Tying up Loose Ends

The Health and Human Services Department, the Labor Department, and the Internal Revenue Service did make the grandfathered plan regulation public yesterday. Here are links to the regulation, the Departments’ fact sheet, and the Departments’ questions and answers. Essentially grandfathering permits the plan sponsor, OPM in the case of the FEHB Program, to retain more control over its plan/program. The regulation was issued as an interim final rule. The Departments will be accepting public comments for sixty days from the date the regulation is published in the Federal Register.

Footnote 7 of the regulation’s preamble explains that

Independent of these rules regarding the impact on grandfather status of newly adopted or reduced annual limits, group health plans and group or individual health insurance coverage (other than individual health insurance policies that are grandfathered health plans) are required to comply with PHS Act section 2711, which permits restricted annual limits (as defined in regulations) until 2014. The Departments expect to publish regulations regarding restricted annual limits in the very near future.

This is the last piece of the 2011 puzzle.

Yesterday, CMS extended the hold on Medicare Part B claims processing through this Thursday in the hope the Senate will act on the doctor fix this week according to Kaiser Health News.

The FEHBlog recently explained that there are a lot of time consuming operational / computer programming issues associated with PPACA’s expansion of dependent children coverage.  AIS Health Plan Week adds support for the FEHBlog’s position.