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Compliance Bulletins

Temporary Guidance on the Employee Notice of Exchange Options
May 2013
On May 8, 2013, the Department of Labor (DOL) provided temporary guidance and model notices that employers can use to inform their employees about the Exchanges, which will be available January 1, 2014. Please note that the Department of Health and Human Services (HHS) now calls the Exchange the “Health Insurance Marketplace,” and DOL refers to the notice as the “Employee Notice of Coverage Options.”

The original deadline for providing this notice to employees was March 1, 2013. The effective date has been changed to October 1, 2013 to coincide with the Exchange or Marketplace open enrollment period, which also begins on that date. Employers who want to start providing notices sooner can follow this temporary guidance and use these model notices. However, employers are not required to provide notices under this temporary guidance and can wait until formal guidance is provided later this year.
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Massachusetts Allowed to Phase in ACA Rating Rules
April 2013
Federal regulators gave Massachusetts—a state with an individual mandate much like the Affordable Care Act’s (ACA)—rare permission to phase in ACA rating rules over three years. But many businesses that argued for an outright exemption are not happy.
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Key Exchange Feature For Small Business Postponed Until 2015
April 2013
The Obama administration is postponing a feature of the Small Business Health Options Program (SHOP) on federally facilitated exchanges. SHOP exchanges will launch in 2014 with an employer choice model, but an employee choice model will not be available until 2015 on federally facilitated exchanges.
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Study Shows Health Reform Could Mean ‘Sticker Shock’ in 2014
April 2013
New evidence points to a likely outbreak of health insurance sticker shock when the bulk of the Affordable Care Act (ACA) takes effect in 2014. A Society of Actuaries report predicts medical claims costs will jump an average 32 percent for individual policies next year.
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Poll Shows Americans Still Uncertain of Health Reform Law
March 2013
A new tracking poll shows two-thirds of the uninsured are struggling to understand how the Affordable Care Act (ACA) will impact them and awareness of the law’s key elements has declined somewhat since its passage.
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House and Senate Committees Adopt Much Different Budgets
March 2013
The House Budget Committee adopted a budget resolution drafted by Representative Paul Ryan (R-WI) that calls for $4.633 trillion deficit reduction over 10 years and the repeal of the Affordable Care Act. The Senate Budget Committee approved a budget drafted by Senator Patty Murray (D-WA) that calls for $975 billion in new revenue and $975 billion in cuts over 10 years.
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New Regulations released on Individual Mandate
February 2013
Federal regulators released new regulations last week that address perhaps the most controversial provision of the Affordable Care Act (ACA) – the individual mandate.
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Coalition Calls for Scaling Back Essential Health Benefits
January 2013
The Essential Health Benefits Coalition last week called on regulators to revise the essential health benefits rules to prevent the cost of coverage, in the new insurance marketplace that starts in 2014, from being out of reach for many businesses and consumers.
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Congress Returns To More Budget, Debt Ceiling Talks
January 2013
Congress returned this week to a resumption of the budget and debt ceiling issue. The House has announced it will vote this week on a short-term extension of the debt limit.
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Fiscal Cliff Deal Will Impact Health Care Programs
January 2013
The “fiscal cliff” deal includes provisions that will have an impact on Medicare and other health care programs. For example, the remaining money set aside to fund new Consumer Oriented and Operated Plans (CO-OPs) has been cut, and the Community Living Assistance Services and Support program, or CLASS Act, was officially repealed.
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Eight State-Based Health Exchanges Get Conditional Approval
December 2012
State-based health insurance exchanges in eight states and the District of Columbia received conditional approval from the Department of Health and Human Services (HHS) last week. Another 10 states have submitted applications for state-based exchanges, which HHS is now reviewing.
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Health Care Reform Tax Will Increase Health Coverage Costs
December 2012
A new state-by-state analysis shows that the new health insurance tax established by the Affordable Care Act (ACA) will increase the cost of health care coverage for consumers and employers in every state.
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Exchanges a Growing Part of Post-Elections Market
December 2012
While efforts to strike a bipartisan deal to avoid the “fiscal cliff” remain stalled, a new report released last week shows that the post-elections market for health insurance exchanges will grow 30 percent to 40 percent in the next year.
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All Eyes Turn To Debt Reduction Talks in Washington
November 2012
A group of 12 business leaders that included Aetna Chairman and CEO Mark Bertolini met last week with President Barack Obama to urge a solution to the debt-related problem known as the “fiscal cliff.” By week’s end, the president met with Congressional leaders in initial debt-reduction talks described as conciliatory.
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Affordable Care Act A Go After Presidential Election
November 2012
The re-election of President Obama last week virtually ended the threat of repeal of the Affordable Care Act (ACA), but that does not mean smooth sailing for all aspects of the law. The Congressional Budget Office has released a new report outlining deficit-reduction options that include sacrificing some ACA provisions.
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Health Care Research Emerges In Campaign’s Final Days
November 2012
With the presidential campaign in its final week, the Commonwealth Fund released new research illustrating how health care reform can help stop the decline in small business health care coverage, while Forbes reported that the health reform law is actually driving up consumer costs in eight key swing states.
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CEOs Call on Congress to Fix the Deficit
November 2012
The CEOs of more than 80 American corporations, including Aetna, have banded together to pressure Congress to avoid the “fiscal cliff” at year-end by striking a deal to reduce the federal debt through both spending cuts and revenue increases.
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Candidates Spar Over Future of Medicare
October 2012
Last week’s presidential debate included debate over the health care reform law’s impact on the future of Medicare, in particular the impact of a $700 billion reduction in projected Medicare spending under the law.
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Marketplace Changing in Advance of Health Exchanges
October 2012
A well-known restaurant chain made headlines last week when it disclosed that it was shifting more workers to part-time status in four test markets across the country in advance of 2014 implementation of health insurance exchanges and new penalties on larger employers that fail to offer health benefits.
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Voters More Concerned About Medicare Than Health Reform
October 2012
Americans now are more concerned about Medicare than the merits of the Affordable Care Act, according to a new poll. For seniors, Medicare is just as important an issue as the economy.
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Americans Now Think Health Reform Law Is Here To Stay
October 2012
If Americans remain divided over the merits of the Affordable Care Act, a new poll shows most now believe it is here to stay, though possibly in a revised form. At the same time, new research shows it is getting tougher to control rising health care costs.
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Congress Funds Government Six More Months
September 2012
Shortly before heading out of town on a break that will last until after election day, the Senate passed a continuing resolution that extends government funding through March 27, 2013. The President is expected to sign the measure.
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SBC Requirements Effective September 23, 2012
September 2012
One of the new compliance requirements added by the Patient Protection and Affordable Care Act (“PPACA”) is the obligation to furnish participants in a group health plan with a Summary of Benefits and Coverage or “SBC.” The Summary of Benefits and Coverage is a 4-page summary of material provisions of a health plan in a uniform format, accompanied by a glossary of health coverage and medical terms.
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Census Bureau Report Shows Uninsured Rate Declining
September 2012
A U.S. Census Bureau report released last week shows the number of uninsured has declined for the first time since 2007, a drop attributed in part to the Affordable Care Act requirement expanding coverage for dependent children up to age 26.
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Republican Platform Includes Plan to Reshape Medicare
September 2012
The Republican National Convention recently adopted a party platform that calls for significant changes to Medicare and Medicaid in keeping with proposals made by U.S. Rep. Paul Ryan, the party’s nominee for vice president.
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Congressional Budget Office Updates Medicare and Medicaid Spending Projections
August 2012
The Congressional Budget Office has released updated projections that show Medicare and Medicaid spending growing from 3.7 percent of Gross Domestic Product in 2013 to 4.3 percent in 2022.
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HHS Issues Health Insurance Exchange Blueprint
August 2012
HHS has issued a final “blueprint” that states can use to operate their own health insurance exchange markets, or to partner with the federal government.
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Survey Shows Employers Expect Costs to Rise Under Health Care Reform Law
August 2012
A new survey from Mercer Consulting has found that more than 60 percent of employers expect that the Affordable Care Act (ACA) will mean higher costs for them.
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Preventative Services and the Affordable Care Act
August 2012
Required coverage for preventative care services has expanded. Learn which services are now covered.
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Prepare for Insurance Rebate Checks
July 2012
Now that the U.S. Supreme Court has upheld the Patient Protection and Affordable Care Act (PPACA), employers must pay close attention to insurance “rebates” that may be issued to health plan participants beginning next month.
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Health Reform Requirements 2013 and Beyond
July 2012
Learn about new requirements that take effect before the Affordable Care Act is fully implemented.
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