From a compliance perspective, 2010 brought some of the most sweeping changes for health and welfare plans we’ve seen in decades.
As we move further into the new year, here’s a recap of some of the changes we experienced in 2010 and some that may be coming in 2011:
Children’s Health Insurance Program Reauthorization Act
This specifies that employers must provide annual notification to employees that they may qualify for premium assistance if your state provides premium assistance subsidies for Medicaid or CHIP plans.
Employers that fail to issue these notices are subject to penalties of up to $100 per day, per employee.
Title II of the Genetic Information Nondiscrimination Act
This went into effect in January. Issued by the Equal Employment Opportunity Commission, the provision is designed to protect individuals from employment discrimination based on their genetic information.
Employers are required to post a notice of employees’ rights regarding genetic information.
Know the rules for group health plans and insurance carriers, along with the impact the clarification has on the use of health risk assessments. These tools are commonly used by wellness and disease management programs.
The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA)
This act imposes requirements on group health plans of employers with more than 50 employees that offer mental health and substance abuse disorder benefits.
MHPAEA expanded the existing parity requirements. Fully insured health plans will be modified for compliance by the insurance company.
Family Medical Leave Act
This act expanded rights for nontraditional families.
Employees who have a parental relationship with a child, regardless of the legal or biological relationship, now can take advantage of the 12 weeks of unpaid leave to care for that child.
Health care reform provisions for 2011
Several key provisions of the health care reform law will go into effect this year, affecting both employers and private insurers.
Among the provisions slated for 2011 are:
- Higher raised premiums for higher-income Medicare beneficiaries;
- Subsidies and drug discounts to help close the Medicare coverage gap;
- Grants to help states launch health insurance exchanges; and
- The establishment of national minimum medical loss ratios for health plans. This will require health plans to report the proportion of premium dollars spent on medical services and provide rebates to consumers if the share of the premium spent on medical services is less than a federally mandated standard.
On January 19, the House voted to repeal health care reform legislation, although the Senate isn’t likely to follow suit. However, republicans may try to dismantle this law using other means.
Hold on tight
Looking back on 2010 is clearly easier than accurately predicting what changes or new requirements might be coming in 2011, especially regarding health care reform.
There are approximately 25 lawsuits filed by numerous states challenging the constitutionality of various provisions of the health care reform laws. Their outcomes, and the debate that is generated from them, deserves close analysis in 2011 and will (dare I say) be interesting to watch.
Hold on tight: Any new matters related to health and welfare plans typically lead to a bumpy ride.
Visit CUNA Mutual’s website for information and resources, including model notices for employees.