Healthcare reform continues to be a priority issue for Oklahoma municipalities. OMSC partners want to ensure that our members are kept informed on any upcoming issues that may affect them in the near future. When it’s time to renew your employee health insurance, please check with one of our OMSC Healthcare Partners for benefits geared towards cities and towns. For further information contact Nancee Morris at OML or contact one of our OMSC healthcare partners.
The month of November brought a new delay in reporting required from self-funded plans. It also brought several new notices and regulations that may affect sponsors of group health plans and an updated employer guide and health plan compliance checklist from the Department of Labor (DOL).
Stop Loss Insurance Regulations Issued - AFA 11/14/14
On November 6, 2014, the U.S. Department of Labor (DOL) issued guidance on state regulation of stop-loss insurance for self-insured group health plans.
The guidance provides that unless prohibited by state insurance law, a stop-loss insurer could offer insurance policies with attachment points set so low that the insurer assumes nearly all of the employer's claim's risk.
Some states have considered measures to prohibit insurers from issuing stop-loss contracts with attachment points below a specified level, but have been unsure that they may regulate stop-loss coverage due to ERISA preemption of state regulation of private sector employee benefit plans.
The guidance clarifies the role of states to regulate stop-loss insurance for employee benefit plans while maintaining an employer’s flexibility in stop loss design based on what is allowable in its state of residence.
This effectively provides the employer with the advantage of not being required to meet state insurance laws with a self-funded major medical plan and the ability to shift the risk of the self-funded plan through stop-loss insurance.
Healthcare Reform Newsletter from American Fidelity Assurance, October 3rd, 2014: Includes New Resources Available to Assist with November 5, 2014 HPID Requirement, Additional resources from AFA about Healthcare Reform
AFA Information on New Rules: On August 28, 2014, the IRS released long-awaited draft instructions for completing and filing the forms that employers and insurers must submit annually to report on health coverage as required by the Patient Protection and Affordable Care Act (ACA) under Internal Revenue Code Sections 6055 and 6056.
More information about the requirements, along with the draft forms and instructions, are available on our website.
UBA PPACA Advisor: September 22, 2014: What Employers Need to Know Right Now About Health Care Reform; Includes IRS Issues Drafts of Instructions for Employer and Individual Responsibility Reporting Forms