Human Resources
Yes, Employer, There Is an Escape Clause!—Guidance Exempts Some EAPs and Limited Scope Dental and Vision Plans From HIPAA and ACA

Yes, Employer, There Is an Escape Clause!—Guidance Exempts Some EAPs and Limited Scope Dental and Vision Plans From HIPAA and ACA


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On December 24, 2013, the Departments of Labor, Treasury, and Health and Human Services (the Departments) brought good cheer to employers—proposed regulations that would exempt certain plans from parts of HIPAA and the Patient Protection and Affordable Care Act (Affordable Care Act) by expanding the definition of “limited excepted benefits” to include:

  • Employee Assistance Plans (EAPs) that do not provide significant benefits in the nature of medical care;
  • Self-insured limited scope dental and vision benefits, regardless of whether participants pay a separate contribution; and
  • “Wraparound” employer-provided secondary medical coverage for individuals who purchase coverage in the public Exchanges (marketplaces) because the employer’s primary medical coverage is unaffordable for them.

Under the proposed regulations, EAPs, limited scope dental and vision plans, and wraparound coverage that meet the requirements will be exempt from certain requirements under HIPAA and the Affordable Care Act.

This Aon Hewitt bulletin provides an overview of the proposed regulations.

Download Yes, Employer, There Is an Escape Clause!—Guidance Exempts Some EAPs and Limited Scope Dental and Vision Plans From HIPAA and ACA