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Regulatory Guidance Under the Affordable Care Act

2014-02-03

The enactment of comprehensive health care reform has resulted in many questions for employers. Aon Hewitt's resources can help employers navigate the regulatory guidance being issued by government agencies to implement the Affordable Care Act.

President Obama signed the "Patient Protection and Affordable Care Act" and the "Health Care and Education Reconciliation Act of 2010" into law in March 2010, completing his vision of enacting a comprehensive health care reform package during his presidency. Taken together, the two laws are called the "Affordable Care Act."

Read Aon Hewitt's Washington Report and visit the Aon Hewitt Health Care Reform microsite for the latest health care reform developments.

Affordable Care Act: Guidance

The following resources provide more information on guidance issued under the law that is of importance to employers.


Topics

Frequently Asked Questions (FAQs) | Wellness Programs |Medical Loss Ratio (MLR) |Tax Provisions |Patient-Centered Outcomes Research Trust Fund | Shared Responsibility Provisions | Summary of Benefits and Coverage | Risk and Reinsurance |Health Insurance Exchanges | Form W-2 Reporting | Nondiscrimination Testing | FSAs/HRAs/HSAs | "Patient's Bill of Rights" — Lifetime/Annual Limits and Rescissions | Preventive Services | Claims and Appeals and External Review Processes | Grandfather Status | Dependent Coverage | Early Retiree Reinsurance Program (ERRP) | Aon Hewitt Resources


Frequently Asked Questions (FAQs)

Into the Woods—Latest Round of FAQs Addresses Details of Cost Sharing, Wellness, Preventive Services, and Transitional Reinsurance Fee (January 09, 2014)

That's All Folks?—Agencies Say Some Affordable Care Act Rules Will Be Implemented Without Guidance (April 29, 2013)

Agencies Release 12th Set of FAQs on Health Care Reform Transition Rule (February 20, 2013)

Affordable Care Act FAQs Offer Employers the Good, the Bad, and the Ugly on Notices, EGWPs, Fixed Indemnity, and HRAs (January 24, 2013)

Agencies Release Sixth Set of FAQs on Affordable Care Act (April 1, 2011)

Agencies Release Fifth Set of FAQs on the Affordable Care Act (December 10, 2010)

Agencies Release Fourth Set of FAQs on Affordable Care Act (November 2, 2010)

Agencies Release Additional Guidance on Affordable Care Act Implementation Issues (September 22, 2010)


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Wellness Programs

If at First You Don’t Succeed, Try, Try Again: Agencies Require Reasonable Alternatives for Individuals Who Fail Health-Contingent Wellness Programs (May 29, 2013)

Agencies Propose New Wellness Program Rules (November 20, 2012)


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Medical Loss Ratio (MLR)

Employers Need to Address Medical Loss Ratio Rebates Paid by Health Insurers (July 23, 2012)


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Tax Provisions

How “Minimum” Is Your Health Insurance Coverage? IRS Proposes Regulations on Offering and Maintaining Minimum Essential Coverage Starting in 2014 (February 1, 2013)

IRS Issues Rules on New Taxes Imposed by the Affordable Care Act (December 5, 2012)

IRS Releases Final Regulation on Federal Premium Tax Credit for Health Insurance Purchased in State Exchanges (May 18, 2012)

Aon Hewitt Submits Comments on Proposed Rule on the Health Insurance Premium Tax Credit (October 27, 2011)

IRS Proposes Rules for Federal Subsidy of Health Insurance Purchased in State Exchanges (August 12, 2011)


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Patient-Centered Outcomes Research Trust Fund

PCORI Fee Due July 31; IRS Updates Form 720 (June 3, 2013)

IRS Releases Final Regulations Imposing PCORI Fee on Sponsors of Fully Insured and Self-Insured Health Plans (December 5, 2012)

Aon Hewitt Submits Comments on Fees on Health Insurance Policies and Self-Insured Plans for the Patient-Centered Outcomes Research Trust Fund (July 23, 2012)

IRS Releases Proposed Regulations Regarding Fees Imposed on Health Insurers and Health Plan Sponsors to Fund Patient-Centered Outcomes Research Trust Fund (April 17, 2012)

Aon Hewitt Submits Comments on Notice 2011-35 (Funding Comparative Clinical Effectiveness Research Through Patient-Centered Outcomes Trust Fund) (September 6, 2011)


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Shared Responsibility Provisions

The Wait Is Over—Government Issues Final Regulations on 90-Day Waiting Period (February 24, 2014)

IRS Eases Employers Into Employer Mandate (February 10, 2014)

Summer Arrives—Administration “Beaches” Employer Shared Responsibility Payments for 2014 (July 9, 2013)

Affordable Care Act's Employer Mandate Goes to the Waiting Room (July 2, 2013)

Up in Smoke?—IRS Filters Out Most Wellness Programs From Affordability and Minimum Value Tests and Clears the Air on COBRA and Retiree Medical Coverage (April 30, 2013)

Proposed Regulations Implement 90-Day Waiting Period and End HIPAA Creditable Coverage Certificates (March 18, 2013)

Aon Hewitt Submits Comments on Shared Responsibility for Employers Regarding Health Coverage (March 18, 2013)

Final Rule Limits Out-Of-Pocket Maximums; Addresses Minimum Value and Essential Health Benefits (February 25, 2013)

IRS Proposes Rules on Employer Shared Responsibility Payment (December 28, 2012)

HHS Proposes Rule Related to Calculating Minimum Value of Employer-Provided Health Coverage (November 20, 2012)

Agencies Provide Guidance on Determining Full-Time Employees and 90-Day Waiting Period (August 31, 2012)

Aon Hewitt Submits Comments on Reporting of Health Insurance Coverage (June 11, 2012)

Aon Hewitt Submits Comments on Reporting by Applicable Large Employers on Health Insurance Coverage Under Employer-Sponsored Plans (June 11, 2012)

Agencies Issue Requests for Comments on Determining Minimum Value of an Employer Plan, Reporting Requirements, and Verification of Access to Employer Coverage (April 26, 2012)

Agencies Answer Employer Questions on Automatic Enrollment, Employer Shared Responsibility, and Waiting Periods (February 9, 2012)

Aon Hewitt Submits Comments on Health Coverage Affordability Safe Harbor for Employers (December 13, 2011)

Aon Hewitt Submits Comments on Shared Responsibility for Employers Regarding Health Coverage (June 17, 2011)


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Summary of Benefits and Coverage

FAQs Provide Guidance on 2014 SBCs: You Get What You Get and You Don't Get Upset (April 23, 2013)

Agencies Issue Additional FAQS on Summary of Benefits and Coverage (May 11, 2012)

Agencies Release FAQs on Compliance With Summary of Benefits and Coverage Provisions (March 19, 2012)

Agencies Release Final Regulations Regarding Summary of Benefits and Coverage and Uniform Glossary Requirements (February 9, 2012)

Agencies Delay Effective Date of Summary of Benefits and Coverage and Address Mental Health Parity Issues (November 17, 2011)

Aon Hewitt Submits Comments on Summary of Benefits and Coverage (October 20, 2011)

Agencies Release Proposed Regulations and Request for Comments Regarding Summary of Benefits and Coverage and Uniform Glossary Requirements (August 17, 2011)


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Risk and Reinsurance

HHS Final Rule on Transitional Reinsurance Fee Adds to Employer Costs (March 1, 2013)

Aon Hewitt Submits Comments on Notice of Benefit and Payment Parameters for 2014 (December 31, 2012)

HHS Proposes $63 Transitional Reinsurance Fee for Group Health Plans in 2014 (November 30, 2012)

Affordable Care Act's Reinsurance Fee Hits Employer Plans Beginning in 2014 (August 10, 2012)

Aon Hewitt Submits Comments on Standards Related to Reinsurance, Risk Corridors and Risk Adjustment (October 17, 2011)


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Health Insurance Exchanges

Have You Heard? Employers Must Notify Employees of Exchange Option (March 08, 2013)

New HHS Regulations Make "SHOP"-ing Easy in 2014 (March 11, 2013)

HHS Finalizes Rule on Implementing Health Insurance Exchanges (March 12, 2012)

Aon Hewitt Submits Comments on Proposed Rule on Exchange Functions in the Individual Market: Eligibility Determinations and Exchange Standards for Employers (October 31, 2011)

Aon Hewitt Submits Comments on the Establishment of Exchanges and Qualified Health Plans (September 23, 2011)

HHS Issues Proposed Rules on Implementing Health Insurance Exchanges (July 11, 2011)


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Form W-2 Reporting

IRS Releases Additional Guidance on Informational Reporting to Employees the Cost of Group Health Insurance Coverage (January 3, 2012)

Aon Hewitt Submits Comments on Interim Guidance on Informational Reporting to Employees of the Cost of Their Group Health Insurance Coverage (July 15, 2011)

IRS Issues Guidance on Reporting Cost of Health Care on Form W-2 (March 29, 2011)

IRS Provides Form W-2 Reporting Relief to Employers; Releases Draft Form W-2 (October 12, 2010)


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Nondiscrimination Testing

Aon Hewitt Submits Comments on Affordable Care Act Nondiscrimination Provisions Applicable to Insured Group Health Plans (March 11, 2011)

Sponsors of Fully Insured Health Care Plans Get Early Christmas Gift as Treasury Postpones Testing Rules (December 22, 2010)

Aon Hewitt Submits Comments on Requirements Prohibiting Discrimination in Favor of Highly Compensated Individuals in Insured Group Health Plans (November 8, 2010)


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FSAs/HRAs/HSAs


In Perfect Harmony—IRS Clarifies Health FSA Carryover Impact on Eligibility to Contribute to an HSA (March 28, 2014)


IRS’s Halloween Guidance “Treats” Health FSAs to $500 Carryover “Trick” (October, 2013)


So Complex It’s Scary: Friday the 13th Affordable Care Act Guidance on HRAs, Health FSAs, and EAPs (September 25, 2013)

Aon Hewitt Submits Comments on Possible Modification of Use-or-Lose Rule for Health FSAs (August 17, 2012)

Like a Cool Summer Breeze, the IRS Provides Relief to Non-Calendar Year Health FSAs and Clarifies the $2,500 Limit (May 30, 2012)

Ring it Up! The IRS Issues Guidelines for Health FSAs and HRAs Allowing Use of Debit Cards to Purchase Over-the-Counter Medicines (December 23, 2010)

Just What the Doctor Ordered — IRS Issues Guidance on Over-the-Counter Medicine Reimbursements for FSAs and HRAs (September 8, 2010)


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"Patient's Bill of Rights" — Lifetime/Annual Limits and Rescissions

CMS Issues New Guidance for Mini-Med Waivers (June 17, 2011)

Subregulatory Guidance Issued on Annual Limit Waivers and MLR for Mini-Med Policies (November 12, 2010)

HHS Releases Guidance on Annual Dollar Limit Waivers (September 8, 2010)

Hewitt Submits Comments on Interim Final Rules Related to Lifetime and Annual Limits, Rescissions (August 26, 2010)

Agencies Issue Regulations Implementing Health Care Reform "Patient's Bill of Rights" (June 23, 2010)


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Preventive Services

Obama Administration Modifies Rules on Religious Organizations and Coverage of Contraceptives (February 1, 2013)

Aon Hewitt Submits Comments on Women's Preventive Services (September 30, 2011)

Agencies Issue Additional Details on Preventive Care Requirements for Women (August 1, 2011)

Aon Hewitt Submits Comments on Value-Based Insurance Design (February 28, 2011)

Hewitt Submits Comments on Interim Final Rules on Preventive Services (September 17, 2010)

Agencies Release Interim Final Rule on Preventive Care (July 15, 2010)


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Claims and Appeals and External Review Processes

Aon Hewitt Submits Comments on Amendment to Interim Final Rules Relating to Internal Claims and Appeals and External Review Processes (July 25, 2011)

Agencies Release Amended Procedures for Internal Claims and Appeals and External Review (June 22, 2011)

DOL Extends Enforcement Grace Period for Certain Internal Claims and Appeals Procedures (March 18, 2011)

Hewitt Submits Comments on Claims and Appeals and External Review Processes (October 6, 2010)

HHS Issues Guidance on Federal External Review Process for Fully Insured Group Health Plans (September 2, 2010)

Agencies Release Interim Procedures for Federal External Review and Model Notices (August 24, 2010)

Agencies Release Interim Final Rule on Claims and Appeals and External Review Processes (July 23, 2010)


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Grandfather Status

Agencies Amend Grandfather Rules to Allow Change in Insurance Issuers or Policies (November 16, 2010)

Hewitt Submits Comments on Interim Final Rules on Retaining Status as a Grandfathered Health Plan (August 16, 2010)

Agencies Issue Interim Final Rule on Grandfather Status (June 14, 2010)


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Dependent Coverage

Hewitt Submits Comments on Interim Final Rules on Adult Child Coverage to Age 26 (August 16, 2010)

DOL Issues Model Notices for Patient Protections, Annual/Lifetime Limits, Dependent Coverage Extensions (June 28, 2010)

Agencies Issue Interim Final Rules on Dependent Coverage to Age 26 (May 10, 2010)

IRS Releases Guidance on Tax Treatment of Health Care Coverage Provided to Adult Children (April 27, 2010)


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Early Retiree Reinsurance Program (ERRP)

Complicated Answers to Common Questions—CMS Releases More Guidance on the Early Retiree Reinsurance Program (ERRP) (November 30, 2012)

HHS Releases ERRP Reimbursement Guidance (September 30, 2010)

HHS Announces Approved ERRP Applicants; New Resources Available for Employers (September 1, 2010)

HHS Now Accepting Early Retiree Reinsurance Program Applications (June 29, 2010)

Hewitt Comments on Early Retiree Reinsurance Program (June 4, 2010)

HHS Proposes New Recordkeeping System for the Early Retiree Reinsurance Program (June 3, 2010)

HHS Issues Important Interim Final Rule on Early Retiree Reinsurance Program (May 4, 2010)


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Aon Hewitt Resources

CMS Says Obama Fix Applies to Small Group and Individual Policies (November 14, 2013)

Debt Deal Contains Verification Requirement for Affordable Care Act Exchange Subsidies (October 17, 2013)

Supreme Court Strikes Down Key Section of DOMA; Dismisses Prop 8 Case on Jurisdictional Grounds (June 26, 2012)

U.S. Supreme Court Upholds Affordable Care Act (June 28, 2012)

Supreme Court Hears Oral Arguments on Affordable Care Act (March 26-28, 2012)

Special Report: With Passage of Reconciliation Bill, U.S. Congress Completes Health Care Reform (March 30, 2010)


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