Health Care Reform News

FAQ Issued - ACA Part XI

January 24, 2013


The Department of Labor, Health and Human Services (HHS) has released a set of FAQs regarding implementation of various provisions of the Affordable Care Act (ACA). Of particular note to employer groups is an FAQ which provides an extension of the previous provision requiring employers to notify employees regarding the exchanges as of March 2013. The FAQ was prepared by the HHS and the Treasury.


Topics covered in the FAQ include:

  • ACA provision (Section 1512) required employer notification of exchanges by March 2013. The new FAQ acknowledges that the timing for such notice is unrealistic and the agency will issue additional guidance in the future, moving the implementation date to late summer or the fall of 2013. 
  • The use of Health Reimbursement Arrangements (HRAs) in employer-based coverage:
    • An employer-sponsored HRA cannot be integrated with individual market coverage because this would violate the ACA's ban on annual or lifetime limits;
    • If an employee is offered coverage, but does not enroll in it, an HRA provided to the employee violates the ACA's ban on annual or lifetime limits; and
    • Guidance will be issued limiting amounts provided under HRAs issued in 2013 to amounts provided under HRAs issued in 2012.
  • A statement that nothing in the ACA prohibits or otherwise limits communication between health care professionals and their patients, including communications about firearms.
  • Prescription supplemental benefits that are non-Medicare benefits offered under Part D Employer Group Waiver Plans (EGWPs) rules will not be subject to ERISA if the group health plan is self insured. If the plan is offered on an insured basis, non-Medicare prescription supplemental benefits will be considered as excepted benefits under the Public Health Service Act. 
  • A statement that fixed indemnity coverage constitutes excepted benefits if the coverage pays on a per-period basis as opposed to a per-service basis
  • A statement that a multiemployer plan's joint board of trustees may pay the Patient-Centered Outcomes Research Institute fee from assets of the plan unless the plan document specifies a source other than plan assets for payment of the fee. 

To learn more about this proposed rule, see the attached document. Please know that the information Wellmark is providing is for informational purposes only. These proposed rules are not binding until final regulation has been issued.


We will continue to provide timely information as it becomes available. Additional information on health care reform can be found on


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