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Unclear Reform Laws Leave Plan Sponsors Guessing

05/21/13

  09:12:16 pm, by MedBen5   , 222 words,  
Categories: News, Health Plan Management

Unclear Reform Laws Leave Plan Sponsors Guessing

“We don’t know how much information the Department of Health and Human Services will want.” According to Employer Benefits News, this statement became something of a mantra during a talk on the Affordable Care Act.

Speaking at the International Foundation of Employee Benefit Plans’ Washington legislative update earlier this week, Mark Nielsen repeatedly expressed his frustration with HHS. “Bottom line is, we don’t know how much information HHS is going to be requesting on [plan participants], but it is going to be new reporting from what happened with the plans previously that you have not had to do, so you want to be aware of that,” said Nielsen, a principal with the Groom Law Group with experience in fiduciary duty, ERISA and other labor law issues.

Nielsen said that plan sponsors are hopeful that the HHS would provide “more and better guidance” on specifics to the law, but in the meantime are focused on such upcoming provisions as health care exchanges, the individual mandate and the employer mandate. He also noted that lack of state participation in the exchanges caught the Obama administration off guard.

One thing Nielsen knows is definitely set: a new cost sharing limit. “Participants out-of-pocket expense cannot be more than $6,350 for individuals or $12,000 for families. That applies in both the insured market and the self-funded market.”

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