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  • Compromise on Contraceptive Coverage for Religious Employers

    February 21, 2012 - no Comments

    Under health care reform, non-grandfathered health plans must cover women’s preventive care services, including contraception, without charging a co-pay or deductible. This rule is effective as soon as August 2012 for some plans. Churches, other houses of worship and similar organizations are exempt from covering contraception on the basis of their religious objections. However, this exemption does not cover other church-affiliated institutions, such as schools, charities, hospitals and universities. On Feb. 10, 2012, President Obama announced a proposal to address objections of non-exempt religious organizations. Under this proposal, the organization may choose whether or not to cover contraceptives. The insurance

  • HealthCare Reform: Nondiscrimination Rules for Fully-insured Group Health Plans

    February 21, 2012 - no Comments

    Under health care reform, some fully insured group health plans will be required to comply for the first time with federal nondiscrimination rules related to compensation. These rules prohibit discrimination in favor of highly compensated individuals (HCIs). They will apply to non-grandfathered, fully insured plans only. The nondiscrimination rules were set to be effective for plan years beginning on or after Sept. 23, 2010. However, they have been delayed indefinitely, pending the issuance of regulations. Once regulations are issued, they will specify the new effective date. Please read below for general information on the existing nondiscrimination requirements that will be

  • HealthCare Reform: 60-Day Advance Notice of Plan Changes

    February 14, 2012 - no Comments

    The Patient Protection and Affordable Care Act (PPACA) requires health plans and health insurance issuers to provide a summary of benefits and coverage (SBC) to applicants and enrollees. The SBC is intended to be a concise explanation of important health plan information. Its purpose is to help consumers better understand their coverage options. The SBC requirement applies to both non-grandfathered and grandfathered plans. In addition, PPACA requires plans and issuers to keep the SBC up-to-date by giving at least 60 days’ advance notice of certain changes to their plans. Changes that must be disclosed are material modifications in plan terms

  • Types of Coverage Subject to Form W-2 Reporting

    February 14, 2012 - no Comments

    The Patient Protection and Affordable Care Act (PPACA) requires employers to report the aggregate cost of employer-sponsored group health coverage on employees’ Forms W-2. The purpose of the reporting requirement is to provide employees with useful and comparable information on the cost of their health coverage. It does not cause employer-provided health coverage to become taxable. For 2011, this informational reporting was optional for all employers. The reporting requirement remains optional for small employers (those that filed fewer than 250 Forms W-2 for the preceding calendar year) for 2012 and for later years until the IRS issues further guidance. All

  • Overview of Grandfathered Plans

    February 13, 2012 - no Comments

    The health care reform law contains many provisions that affect the health coverage you provide for your employees. The extent of the law’s impact depends, in part, on whether you maintain a “grandfathered” health plan. Grandfathered plans can avoid a number of the health care reform provisions. This The Horton Group, Inc.  Legislative Brief provides an overview of grandfathered plans, including information to help you understand what makes a plan “grandfathered.” It also includes a summary of the health care reform provisions that are applicable to grandfathered plans and those that are inapplicable to grandfathered plans. GRANDFATHERED STATUS What Is

  • HealthCare Reform: Grandfathered Plans – Permitted and Prohibited Changes

    February 13, 2012 - no Comments

    The health care reform law contains numerous changes for group health coverage. The extent of the law’s impact on an employer’s health plan depends, in part, on whether the health plan has “grandfathered” status. A grandfathered plan is a group health plan that existed on March 23, 2010 (the date the health care reform law was enacted) and has not had certain prohibited changes made to it. If a plan is grandfathered, it is exempt from certain health care reform requirements, such as the requirement to provide preventive health services without cost-sharing. If a plan loses its grandfathered status, it