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Reform News That Matters

Health Care Reform News

  For You & Your Family    For Your Employees
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ACA News for Providers

 

  Important news on the ACA as published in BlueInk.    

Affordable Care Act final rules, proposed rules and guidance

Below are links to Affordable Care Act final rules, proposed rules or guidance issued by the federal government.

 

Final Rules
Proposed Rules 
Guidance and FAQs

 

 

Final Rules

Date

Document Title

Topic(s)

2/26/13 Standards Insurance Market Reforms and Rate Rules 
  • Insurance Market Reforms
  • Rate Review
  • Participation/Contribution Requirements
  • Family Rating
  • Rating Geography Requirements
  • Tobacco Rating
 2/8/12 Health Insurance Premium Tax Credit
  • Affordable Coverage Defined
  • Premium Tax Credit

12/31/12

Taxable Medical Devices
  • Medical devices

12/31/12

Final Rules - Patient-Centered Outcome Research Institute Fees
  • Patient-Centered Outcomes Research (PCORI) Fees
  • PCORI
  • Comparative Effectiveness Research Fee

 

 

Proposed Rules

Date

Document Title

Topic(s)

3/19/13 Proposed Rule on 90-Day Waiting Period Limitation and Technical Amendments to Certain Health Coverage Requirements Under the Affordable Care Act
  • 90-Day Waiting Period
  • Creditable Coverage

2/8/13

Shared Responsibility Payment for Not Maintaining Minimum Essential Coverage
  • Individual Shared Responsibility
  • Individual Mandate
  • Minimum Essential Coverage
  • Individual tax penalties 

2/8/13

Exchange Functions: Eligibility for Exemptions; Miscellaneous Minimum Essential Coverage Provisions
  • Exchange Functions
  • Exchange Exemptions
  • Minimum Essential Coverage
  • Individual Shared Responsibility
  • Individual Mandate 

1/15/13

Eligibility Requirements for Medicaid, the Children's Health Insurance Program (CHIP), and Exchanges
  • Eligibility for Medicaid
  • Eligibility for CHIP
  • Eligibility for Exchanges 

1/13/13

Shared Responsibility for Employers Regarding Health Coverage 
  • Employer Shared Responsibility
  • Employer Penalties 

12/31/12

Standards Related to Essential Health Benefits, Actuarial Value and Accreditation
  • Essential Health Benefits
  • Actuarial Value
  • Accreditation

12/31/12

Incentives for Non-discriminatory Wellness Programs in Group Health Plans
  • Employer Based Wellness Programs

12/31/12

Health Insurance Market Rules
  • Market Rules

 

 

Guidance and FAQs

Date

Document Title

Topic(s)

1/24/13

FAQ Issued — ACA Part XI
  • Notification of Exchanges
  • HRAs
  • Doctor/Patient Communications
  • Prescription Supplemental Benefits
  • Excepted Benefits
  • Payment of PCORI fees by multi-employer plans 

 

 

Wellmark is not providing any legal or professional advice with regard to compliance with any federal or state law, regulations, or guidance. Law, regulations and guidance on specific provisions has been and will continue to be provided by the appropriate federal and state agencies and regulators. The information provided reflects Wellmark's understanding of the most current information and is subject to change without further notice. Please note that plan benefits, rates, renewal rate adjustments, and rating impact calculations are subject to change and may be revised during a plan's rating period based on guidance and regulations issued by the appropriate federal and state agencies and regulators. Wellmark makes no representation as to the impact of plan changes on a plan's grandfathered status or interpretation or implementation of any other provisions of law or regulation. Wellmark will not determine whether coverage is discriminatory or otherwise in violation of Internal Revenue Code Section 105(h). Wellmark also will not provide any testing for compliance with Internal Revenue Code Section 105(h). Wellmark will not be held liable for any penalties or other losses resulting from any employer offering coverage in violation of section 105(h). Wellmark will not determine whether any change in an Employer Administered Funding Arrangement affects a health plan's grandfathered health plan status under ACA or otherwise complies with ACA. Wellmark will not be held liable for any penalties or other losses resulting from any Employer Administered Funding Arrangement. For purposes of this paragraph, an "Employer Administered Funding Arrangement" is an arrangement administered by an employer in which the employer contributes toward the member's share of benefit costs (such as the member's deductible, coinsurance, or copayments) in the absence of which the member would be financially responsible. An Employer Administered Funding Arrangement does not include the employer's contribution to health insurance premiums or rates.


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