Employee Benefits

Preparing for the Future

Ice Miller is reissuing an updated summary of the provisions under the Patient Protection and Affordable Care Act (PPACA) that impact employers.  Ice Miller originally issued this summary on March 30, 2010.  Since that date, the Departments of Health and Human Services, Labor, and the Treasury have issued several rounds of interim final rules and other guidance regarding the PPACA provisions that apply to Group Health Plans.  As of the date of this reissue, guidance has been published with respect to:

• a tax credit available to small employers that offer health coverage to their employees;
• the extension of dependent coverage mandate and related tax relief;
• the Early Retiree Reinsurance Program;
• rules for maintaining grandfathered plan status;
• application of the PPACA coverage reforms on retiree-only health plans and HIPAA excepted benefits;
• the prohibition on lifetime and annual dollar limits and procedures for a temporary waiver;
• the prohibition on pre-existing condition exclusions;
• the prohibition on rescissions in health plans;
• patient protections afforded under the PPACA;
• coverage for preventive health services with no cost-sharing requirements;
• requirements for internal claims and appeals processes and external reviews; and
• the HIPAA opt-out for self-funded nonfederal governmental health plans.

While there is still more expected, a critical mass of guidance has now been issued that allows employers sponsoring group health plans to move toward finalizing plan design changes for next plan year.  As employers begin preparing for open enrollment season in the coming weeks and months, the PPACA provisions discussed in this summary require a fresh look.  Ice Miller has, therefore, revised its original summary to include discussion of relevant guidance and the obligations such guidance places on employers sponsoring group health plans to timely amend plan materials, make required disclosures to employees, and offer special enrollment opportunities to their employees.

View and print the updated summary.

View and print Ice Miller's list of steps that plan sponsors should be taking now to comply.