The Obama administration has posted a 32-page batch of Patient Protection and Affordable Care Act (PPACA) regulations that could reshape some non-medical health benefits.
The package, Amendments to Excepted Benefits, affects one category of benefits that are free from most of the requirements that apply to major medical coverage: “limited excepted benefits.” The category includes dental benefits, vision benefits, long-term care (LTC) benefits and some other types of benefits, such as employee assistance plans (EAPs).
The Internal Revenue Service (IRS), the Employee Benefits Security Administration (EBSA) and the U.S. Department of Health and Human Services (HHS) have decided to let employers with self-insured dental and vision plans treat the plans as excepted benefits without necessarily having to charge workers separate premiums for the benefits.
The excepted-benefits regulation changes that affect vision and dental benefits will also apply to employer-sponsored LTC benefits, such as long-term care insurance (LTCI) benefits or home care benefits, officials say in a preamble to the final rule.
The IRS, EBSA and HHS have decided that the provider of an EAP program with excepted benefits status cannot include wellness benefits, such as coverage for checkups and immunizations, in the benefits packages, and that the employer and EAP cannot charge the employees to participate in the EAP.
The rules do not apply to individual health coverage
The regulations are set to appear in the Federal Register Oct. 1, take effect 60 days later, and apply to group plans and group plan insurance issuers for plan years beginning on or after Jan. 1, 2015.