Archive | September 2013

ACA Update as October Approaches

btn-ppacaThe deadline of October 1 for employer ACA notices is almost upon us. October 1 is also the date that the ACA Health Insurance Marketplace will become operational. Open enrollment begins October 1 with coverage starting January 1, 2014.

As that happens, more information is being made available.  The federal government–calling the Exchanges a simple and affordable way to get insurance coverage under the ACA–is promoting the system through several sources.

According to a White House release, “A new report shows that the Marketplace will give uninsured Americans access to affordable health insurance — and finds that average premiums are even lower than experts initially projected. For instance:

  • A working family making $50,000 a year can get health insurance for less than $100/month.
  • A 27 year-old making $25,000 a year could get coverage for an average of $93 a month.”
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Expanded Scope for New HIPAA Rules

HIPAASeptember 23, 2013.  Today is the day that many of those who use protected health information (PHI) must comply with new Health Insurance Portability and Accountability Act (HIPAA) Privacy and Security Rules, which went into effect 180 days ago.

If you use PHI in your work, hopefully by now you are aware of those changes. For the first time, Privacy and Security rules apply not only to covered entities and business associates, but also to subcontractors who provide services to those business associates. This includes the security breach notification requirements when PHI is compromised.

An HHS press release earlier this year noted, “Some of the largest breaches reported to HHS have involved business associates.”  With the expanded scope of the rules, look for more enforcement actions in the future.

Affordable Care Act (ACA) Tax Provisions Outlined

PPACASo you’ve got questions about what you need to be doing with the Affordable Care Act and how it impacts your business?  You aren’t the only one.

The IRS has an on-line resource with links that outline key tax issues facing small employers (those with fewer than 50 employees) and large employers (those with 50 or more employees).

The site is available by clicking here:  http://www.irs.gov/uac/Affordable-Care-Act-Tax-Provisions-for-Employers.

Affordable Care Act (ACA) Notices Required by October 1

PPACABy October 1, 2013, employers must provide a written “Exchange Notice” under the Affordable Care Act (ACA) to employees. The employer must give this to all current and new full-time and part-time employees and seasonal employees. This notice is required even if you provide health insurance.

The notice tells employees of the option to purchase health insurance coverage through an insurance exchange. The notice also outlines benefits and consequences of choosing that coverage.

The U.S. Department of Labor has guidance for contents of the notice, which as a threshold, must include the following:

  • The contact information of the health exchange available in the state;
  • The services provided by the exchange available in the state; and
  • Possible eligibility for premium tax credits or cost sharing reductions when health coverage is purchased on the exchange.

HIPAA Notice of Privacy Practices 2013

HIPAAThe HIPAA Omnibus Final Rule changes go into effect on September 23. Covered entities have been required to provide Notice of Privacy Practices for several years.  Those notices need to be revamped. The Final Rule clarifies and expands the obligation to report breach of protected health information (PHI) to patients. Covered entities must specifically notify patients of a right to be informed of breach. More importantly, there will now be a rebuttable presumption of breach unless the covered entity can show through a four-factor test that there is a low probability of PHI compromise.

There are also requirements for the notice of disclosures to health plans, marketing and sale of PHI, and the right to opt out of communications.

These are considered material changes, thus it is important to revise the notice to reflect the changes and make it available.