limitations must be communicated and disclosure rules for non-excepted abortion coverage or exclusions.
The Department of Health and Human Services' (HHS) Office for Civil Rights (OCR) has begun its next phase of HIPAA audits for covered entities and business associates. Phase 2 is intended to enhance industry awareness of compliance obligations in relation to HIPAA's Privacy, Security, and Breach Notification Rules.
The Centers for Medicare & Medicaid Services (CMS) has also decided to extend the transition policy that allows insurers in the individual and small group markets to renew policies that would otherwise have to be cancelled because they do not comply with the Patient Protection and Affordable Care Act (ACA) market reforms. In states that permit renewal, policies that have been continuously renewed since January 1, 2014, may renew coverage for policy years beginning on or before October 1, 2017. This date was previously October 1, 2016. Policies renewed under this transition relief will not be out of compliance with the market reforms. The policies cannot extend past December 31, 2017.