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Business Group Resources and Publications

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ACA Preventive Services Chart
This chart lists the preventive services that, under the ACA, non-grandfathered plans must cover without cost-sharing.
Jun 18, 2019
New ACA Preventive Service Coverage Requirement for HIV (PrEP)
The U.S. Preventive Services Task Force has issued a new recommendation that clinicians offer preexposure prophylaxis (PrEP) with effective antiretroviral therapy to persons who are at high risk of HIV acquisition.
Jun 12, 2019
Public Policy Webinar - Update on HSA Rules, HIPAA, ACA, and Other Regulatory Issues
During this webinar, we discuss the latest regulatory developments for group health plans, including HSA rules, new HIPAA guidance, ACA updates.
May 30, 2019
Public Option Coming to Washington State by 2021
Last week, Washington's legislature passed a bill (SB 5526) that Governor Jay Inslee (D) is expected to sign that would require the WA Health Care Authority to contract with one or more insurers to offer a public plan on the exchange by 2021.
May 9, 2019
ACA Update: Out-of-Pocket Maximums & Prescription Drug Coupons
Recently, the Department of Health and Human Services (HHS) issued its annual regulatory update for public Exchanges and other ACA requirements. These regulations include several new developments on the OOPM and drug coupons for employer-sponsored group health plans.
May 1, 2019
Health Insurance Exchanges Year 6 Results, Medicaid Expansion and Looking Ahead to 2020 – What Employers Should Know
This webinar focuses on the year 6 enrollment results of the health insurance exchanges and changes in Medicaid expansion. Additionally, we will look ahead to what employers should expect for the 2020 exchange plan year.
Apr 30, 2019
Exchange Enrollment Dips 3%, Democrats Pivot to Bolstering ACA
In late March, CMS reported that the number of people selecting plans for the 2019 exchange open enrollment period was down 3% from last year (11.4 vs. 11.8 million).
Apr 5, 2019
Public Policy Webinar: Update on Federal and State Leave Requirements, HSA Rules, and Other Regulatory Issues
During this webinar, we discuss the latest federal and state regulatory developments, including state paid leave rules, HSA and FMLA guidance, and ACA updates.
Mar 29, 2019
Working for You in Washington – March 6, 2019
The Business Group's recent policy initiatives include meeting with the CMS Administrator to advance alternative payment and delivery models for health care, advocating employers' views on surprise billing legislation on the hill and at the White House pushing again to repeal the ACA excise tax on employer plans, meeting with the Department of Labor on Mental Health Parity requirements and sending a letter to HELP Committee Chair on legislation and administration action to control health care costs.
Mar 6, 2019
Public Policy Webinar: Paid Leave, ACA, and Tax Rules – Update on Federal and State Regulations
During this webinar, we provide an update on federal and state regulatory developments. Topics will include Massachusetts paid family and medical leave, Michigan tax and paid leave updates, ACA proposals, HSA guidance, and wellness incentives.
Feb 22, 2019
Public Policy Alert: New ACA Coverage Requirement: Interventions to Prevent Perinatal Depression
The U.S. Preventive Services Task Force issued a new recommendation that that clinicians provide or refer pregnant and postpartum persons who are at increased risk of perinatal depression to counseling interventions. Non-grandfathered group health plans must cover this service, without cost-sharing, effective for plan years beginning on or after February 28, 2020 (January 1, 2021 for calendar year plans).
Feb 13, 2019
Comments to USPSTF on Requiring Employers to Cover without Plan Participant Cost-sharing Pre-exposure Prophylaxis (PrEP) with Effective Antiretroviral Therapy for People at High Risk of HIV Acquisition
The National Business Group on Health submitted comments to the USPSTF on a draft recommendation statement that clinicians offer pre-exposure prophylaxis (PrEP) with effective antiretroviral therapy to persons who are at high risk of HIV acquisition recommending that the USPSTF weigh certain factors, beyond clinical evidence, when making their final recommendation statement.
Dec 26, 2018
New Guidance on HRAs, ACA Developments, and Other Regulatory Topics
During this webinar, we discuss new guidance on HRAs, ACA rules, and other regulatory guidance.
Dec 14, 2018
CMS Promotes More State Flexibility to Reform Individual/Small Group Market under ACA
Late last month, CMS unveiled a fact sheet and a discussion paper that provides waiver concepts to the states, giving them more federal flexibility under ACA Innovation Waivers.
Dec 13, 2018
Health Insurance Exchanges Year 6 Details and Medicaid Expansion Update – What Employers Should Know
During this webinar, Business Group staff provides the latest details on the health insurance exchanges in year 6 including: overall trends in premiums and plan competition, a closer look at 5 key states, comparisons between exchange coverage and employer-sponsored coverage and more. Additionally, we will cover the latest developments in Medicaid expansion and its potential impacts on employer plans.
Nov 30, 2018
2019 Public Exchanges Chart with State-Level Premium and Insurer Information
A continuously updated chart with the latest details on the public health insurance exchanges for 2019 including insurers and premiums.
Nov 29, 2018
Spreadsheet of 2019 State and County Level Health Insurance Exchange Carriers and Premiums
This spreadsheet includes 2019 details of health insurance exchange carriers, premiums, cost-sharing information and more for 39 states.
Nov 29, 2018
IRS Updates PCORTF Fees
In IRS Notice 2018-85, the IRS announced that for plan years ending on or after October 1, 2018 and before October 1, 2019 (i.e., the 2018 plan year for calendar year plans), Patient-Centered Outcomes Research Trust Fund (PCORTF) fees will be $2.45 multiplied by the average number of covered lives.
Nov 26, 2018
Medicaid Expansion Ballot Measures Pass in Idaho, Nebraska and Utah
On November 6th, voters in Idaho (60%), Nebraska (53%) and Utah (53%) passed measures to expand Medicaid to more people as permitted under the ACA.
Nov 20, 2018
House Win for Democrats Impacts Health Policy Agenda in Washington
As the results of the 2018 election are finalized, Democrats have regained control of the House, while the Senate will stay in Republican hands. Democrats highlighted health care as an issue in the election and will likely make it a priority on their agenda
Nov 8, 2018
Administration Gives States More Flexibility for Individual/Small Group Market Reform Waivers under ACA
Recently, HHS and Treasury issued guidance that gives states more flexibility in benefit design and loosens the affordability requirement for Innovation Waivers, which permit alternatives to the state exchange requirements in the individual & small group markets under the ACA.
Oct 31, 2018
Medicaid Expansion on the Ballot in Idaho, Montana, Nebraska and Utah
On November 6th, voters in Idaho, Montana, Nebraska and Utah will cast ballots on whether to expand Medicaid to more people as permitted under the ACA.
Oct 31, 2018
Public Policy Webinar: Update on ACA Developments, State-Level Requirements, and Other Regulatory Topics
During this webinar, we discuss new regulatory developments, including the new proposed HRA rules and how they might apply to self-insured group health plans. Attendees will have an opportunity to ask questions.
Oct 26, 2018
Public Policy Webinar: Update on ACA, FMLA, and Other Topics
During this webinar, we discuss new regulatory guidance on the ACA, FMLA, paid leave, and other issues relevant to group health plans.
Oct 5, 2018
CMS Approves More States' Plans to Stabilize Exchanges; 2 Add Taxes Impacting Employers
Recently, CMS approved 4 states' plans to create reinsurance programs to stabilize their exchanges and reduce premium hikes by offsetting insurer costs for people with high claims.
Sep 7, 2018
CMS Takes Positive Step toward Stabilizing the State Exchanges
Last week, CMS issued a final rule reinstating $10.4 billion of insurer-funded risk-adjustment payments for 2017, which were suspended in early July due to a February court decision.
Aug 3, 2018
Signs of More Instability Ahead for State Exchanges in 2019
Last week, CMS announced that it would halt collecting and distributing $10.4 billion of insurer-funded risk-adjustment payments for 2017, which had been expected to be allocated to plans in the fall of 2018.
Jul 13, 2018
Public Policy Webinar: Regulatory Update
During this webinar, we go over new ACA guidance, state developments, and other topics relevant to group health plans. Attendees will have an opportunity to ask questions
Jun 29, 2018
Group Health Plan Vendor Contracting: Vendor Management
The third topic in our vendor contracting series is vendor management. Most Business Group members contract with a variety of vendors to provide a complete health and welfare benefits package. Effective vendor management is critical to obtaining the best value for employee benefits. During this webinar, we discuss topics such as: best practices for managing multiple group health plan vendors; newer trends such as vendor aggregators, and special issues for pharmacy vendor management, including specialty pharmacy.
Jun 15, 2018
Virginia Becomes 33rd State to Expand Medicaid under the ACA
Yesterday, Virginia Gov. Ralph Northam signed a budget resolution that will expand Medicaid to individuals earning up to 138% of the federal poverty level (FPL) by no later than January 1, 2019.
Jun 8, 2018
Public Policy Webinar: Update on ACA, Mental Health Parity, and Other Regulatory/Compliance Topics
During this webinar, we discuss recent regulatory developments that affect group health plans, including agency guidance on the ACA, mental health parity, and HSA/HDHPs.
May 18, 2018
Comments to Louisiana Department of Insurance on ACA 1332 State Innovation Waiver Recommending that the Per-Covered Life Fee Not Apply to Self-Insured Plans
The Business Group, in response to Louisiana's ACA section 1332 state innovation waiver proposal, recommended that the proposed per-covered-life fee not apply with respect to lives covered by self-insured group health plans.
May 14, 2018
Approved and Pending State ACA Innovation Waivers with Employer Impacts
This chart tracks state actions on ACA innovation waivers that impact employer-sponsored coverage.
May 11, 2018
Louisiana Explores Taxing TPAs and Insurers to Fund Exchange Reinsurance Program
Louisiana's Department of Insurance is seeking to establish a reinsurance program in 2019 to stabilize exchange premiums funded by taxes on third party administrators (TPAs) and insured plans.
May 11, 2018
Health Insurance Exchanges Year 5 Results, Medicaid Expansion and Looking Ahead to 2019 – What Employers Should Know
This webinar builds upon our November 2017 exchanges webinar, with a particular focus on year 5 exchange enrollment results and changes in Medicaid expansion. Additionally, we will look ahead to what employers should expect for the 2019 exchange plan year.
Apr 27, 2018
Chart - 2018 Public Exchanges with State-Level Premium and Insurer
A continuously updated chart with the 2018 latest available details on the public health insurance exchanges including insurers and premiums.
Apr 26, 2018
Exchange Enrollment Relatively Stable Despite Large Premium Increases; CMS Grants Increased State Flexibility
Earlier this month, CMS reported that exchange enrollment for 2018 remained stable with only a 3% reduction from 2017 to 2018 (12.2 to 11.8 million enrollees), despite average premium increases of 37% for silver plans (70% AV plans).
Apr 13, 2018
Public Policy Webinar: Update on ACA and Other Regulatory Topics
During this webinar, we discuss regulatory developments for the ACA, transgender benefits, and other issues relevant to group health plans.
Mar 30, 2018
Senators Again Push for Bill to Stabilize Exchanges
Senators Again Push for Bill to Stabilize Exchanges
Mar 20, 2018
NBGH Comments to CMS on 2019 Medicare Advantage Call Letter
The Business Group urges CMS to reconsider transitioning EGWP plans to a bid to benchmark (B2B) only rate setting protocol.
Mar 5, 2018
States Sue Again Over ACA Constitutionality
Republican Attorneys General from 20 states sue arguing that eliminating individual mandate penalties voids the entire ACA
Mar 5, 2018
Letter Thanking Members of Congress for HSA Improvement Bill
This letter thanks the sponsors of bipartisan legislation that would ensure HDHPs/HSAs participants have better access to onsite and retail primary care clinics, enhanced primary care overall, fitness and activity services to promote wellness, as well as chronic disease management.
Mar 1, 2018
Letter Urging Congress to Improve HSAs
Changes are needed to ensure that all employees have equal access to these benefits regardless of whether they have an HSA, and thus Congress should make necessary technical corrections to the IRS code.
Mar 1, 2018
2018 State Exchange Enrollment Down 3.7% from 2017
As we await official tallies from the federal government, the National Academy for State Health Policy indicated that 11.8 million people selected a plan in 2018 vs. 12.2 million in 2017, a 3.7% reduction.
Feb 14, 2018
Congress Weighs Reinsurance Programs to Help Stabilize Exchange Premiums
Senator Susan Collins (R-ME) and Representative Ryan Costello (R-PA) are pushing for federal funding for reinsurance programs to help stabilize exchange premiums.
Feb 1, 2018
More States Could Expand Medicaid after Administration Permits Work and Community Service Requirements
Earlier last month, CMS issued guidance allowing states to apply for Medicaid waivers to encourage working-age, non-pregnant and non-disabled beneficiaries to meet work or community engagement requirements (skills training, education, job search, volunteering or caregiving) in order to maintain benefits.
Feb 1, 2018
What's Next? 2018 Health Policy Outlook
This webinar will cover the outlook for the future of the excise tax on employer plans, other ACA taxes, the employer mandate, stabilization of the individual market, drug policy, and other areas. We will examine the alternatives and prospects for action on these and other health care issues by Congress and the Administration and the potential impacts.
Jan 26, 2018
Public Policy Alert: ACA Employer Reporting Deadline Extended
The IRS issued Notice 2018-06, which extends the due date for furnishing Forms 1095-C (or 1095-B, if applicable) to employees to March 2, 2018.
Dec 22, 2017
What Your CEO Is Reading: Tax Reform
In the final weeks of 2017, Congress passed the new tax reform bill (H.R. 1). As the most significant change to the U.S. Tax Code since 1986, this law will have wide-ranging short and long-term effects on employers and employees alike, including in the area of employee benefits. This article provides an overview of how this new law will affect employer-sponsored group health, leave, and fringe benefits.
Dec 20, 2017
Public Policy Webinar: ACA Update, Disaster Relief Guidance, and Other Regulatory Developments
During this webinar, we provide an overview of ACA guidance on employer shared responsibility payments, disaster relief guidance, and other regulatory developments.
Dec 14, 2017
Details on ACA Employer Mandate Penalties
The IRS issued guidance and forms related to ACA employer shared responsibility payments (often referred to as employer mandate penalties).
Nov 29, 2017
IRS Form 14764
ACA Employer Shared Responsibility Payment Response Form
Nov 28, 2017
Health Insurance Exchanges Year 5 Details: What Employers Should Know
During this webinar, Business Group staff provides the latest details on the health insurance exchanges in year 5 including: overall trends in premiums and plan competition, a closer look at 5 key states, comparisons between exchange coverage and employer-sponsored coverage and more.
Nov 17, 2017
Spreadsheet of 2018 State and County Level Health Insurance Exchange Carriers and Premiums
This spreadsheet includes 2018 details of health insurance exchange carriers, premiums, cost-sharing information and more for 39 states.
Nov 9, 2017
Working for You in Washington – November 3, 2017
The Business Group's public policy team's recent policy initiatives include: pushing to eliminate the ACA's excise tax, separating preventive services policy from benefit mandates, simplifying ACA reporting requirements for employers, improvements to wellness rules, advancing pay-for-performance and alternative payment models and value payments in Medicare.
Nov 3, 2017
Iowa and Oklahoma Withdraw ACA Waiver Requests for Alternative Health Reform
Recently, Iowa Insurance Division (IID) Commissioner Doug Ommen announced that the state would withdraw its waiver request to CMS to make only one plan available in the exchange with deductibles of $7,350/$14,700 (single/family).
Oct 31, 2017
Senate HELP Committee Leaders Reach Deal on Stabilizing Exchanges; Bill's Future Uncertain
Earlier this month, Senate HELP Committee Chairman Lamar Alexander (R-TN) and Ranking Member Patty Murray (D-WA), along with 22 other Republican and Democrat Senators, introduced a bill that could help stabilize the exchanges by assuring federal cost-sharing reduction payments for 2 years.
Oct 31, 2017
Letter to Senators Portman and Warner Supporting Commonsense Reporting Act of 2017
The Business Group strongly supports the Commonsense Reporting Act of 2017, which would establish a much-needed, streamlined, and less burdensome alternative to the current employer reporting system under the ACA.
Oct 30, 2017
Public Policy Webinar: Update on ACA Rules and Other Regulatory Developments
During this webinar, we discuss new regulatory developments for group health plans, including ACA fees and reporting rules, coming changes to disability claims regulations, and an update on benefits for transgender individuals.
Oct 27, 2017
Public Policy Alert - IRS Issues 2017 ACA Employer Reporting Forms and Instructions
The IRS issued final forms and instructions for Forms 1094-C and 1095-C, which employers use to fulfill the Affordable Care Act's employer reporting requirements.
Oct 13, 2017
Model Language For Employee Communications on IRS Form 1095-C
This document provides model language that plan sponsors can customize for communications to employees about IRS Form 1095-C, which self-insured plan sponsors will use to fulfill ACA employer reporting requirements.
Oct 11, 2017
Public Policy Webinar: Regulatory Update
During this webinar, we provide an update on new regulatory guidance applicable to group health plans. Topics will include lactation accommodations, ACA reporting, wellness rules, and more.
Sep 29, 2017
Oregon and Oklahoma Seek to Establish Exchange Reinsurance Programs Funded in Part by Taxes on Insured Plans
Last month, Oregon and Oklahoma filed 1332 waiver requests with CMS seeking federal funding for reinsurance programs that will also be funded by taxes on insured plans.
Sep 15, 2017
Senate HELP Committee Holds 4 Hearings on Stabilizing Public Exchanges; Seeks to Pass Legislation
Since returning from August recess, the Senate HELP Committee has held 4 hearings on stabilizing the exchanges featuring state insurance commissioners, governors, insurers, providers, actuaries, and current and former government officials seeking legislative consensus.
Sep 15, 2017
Governors John Kasich (R-OH) and John Hickenlooper (D-CO) Release Proposal Calling for Exchange Stabilization
Yesterday, Governors John Kasich (R-OH) and John Hickenlooper (D-CO) joined by governors from Alaska, Louisiana, Montana, Nevada, Pennsylvania and Virginia sent a proposal to House and Senate leadership with recommendations to stabilize the exchanges.
Sep 1, 2017
Congress to Consider Moves to Stabilize the Exchanges in Wake of Senate Failure to Pass ACA Changes
Following the collapse of Senate attempts to change the ACA, Senators plan on holding hearings on stabilizing the exchanges and may still consider changes to the ACA.
Aug 9, 2017
Comment Letter to Treasury on Reducing Regulatory Burdens
The Business Group, in response to the Department of the Treasury's request for information, submitted comments on regulations--particularly those related to the ACA--that can be eliminated, modified, or streamlined to reduce burdens.
Jul 31, 2017
Comment Letter to HHS on Reducing ACA Regulatory Burdens
The Business Group, in response to HHS's request for information, submitted comments emphasizing the need for future guidance that encourages plan design features that promote clinical effectiveness, efficiency, and value-based benefit design.
Jul 12, 2017
Letter to Senate Finance Committee Chairman Orrin Hatch (R-UT) with Recommendations for the Senate as it Considers the American Health Care Act of 2017
NBGH urges the Senate to repeal the 40% excise tax on health benefits, or at a minimum delaying it to 2026, and protecting the longstanding tax treatment of employer-sponsored coverage. NBGH also supports enhancements to consumer-driven health accounts.
May 23, 2017
Employer Alert: The ACA Out-of-Pocket Maximum: Is Your Plan in Compliance?
This Employer Alert details and provides compliance tips on the ACA's out-of-pocket maximum rules for group health plans.
May 5, 2017
CMS Makes Changes Aimed at Shoring Up Exchanges as More Insurers Plan to Leave
Last Thursday, CMS issued a final rule aimed at stabilizing the exchanges. Meanwhile, in a sign of continuing instability on the exchanges, more insurers indicated that they will not participate in the exchanges in 2018.
Apr 19, 2017
Letter to House Speaker Paul Ryan and House Ways and Means and Energy and Commerce Chairmen Kevin Brady and Greg Walden Supporting Recently Introduced Reconciliation Legislation
The National Business Group on Health sent a support letter to House Speaker Paul Ryan and House Ways and Means and Energy and Commerce Chairmen Kevin Brady and Greg Walden supporting reconciliation legislation that that would eliminate the ACA’s direct and indirect taxes on employer-sponsored coverage and delay the ACA’s excise until 2025. However, our ultimate goal is repeal of the ACA’s excise tax in its entirety and we strongly support the bipartisan effort to enact legislation (H.R.173 and S.58).
Mar 9, 2017
Trump Speech Signals Goals for ACA Replacement
In his first speech to Congress, President Trump laid out the priorities of his Administration in a wide range of areas, including the future of the Affordable Care Act (ACA).
Mar 1, 2017
House Republican Leaders Developing ACA Replacement
Recently, House Republican leadership met with Republican members to discuss their proposal to repeal and replace the ACA. While the proposal doesn’t directly call for capping the income tax exclusion for employer-sponsored health benefits, according to reports they are floating the idea.
Feb 28, 2017
Latest Details of Private Exchanges
This chart tracks the latest details on the private exchanges, including: names and websites of private exchanges, target market, number of participating employers and total number of covered lives, participating carriers, other products offered and structure.
Feb 17, 2017
Excise Tax on High Cost Employer-Sponsored Coverage FAQ
An FAQ associated with the Health Reform (Patient Protection and Affordable Care Act) Implementation and Communications Toolkit
Feb 16, 2017
Trump Nominates R. Alexander Acosta as Labor Secretary
One day after restaurant executive Andrew Puzder withdrew his name from consideration as Labor Secretary, President Trump announced that R. Alexander Acosta, currently Dean of the Florida International University College of Law, will be the new nominee.
Feb 16, 2017
Trump Labor Secretary Nominee, Andrew Puzder Withdraws
Late today, President Donald Trump's nominee for Labor Secretary, Andrew Puzder, CEO of CKE Restaurants, owner of Hardee's and Carl's Jr. and other fast food brands, withdrew his name from consideration.
Feb 15, 2017
Public Policy Webinar: Update on ACA and Other Compliance Topics
During this webinar, we discuss current compliance issues for group health plans, including recent guidance from HHS, DOL, and IRS on contraceptive coverage, indemnity plans, and the definition of “dependent.” Attendees will have an opportunity to ask questions
Feb 10, 2017
Letter to Representatives Kelly and Courtney and Senators Heller and Heinrich Supporting Bipartisan Legislation to Repeal the ACA’s Excise Tax
The National Business Group on Health sent a letter to Representatives Kelly and Courtney and Senators Heller and Heinrich supporting their legislation that would eliminate the 40 percent tax on health benefits imposed by the Patient Protection and Affordable Care Act (ACA). The Business Group believes that any tax that raises the cost of health benefits will harm the more than 150 million Americans who rely on and value employer-sponsored health coverage and should be eliminated.
Feb 3, 2017
Bipartisan Bills to Repeal ACA Excise Tax Introduced in House and Senate
Recently, Representatives Mike Kelly (R-PA), Joe Courtney (D-CT), Senators Dean Heller (R-NV) and Heinrich Republican (D-NM) introduced legislation that would repeal the ACA’s excise tax.
Feb 1, 2017
Public Policy Webinar: Regulatory Update on ACA, Disability and Other Topics
During this webinar, we provide an overview of recent regulatory guidance, including disability claims regulations and recent executive actions affecting the regulatory process.
Jan 31, 2017
Joint Letter to the White House Urging Immediate Steps to Ease the Burdens of the ACA Employer Mandate and Reporting Requirements
The National Business Group on Health sent a joint letter to the Assistant to the President and Director of the Domestic Policy Council to act within President Trump’s Executive Order to eliminate the administrative burden associated with the ACA’s employer mandate and reporting requirements.
Jan 30, 2017
Joint Letter to Congress Urging Repeal of the ACA’s Excise Tax and No Adverse Changes to Tax Treatment of Health Benefits
The National Business Group on Health sent a joint letter to Congress recommending repeal of the ACA’s excise tax and not to take additional action to cap the individual tax exclusion for employer-provided health care benefits, or limit employers’ deductibility of health care expenses.
Dec 16, 2016
Public Policy Webinar: Regulatory Update on on Mental Health Parity and ACA Topics
During this webinar, we provide an overview of new regulatory developments, including recent mental health parity legislation and final regulations on ACA premium tax credits and nondiscrimination rules.
Dec 16, 2016
Comments to DOL, IRS, and PBGC on Proposed Revisions to Form 5500
The Business Group, in response to proposed regulations regarding revisions to Form 5500, submitted comments encouraging agencies to maintain compliance flexibility for employer-sponsored group health plans.
Dec 5, 2016
Statement for the Record to the House Energy and Commerce Committee with Recommendations Regarding USPSTF A and B-recommended Services
The National Business Group on Health sent a statement for the record in response to a hearing on ACA preventive services and USPSTF A and B-recommended services recommending increased transparency and opportunity for expanded public input on the USPSTF A and B-recommended services recommendations before they become coverage mandates for employer plans.
Nov 29, 2016
ACA Employer Reporting Deadline Extended
Last week the IRS extended the due date for furnishing Forms 1095-C (or 1095-B, if applicable) to employees to March 2, 2017 (previously January 31, 2017)
Nov 23, 2016
Public Policy Webinar: Update on Mental Health Parity, Excepted Benefits and Other Regulatory Issues
During this webinar, we provide an overview of new regulatory developments, including recent mental health parity guidance and final regulations on excepted benefits.
Nov 18, 2016
What Your CEO is Reading - Trump and ACA
This newsletter highlights a Washington Post article about the future of the Affordable Health Care Act (ACA) under the Trump administration.
Nov 11, 2016
IRS Updates PCORTF Fees
Fees increase to $2.26 per covered life for 2016, payable in 2017.
Nov 7, 2016
California and Colorado Health Initiatives on November 8th Ballot
As people vote on November 8th, California and Colorado voters will also decide on health ballot initiatives. In Colorado, voters will decide whether the state will apply for an ACA Innovation Waiver that would implement a universal health plan beginning January 2019. ). In California, voters will decide whether to require the state to pay prices for prescription drugs no higher than those paid by the U.S. Department of Veteran’s Affairs (up to 24% lower) for certain populations.
Oct 31, 2016
Public Policy Webinar: Update on ACA Employer Reporting and Other Topics
During this webinar, we provide an overview of the most recent IRS guidance on ACA employer reporting and other new regulatory guidance.
Oct 28, 2016
What Your CEO is Reading - State Exchange Premiums
This newsletter highlights a New York Times article about the cost of state exchange premiums versus that of employer-sponsored coverage.
Oct 27, 2016
Declining Number of Carriers Participating in Public Exchanges
This Numbers You Need highlights the findings of an analysis of carrier participation in the public exchanges.
Oct 11, 2016
IRS Issues 2016 ACA Employer Reporting Forms and Instructions
Recently, the Internal Revenue Service (IRS) issued final forms and instructions for Forms 1094-C and 1095-C, which provide additional guidance on the Affordable Care Act’s employer reporting requirements.
Oct 7, 2016
Comments to IRS on ACA Employer Reporting
The Business Group, in response to IRS proposed regulations, submitted comments encouraging the Service to maintain compliance flexibility for employer-sponsored group health plans.
Oct 3, 2016
Consumer Groups Want CA to Scrutinize Exchange Premium Increases
Recently Consumers Union complained to the CA Department of Managed Healthcare that two insurers on the state’s exchange were unjustly raising premiums and using prescription drug prices as an excuse.
Sep 22, 2016
Toward the Finish Line: How Election 2016 is Shaping Up
Steve Wojcik discussed the impact of a Clinton or Trump White House, and control of the House and Senate, on various aspects of health care, including the excise tax and other proposals to tax health care benefits, ACA changes, the state exchanges, Medicare, and prescription drug policy.
Sep 12, 2016
Public Policy Webinar: Regulatory Update on Reporting Rules for Employers
During this webinar, we provide an overview of upcoming reporting changes for group health plans, including proposed Form 5500 changes, ACA employer reporting, and other regulatory topics.
Aug 26, 2016
More Large Insurers Pull Back from Public Exchanges Due to Losses
After losing $200 million during the second quarter of 2016 and expecting it to grow to $300 million by year’s end, Aetna recently announced that it will reduce its 2017 public exchange footprint.
Aug 25, 2016
NY Fed Survey Shows Small Employers Reducing Full-Time Workforces Due to ACA
A recent Federal Reserve Bank of New York survey of manufacturing and service sector executives in New York, northern New Jersey, and Fairfield County, Connecticut indicated that the ACA is reducing the number of workers that they employ by 17% - 21%.
Aug 25, 2016
Percentage of Employers that will be Subjected to the Excise Tax
This Numbers You Need chart includes projections on when employers will be subjected to the excise tax.
Aug 19, 2016
Comments to Agencies on Expatriate Health Plans and Other Benefits
The Business Group, in response to the DOL's, IRS's, and HHS's proposed regulations regarding ACA rules applicable to expatriate health plans and other benefits, submitted comments encouraging the agencies to maintain compliance flexibility for employer-sponsored group health plans.
Aug 9, 2016
ACA Boot Camp: Fees, Taxes, and Penalties
This webinar is a one-hour session designed to provide an overview of the ACA's fees, taxes and penalties for employer-sponsored group health plans.
Aug 4, 2016
ACA Boot Camp: Employer Shared Responsibility Payments
This webinar is a one-hour session designed to provide an overview of the ACA's employer shared responsibility (or "employer mandate") rules, including rules for determining full-time status, treatment of temporary and seasonal employees, and more.
Jul 7, 2016
ACA Boot Camp: Plan Design and Coverage Rules
This webinar is a one-hour session designed to provide an overview of the ACA's plan design and coverage requirements, including the 90-day waiting period limitation, lifetime and annual dollar limit rules, out-of-pocket maximum rules, and more.
Jun 29, 2016
CMS Proposes Changes to Strengthen Public Exchanges
In the midst of higher than expected health care utilization, increased premiums, fewer insurers (especially in rural markets) and poor risk profiles of public exchange enrollees, CMS recently announced new policies aimed at stabilizing the exchanges’ risk pools.
Jun 17, 2016
ACA Boot Camp: ACA Reporting and Disclosure Requirements
This 60-minute webinar is designed to provide an overview of the ACA's reporting and disclosure requirements for employers and group health plans, such as Form 1095-C and the summary of benefits and coverage (SBC).
Jun 13, 2016
ACA Boot Camp: Affordable Care Act Basics for HR and Group Health Plan Sponsors
This webinar is a one-hour session designed to provide a basic overview of the ACA's employer and plan reporting obligations; plan design and coverage requirements; employer shared responsibility provisions (also known as the employer mandate); fees, taxes, and penalties; and upcoming compliance obligations for employers and plans.
Jun 1, 2016
NBGH Model Language on Exchange, CMS, and HIPAA Notices
This document provides model language that employers can customize for internal communications with managers regarding possible agency notices and calls related to Exchanges, employer-sponsored coverage, and HIPAA audits.
May 17, 2016
NBGH Public Policy Webinar: The Latest on SBCs, EGWPs, Federal Contractors, and Other Regulatory Developments
During this webinar, we will discuss the latest regulatory developments applicable to group health plans, including final SBC templates, new agency FAQs on the Affordable Care Act, and DOL guidance for federal contractors. Attendees will have an opportunity to ask questions.
Apr 29, 2016
More Guidance on Exchange Employer Appeals Process
Recently, federal agencies issued guidance on the Federally-Facilitated Marketplaces’ (also known as Exchanges) appeals process for employers that receive notices of employees being eligible for premium tax credits to subsidize Exchange coverage.
Apr 11, 2016
Agencies Issue Final SBC Template
Recently, federal agencies issue final templates, instructions, and other documents for the summary of benefits and coverage (SBC) and Uniform Glossary of Coverage and Medical Terms.
Apr 7, 2016
California Exchange Board May Require Insurers to Remove Poor Performing Providers by 2019
California’s exchange (second largest exchange by enrollment) is considering a number of new requirements for insurers in 2017 and beyond.
Mar 30, 2016
Status of the Public Exchanges
This Numbers You Need chart details the number of people in the public exchanges, the types of plans they are selecting, and common cost-sharing provisions.
Mar 30, 2016
Comments to OMB on Proposed Revisions to the SBC Template and Associated Documents
The National Business Group on Health, in response to the DOL’s information collection request regarding revision of the SBC and uniform glossary under the Affordable Care Act, submitted comments
Mar 28, 2016
Joint Letter to House Budget, Education and Workforce, Energy and Commerce and Ways and Means Chairmen Urging Their Support for Strengthening the Employer-Sponsored Health Care System
As the House considers health care reform alternatives, the National Business Group on Health sent a joint letter to House Committee Chairmen (Tom Price, John Kline, Fred Upton, and Kevin Brady) expressing support for employer-sponsored coverage in America and the federal Employee Retirement Income Security Act (ERISA) law that protects and enables coverage.
Mar 18, 2016
Agencies Issue Guidance on ACA Out-of-Pocket Maximums, SBCs, and Other ACA Topics
Last week, the Department of Health and Human Services (HHS), Internal Revenue Service (IRS), and Department of Labor (DOL) (collectively, the Agencies) issued regulations and FAQs on various Affordable Care Act requirements applicable to employer-sponsored group health plans.
Mar 15, 2016
Federal Court Allows Class Action Suit over Reduction in Hours to Avoid Employer Mandate to Proceed
Recently, a federal district court allowed a class action lawsuit over a reduction in hours allegedly to avoid the ACA’s employer mandate, Marin v. Dave & Buster’s Inc., to proceed.
Feb 29, 2016
NBGH Public Policy Webinar: Update on Preventive Services, SBCs, and Other Regulatory Topics
During this webinar, we provide an overview of new regulatory developments, including ACA guidance on preventive services and the summary of benefits and coverage.
Feb 26, 2016
Comments to IRS on proposals regarding opt-out payments and other ACA topics
The Business Group, in response to the IRS's request for comments regarding certain ACA rules applicable to employer-sponsored plans, submitted comments encouraging the IRS to maintain the current standards for affordability and minimum value of employer-sponsored plans.
Feb 18, 2016
San Francisco Increases Employer Mandate Amount for 2016
Recently, the San Francisco Board of Supervisors increased the amount that employers must spend on healthcare for 2016 and made other changes to the Health Care Security Ordinance (HCSO).
Feb 16, 2016
Public Policy Webinar - ACA Excise ("Cadillac") Tax Update
During this webinar, we provide an overview of regulatory and legislative developments related to the ACA excise tax and our most recent data on employers' benefit strategies as they prepare for the tax.
Jan 29, 2016
Bernie Sanders (D-Vt) Calls for Single-Payer Coverage Funded by New Payroll and other Taxes
Democratic presidential candidate Bernie Sanders (VT) unveiled his proposal to establish a single-payer health system
Jan 26, 2016
Louisiana Will Become 31st State to Expand Medicaid
Recently, the newly elected Louisiana Governor John Bel Edwards (D) issued an executive order to expand Medicaid to 138% of the federal poverty level (FPL) effective July 1, 2016.
Jan 26, 2016
NBGH/Optum: The Cadillac Tax and the Employer Mindset: A Survey of Employers
The Business Group and Optum surveyed large employers to understand employers’ reaction to the Cadillac tax and how it will impact their health management strategy, the steps they are taking to avoid the tax and how employees will be impacted by the tax.
Jan 26, 2016
Election 2016: What Can We Expect and What It Means for Employers and Health Care
Steve Wojcik, Vice President of Public Policy, provides early analysis, expectations and what to watch during the 2016 election.
Jan 22, 2016
Chart: State Actions Implementing Federal Health Reform
A chart tracking state efforts implementing federal health reform including creating Health Insurance Exchanges, expanding Medicaid and establishing the Basic Health Program.
Jan 20, 2016
HR Slides - Medicaid Expansion
This chart reflects previous state decisions to implement a health insurance exchange as well as current decisions on whether or not to expand Medicaid.
Jan 20, 2016
Health Care Only a Minor Part of President Obama’s Last State of the Union Address
Last night, President Obama delivered his last State of the Union Address that only briefly focused on health care.
Jan 13, 2016
USPSTF Updates Breast Cancer Screening Guidelines
Yesterday, the US Preventive Services Task Force (USPSTF) issued an updated recommendation statement on breast cancer screening, which recommends screening mammography every 2 years for women aged 50-74.
Jan 13, 2016
Congress Delays the ACA’s Cadillac Tax until 2020
Later today, the President is expected to sign a funding bill that will delay the ACA’s Excise (“Cadillac”) Tax from 2018 to 2020 tax year.
Dec 18, 2015
Congress Likely to Pass Funding Bill that Would Delay the Cadillac Tax until 2020
Late Tuesday night, House Speaker Paul Ryan (R-WI), Senate Majority Leader Mitch McConnell (R-KY), House Minority Leader Nancy Pelosi (D-CA) and Senate Minority Leader Reid (D-NV), with White House participation, agreed to a two year delay of the ACA’s Excise (“Cadillac”) tax in a trillion dollar legislative package to fund the federal government through September 2016.
Dec 17, 2015
Public Policy Webinar: DOL Proposed Changes for Disability Claims & Appeals
Recently, the Department of Labor issued proposed regulations that, if finalized, will establish additional claims and appeals procedures for disability benefits. This webinar provides an overview of these proposed rules.
Dec 2, 2015
Public Policy Webinar: Update on ACA Preventive Services, Mental Health Parity, and other Regulatory Developments
During this webinar, we discuss the most recent agency guidance on ACA preventive services requirements, the Mental Health Parity and Addiction Equity Act, and final regulations implementing ACA group health plan requirements.
Nov 20, 2015
Coloradans to Vote on Universal Health Plan Alternative to ACA Paid for by New Payroll Taxes
Next November, Colorado voters will decide on a Constitutional Amendment that would require the state to seek an ACA Innovation Waiver to implement a universal health plan by January 2019.
Nov 17, 2015
Public Policy Webinar: EEOC Proposals on Wellness Incentives for Spouses
Recently, the EEOC proposed regulations that, if finalized, will permit group health plans to offer incentives for spouses to complete health risk assessments and biometric screenings. During this webinar, we discuss the details of these proposed regulations and how they fit with the other rules under HIPAA and the ADA that govern wellness programs.
Nov 6, 2015
Evaluating the Population Health Impact of an Early Adopter of Outcome-Based Incentives
Aetna shares its insight into outcome-based incentives including its program's population health impact as indicated by data analysis, cohort trending and comparison data.
Nov 4, 2015
Congress Repeals ACA Automatic Enrollment Requirement
Congress included the repeal as part a larger budget bill to avoid a government default today by lifting the debt ceiling until March 2017 and increasing budget spending caps for fiscal years 2016 and 2017.
Nov 3, 2015
Budget Deal Would Avert Debt Default
Outgoing House Speaker John Boehner (R-OH), House Minority Leader Nancy Pelosi (D-CA), Senate Majority Leader Mitch McConnell (R-KY) and Minority Leader Harry Reid (D-NV) have reached a deal to avoid a government default on November 3.
Oct 30, 2015
House-Passed Reconciliation Bill Would Repeal Aca Excise Tax, Employer Mandate and Auto Enrollment; Senate Path Unclear
Last Friday, The House passed (240 – 189) a reconciliation bill that would repeal some ACA provisions including the excise tax on high-cost coverage, employer mandate, automatic enrollment, medical device tax and individual mandate.
Oct 30, 2015
More Guidance on ACA Preventive Services and Mental Health Parity
The Departments of Labor, Health and Human Services, and Treasury issued a set of frequently asked questions providing additional guidance on the ACA’s preventive services requirements, mental health parity, and other group health plan rules.
Oct 27, 2015
Public Policy Webinar: Exchange Notices, PCORTF Fees, and Other ACA Regulatory Developments
During this webinar, we provide an overview of new agency guidance on Exchange notices to employers, Patient-Centered Outcomes Research Trust Fund Fees, and other regulatory developments for group health plans.
Oct 23, 2015
Jeb Bush Wants to Cap the Employee Tax Exclusion for Health Benefits
Joining other Republican presidential candidates in their calls to repeal and replace the ACA, Jeb Bush recently elaborated on his health care priorities
Oct 16, 2015
Comments to IRS on ACA Excise ("Cadillac") Tax on High Cost Employer-Sponsored Health Coverage
The Business Group, in response to the IRS's notice and request for comments regarding the ACA’s excise tax on high cost employer-sponsored health coverage, submitted comments encouraging the IRS to minimize the administrative and cost burdens associated with the tax.
Oct 1, 2015
Clinton Wants Benefit Mandates and Caps on Out-of-Pocket Spending
Democratic presidential front-runner Hillary Clinton recently elaborated her health care priorities.
Sep 30, 2015
Senators Introduce Bills to Repeal the Excise Tax
Earlier this week, Senator Sherrod Brown (D-OH) and ten Democratic Senators (including presidential candidate Bernie Sanders) introduced a bill to repeal the ACA’s excise tax while Senators Dean Heller (R-NV), Martin Heinrich (D-NM) and fourteen Republicans introduced a separate excise tax repeal bill earlier this month.
Sep 30, 2015
Federally-Facilitated Exchanges to Begin Notifying Employers of Employees with Premium Tax Credits
CMS issued a set of Frequently Asked Questions announcing that beginning in the spring of 2016, the Federally-Facilitated Marketplace (also known as Exchanges) will begin notifying employers of employees who received premium tax credits subsidizing Exchange coverage.
Sep 28, 2015
Public Policy Webinar: Update on ACA Minimum Value, Nondiscrimination, and Other Regulatory Developments
This webinar provides an overview of new agency guidance on the ACA’s minimum value and nondiscrimination rules, as well as updates on other regulatory developments for group health plans.
Sep 25, 2015
More on ACA Employer Reporting
The IRS issued Notice 2015-68 and final forms and instructions, which provide additional guidance on the Affordable Care Act’s employer reporting requirements
Sep 24, 2015
Joint Letter to Senators Mark Warner (D-VA) and Rob Portman (R-OH) Supporting the Commonsense Reporting Act of 2015
The National Business Group on Health sent a joint letter to Senators Warner and Portman supporting their legislation that would help reduce confusion surrounding the Affordable Care Act’s (ACA) Exchange tax credit eligibility, and provide businesses and insurance carriers with regulatory relief under the law’s reporting requirements.
Sep 17, 2015
IRS Issues Proposed Regulations on ACA Minimum Value
The IRS issued proposed regulations stating that an employer-sponsored plan provides minimum value only if it covers at least 60% of allowed costs and provides “substantial coverage of inpatient hospital and physician services.”
Sep 1, 2015
A Handful of States Begin Exploring Alternatives to ACA
AR, CA, HI, MN, NM AND RI recently took initial steps to explore possible alternatives to the ACA coverage expansion.
Aug 27, 2015
What Your CEO is Reading - August 2015 Update on Cadillac Tax
This newsletter highlights the results of a recently released analysis by the Kaiser Family Foundation on when employers would begin to see the impact of the excise tax known as the "Cadillac" tax.
Aug 27, 2015
ACA Key Plan Effective Dates for 2013-2018
This chart summarizes Affordable Care Act compliance deadlines applicable to group health plans for 2013-2018.
Aug 21, 2015
Public Policy Webinar: New Guidance on the ACA's Excise (“Cadillac”) Tax on High Cost Employer-Sponsored Health Coverage
Recently, the IRS issued Notice 2015-52 on implementation of the ACA's excise tax on high cost employer-sponsored health coverage, which becomes effective in 2018. During this webinar, we discuss this guidance, how it may affect employer-sponsored health plans, and our future comments to the IRS.
Aug 19, 2015
IRS Issues More Guidance on ACA Excise (“Cadillac”) Tax on High Cost Health Coverage
The IRS issued Notice 2015-52, which provides more details on the IRS’s approach to implementing the ACA's excise tax on high cost employer-sponsored health coverage, known as the "Cadillac" tax.
Aug 14, 2015
Public Policy Webinar: Update on ACA Employer Reporting, Same-Sex Spouse Benefits, and Other Regulatory Topics
During this webinar, we provide an overview of the latest agency guidance on ACA employer reporting rules, same-sex spouse benefits, and other new regulatory developments.
Jul 31, 2015
Private Health Exchange Case Study: Hallmark Cards
This webinar presentation covers: • An update on the private health exchange marketplace and how models are evolving; • Why Hallmark decided to adopt a private health exchange strategy; • How to determine and evaluate if an exchange strategy is right for your organization; and • Best practices for a successful transition to a private health exchange
Jul 27, 2015
Employer Alert: Who Are Your “Employees” for ACA Compliance Purposes?
Since the ACA’s enactment, large employers have been preparing for implementation of the ACA’s employer shared responsibility provisions and employer reporting provisions. One issue that has caused some confusion for employers is the distinction between employee and independent contractor for purposes of complying with these ACA requirements—particularly when employers use staffing firms. This Employer Alert provides a brief overview of how the ACA defines “employee”; practice tips that plans sponsors should consider when dealing with this issue; and links to additional resources.
Jul 24, 2015
Medicare Proposes Expanding Bundled Payments and Putting Hospitals at Risk for Joint Replacement
Expanding upon its voluntary bundled payment program for hip and knee replacement, CMS recently proposed a 5 year program that would require all hospitals in 75 selected areas to participate.
Jul 14, 2015
Congress Considers Next Moves in Wake of Health Care Law Ruling
The U.S. Supreme Court’s 6 to 3 decision upholding subsidies in federally-facilitated or federally-assisted exchanges removed a potential opportunity for Congressional Republicans, Democrats and the President to come to the negotiating table regarding ACA improvements.
Jun 30, 2015
Joint Letter to the Senate Finance and House Ways and Means Committees Recommending Repeal of the Excise Tax on High Cost Coverage
The National Business Group on Health (a founding member of the National Coalition on Benefits) sent a joint letter to the leadership of the Senate Finance and House Ways and Means Committees recommending repeal of the excise tax on high-cost coverage.
Jun 29, 2015
Update on the Latest ACA Guidance for Employer Plans, Including Embedded Out of Pocket Limits and Preventive Services
This webinar covers the latest guidance from the government on the out-of-pocket maximum and how it applies to large employer plans, including family coverage and HSA-qualified HDHPs. In addition, the webinar covers the latest guidance on miscellaneous preventive services mandates.
Jun 26, 2015
Joint Letter to the Senate Finance and House Ways and Means Committees Urging Repeal of the Excise Tax on High Cost Coverage
The National Business Group on Health (joined by other large employer associations) sent a joint letter to leadership of the Senate Finance and House Ways and Means Committees recommending repeal of the excise tax on high-cost coverage.
Jun 25, 2015
U.S. Supreme Court Upholds ACA Premium Tax Credits on Federal Exchanges
The U.S. Supreme Court found that individuals who purchase health insurance through federally-facilitated exchanges can continue to receive premium tax credits to subsidize that coverage.
Jun 25, 2015
Summary of Benefits and Coverage FAQ
An FAQ associated with the Health Reform (Patient Protection and Affordable Care Act) Implementation and Communications Toolkit
Jun 16, 2015
California’s Exchange Caps Specialty Drug Cost Sharing
Last week, the California state exchange approved caps on out-of-pocket expenses for specialty pharmacy medications beginning in 2016.
Jun 2, 2015
West Coast Port Operators and Shipping Lines Agree to Pay Excise Tax for Union
In late May, members of the International Longshore & Warehouse Union (ILWU) ratified a 5-year contract with the association representing all West Coast US ports and shipping lines that will require the association to pay an estimated $60 million annually in ACA excise taxes beginning in 2018 on behalf of the union plan.
Jun 2, 2015
Agencies Issue FAQs on Contraceptives and Other ACA Preventive Services
The Departments of Labor, Health and Human Services, and Treasury (the Agencies) issued a set of frequently asked questions (FAQs) that provide additional guidance on the ACA’s requirement that non-grandfathered group health plans cover “recommended preventive services” without cost-sharing.
Jun 1, 2015
Preventive Services Coverage FAQ
An FAQ associated with the Health Reform (Patient Protection and Affordable Care Act) Implementation and Communications Toolkit
Jun 1, 2015
Departments Confirm ACA Embedded Individual Out-of-Pocket Maximum Applies to Self-Insured Plans and High-Deductible Health Plans
Recently, the Departments of Labor (DOL), Health and Human Services (HHS) and the Treasury issued a set of frequently asked questions (FAQs) that provides additional guidance on how the ACA out-of-pocket maximum applies to non-grandfathered self-insured and large group health plans.
May 28, 2015
What Your CEO is Reading - Cadillac Tax Update
This newsletter highlights how CFOs are working to meet the challenge that companies of all sizes in many industries face in dealing with the impending excise tax on high cost coverage (often referred to as the "Cadillac" tax).
May 27, 2015
Comments to IRS on ACA Excise ("Cadillac") Tax on High Cost Employer-Sponsored Health Coverage
The Business Group, in response to the IRS's notice and request for comments regarding the ACA’s excise tax on high cost employer-sponsored health coverage, submitted comments encouraging the IRS to (1) allow plan sponsors flexibility to continue innovative plan designs and health care delivery models that lower the overall cost of health coverage and (2) minimize the administrative and cost burdens associated with the tax.
May 15, 2015
Expected Senate Budget Vote this Week May Open Possibility for ACA Changes Later in Year
The Senate may vote on the joint budget resolution this week, which the House passed last week. Senate passage would put Congress a major step closer to pass ACA changes later in the year through the reconciliation process.
May 5, 2015
Public Policy Webinar: Update on ACA Excise Tax and Other Regulatory Issues for Health Plans
This webinar is a follow-up to our March 3, 2015 overview webinar on the IRS's initial guidance on the ACA's excise tax on high cost employer-sponsored health coverage, which becomes effective in 2018. During this webinar, we cover frequently asked questions, the Business Group's recommendations to the IRS on excise tax implementation, and new regulatory developments for group health plans.
Apr 24, 2015
Public Policy Webinar: An In-Depth Look at ACA Employer Reporting
This webinar is a follow-up to the February 20, 2015 overview webinar on the ACA's employer reporting requirements, which become effective in 2016 for the 2015 calendar year. During this webinar, we cover frequently asked questions, more detailed reporting instructions, and reporting rules for specific populations such as retirees, part-time employees, and collectively bargained employees.
Apr 17, 2015
Employers’ Interest in the Public Exchanges for Active Employees
This Numbers You Need chart contains the latest information on employers’ interest in public exchanges.
Apr 16, 2015
Impact of Excise Tax on Plans for Early Retirees Exceeding the Threshold
This Numbers You Need chart looks at how the excise tax will impact most retiree health plans.
Apr 16, 2015
Budget Resolutions in Congress Set State for Potential Path to ACA Changes Later in Session
Though the votes on the Republican-led bills are largely symbolic, if both houses can agree on a joint resolution, which has not happened in years, it potentially makes it easier to pass ACA changes in the Senate later in the year through the reconciliation process.
Mar 27, 2015
What Your CEO is Reading - Cadillac Tax
This newsletter highlights the challenge that U.S. auto manufacturers and their unions face in dealing with the impending excise tax on high cost coverage (Cadillac tax).
Mar 27, 2015
Agencies Issue Final Rules on Limited Wraparound Coverage
The IRS, DOL, and HHS issued final regulations amending the excepted benefits rules to include limited wraparound coverage as an excepted benefit. These regulations allow more flexibility in offering coverage to retirees and part-time employees that supplements individual market coverage, including Exchange coverage.
Mar 23, 2015
Making the Move to a Private Exchange: The Mercer Marketplace and VCA Inc. Case Study
This webinar focuses on VCA's move to a private exchange and the early benefits of VCA's move. It includes: • How private exchanges became a mainstream solution for employers of all types and sizes. • How the Mercer Marketplace has helped employers bend the trend on benefit costs. • Why VCA chose the Mercer Marketplace. • Lessons learned in year one, with a focus on early results, employee reaction and engagement.
Mar 11, 2015
Public Policy Webinar: An Early Look at the ACA’s Excise (“Cadillac”) Tax on High Cost Employer-Sponsored Health Coverage
The IRS issued Notice 2015-16, which describes potential approaches to implementing the ACA’s excise tax on high cost employer-sponsored health coverage, known as the “Cadillac” tax. During this webinar, we will discuss this initial guidance, how it may affect employer-sponsored health plans, and our future comments to the IRS.
Mar 3, 2015
Comments to DOL, HHS, and Treasury on Summary of Benefits and Coverage and Uniform Glossary
The National Business Group on Health, in response to a notice of proposed rulemaking regarding the ACA’s requirements for the summary of benefits and coverage (SBC) and uniform glossary, submitted comments encouraging flexibility in implementation for plan sponsors.
Mar 2, 2015
Public Policy Webinar: ACA Regulatory Update
During this webinar, we provide an overview of new regulatory guidance implementing the ACA and other group health plan rules, including guidance on excepted benefits, supplemental benefits, FMLA rights for same-sex married couples and new rules related to Exchanges.
Feb 27, 2015
IRS Issues Initial Proposals on Cadillac Tax Implementation
The IRS issued Notice 2015-16, which describes potential approaches to implementing the ACA's excise tax on high cost employer-sponsored health coverage, known as the "Cadillac" tax. This Notice is the first of what is expected to be a series of IRS guidance documents and opportunities to comment before the tax becomes effective in 2018.
Feb 25, 2015
More Republican-Led States Consider Medicaid Expansion
Since the 2014 election, Republican governors in a handful of states that had previously been reluctant to consider Medicaid expansion are now trying to win over their Republican-controlled legislatures to expand Medicaid.
Feb 23, 2015
Public Policy Webinar: ACA Employer Reporting – Final IRS Forms and Instructions
Recently, the IRS issued final forms and instructions for the ACA's employer reporting requirements, which become effective in 2016 for the 2015 calendar year. During this webinar, we provide an overview of these forms and instructions.
Feb 20, 2015
IRS Issues More Guidance on Premium Reimbursement & HRAs
The IRS issued Notice 2015-17, which offers additional guidance for employers who wish to offer benefits that supplement Medicare and TRICARE. This guidance is similar to prior agency guidance permitting employers to offer HRAs to active employees and be considered in compliance with the ACA, provided the HRAs are integrated with other health coverage.
Feb 19, 2015
IRS Issues Final Forms and Instructions for ACA Employer Reporting
The IRS issued final 2014 forms and instructions implementing the ACA’s employer reporting requirements. These forms and instructions will be helpful as employers prepare to furnish statements to employees for the first time by 2/1/2016 and file electronic returns to the IRS for the first time by 3/312016.
Feb 11, 2015
CA’s Network Requirements Could Spread to Other States
California’s Insurance Commissioner issued “emergency” network adequacy requirements for (non-managed care) individual and small group plans in 2016.
Feb 5, 2015
Public Policy Webinar: ACA Regulatory Update
During this webinar, we provide an overview of recent agency guidance on the ACA, including guidance on the Summary of Benefits and Coverage, excepted benefits, and retiree health. Attendees will have an opportunity to ask questions.
Jan 30, 2015
Comments to DOL, HHS, and IRS on Proposed Regulations Regarding Excepted Benefits and Limited Wraparound Coverage
The National Business Group on Health, in response to proposed regulations related to benefits qualifying as "excepted benefits," submitted comments encouraging flexibility in rules for limited wraparound coverage.
Jan 22, 2015
House Sends 40-Hour Employer Mandate Bill to the Senate
The House passed a bill that would change the ACA’s full-time employee definition from 30 hours per week to 40 hours per week.
Jan 16, 2015
No Major Health Care Proposals Expected in State of the Union
In the annual State of the Union address, the President is likely to restate his willingness to work with Congress on minor ACA changes that would cut costs, provide coverage to more people and increase choice, but he will also continue to oppose bills that would repeal or defund major parts of the law.
Jan 16, 2015
Outlook for 2015: What to Expect from Washington in 2015
This webinar will assess the impact of post-election developments and other factors that are likely to affect employers and health care in 2015.
Jan 16, 2015
Essential Health Benefits FAQ
An FAQ associated with the Health Reform (Patient Protection and Affordable Care Act) Implementation and Communications Toolkit
Jan 13, 2015
Transitional Reinsurance Program Contributions FAQ
An FAQ associated with the Health Reform (Patient Protection and Affordable Care Act) Implementation and Communications Toolkit
Jan 13, 2015
1094-C and 1095-C Reporting Requirements
The purpose of this survey is to determine how employers are complying with these new reporting requirements. Thirty-six members of the Business Group responded to this survey.
Nov 6, 2014
Patient-Centered Outcomes Research Trust Fund Fees FAQ
An FAQ associated with the Health Reform (Patient Protection and Affordable Care Act) Implementation and Communications Toolkit
Sep 29, 2014
IRS Issues More ACA Guidance on Fees, Full-Time Status
The IRS issued additional guidance on several ACA-related tax rules that apply to plan sponsors and their group health plans, including PCORTF fees, cafeteria plan rules, and employer shared responsibility rules.
Sep 23, 2014
Large Employers' 2015 Health Plan Design Survey
This year’s survey looks at the benefit offerings of 136 large employer members of the Business Group, and the changes they are making for 2015. Areas of focus include: changes due to ACA provisions, health care costs, consumerism, transparency and health improvement.
Aug 11, 2014
Large Employers' 2015 Health Plan Design Survey Chart Pack
This chart pack provides a summary of the benefit offerings of 136 large employers and the changes they are making for 2015. Areas of focus include: changes due to ACA provisions, health care costs, consumerism, transparency and health improvement.
Aug 11, 2014
Letter to the Mayor of San Francisco Requesting that the City Repeal the Employer Mandate Provisions of the Health Care Security Ordinance
The National Business Group on Health sent a letter to San Francisco Mayor Edwin M. Lee requesting that the city repeal the employer mandate provisions of the Health Care Security Ordinance. While the Business Group supports efforts to increase the number of people insured, we believe that the city can do so without taxing employer plans.
Aug 5, 2014
Questions to Consider When Requesting Information from Private Exchanges
This document provides our members with specific questions to consider when evaluating a private exchange including company overview, profile, transition/technology/implementation, administrative profile, revenue/fees, structure/products, employee exchange experience and financial aspects.
Jul 17, 2014
Agencies Finalize ACA Orientation Period Rule
The IRS, DOL, and HHS issued additional final regulations on the ACA’s prohibition on group health plan waiting periods longer than 90 days. Specifically, the regulations address the 1-month orientation period that can apply in addition to a waiting period of up to 90 days.
Jun 30, 2014
Agencies Update COBRA Guidance
Recently, the Department of Labor, Department of Health and Human Services , and Department of the Treasury issued guidance (1) detailing individuals’ special enrollment rights for Exchange coverage, in reference to COBRA, and (2) providing updated COBRA and CHIPRA notices.
May 8, 2014
Staffing Agencies and the Impact of ACA
The purpose of this survey was to find out whether Business Group members currently require staffing agencies to provide health benefits to temporary employees staffed through the agency. Twenty-two members of the Business Group responded to this survey.
Apr 28, 2014
IRS Issues Final Regulations on Employer Reporting Requirements under ACA
The IRS issued final regulations implementing the Affordable Care Act’s employer reporting requirements. This reporting, among other things, will allow the IRS to verify employers’ liability for employer shared responsibility payments and individuals’ eligibility for premium tax credits.
Mar 11, 2014
The New Health Care Imperative: the 19th Annual Employer Survey on Purchasing Value in Health Care Executive Summary
The National Business Group on Health/Towers Watson Employer Survey on Purchasing Value in Health Care looks at how employers are viewing health benefits in an era of transformation. This executive summary provides an overview of key finding from this year's survey.
Mar 5, 2014
Preventive Services and Billing in the New World of the ACA
This Employer Alert discusses the main reasons why employees face unexpected costs, offers recommendations for large employers, and presents brief examples from health plans.
Feb 28, 2014
90-Day Waiting Period Limitation FAQ
An FAQ associated with the Health Reform (Patient Protection and Affordable Care Act) Implementation and Communications Toolkit
Feb 27, 2014
IRS Issues Final Regulations on ACA Employer Shared Responsibility Provisions
The Internal Revenue Services (IRS) issued final regulations implementing the Affordable Care Act’s employer shared responsibility provisions (often referred to as the “employer mandate”). These regulations largely retain the prior proposed rules but do provide some additional flexibility and helpful clarifications for plan sponsors.
Feb 11, 2014
Health Account FAQ
An FAQ associated with the Health Reform (Patient Protection and Affordable Care Act) Implementation and Communications Toolkit
Feb 6, 2014
Health Insurance Exchanges FAQ
An FAQ associated with the Health Reform (Patient Protection and Affordable Care Act) Implementation and Communications Toolkit
Feb 6, 2014
Testimony to the U.S. House Committee on Ways and Means Recommending Congress Change the 2010 Health Care Law's Full-Time Employee Definition
The National Business Group on Health submitted testimony to the U.S. House Ways and Means Committee urging the Congress to change the full-time employee definition from 30 hours to the more commonly-used 40 hours for employer shared responsibility (mandate) payments under the Patient Protection and Affordable Care Act (ACA)--with flexibility for employers to define a different standard.
Jan 28, 2014
Agencies Issue FAQs on ACA Out-of-Pocket Maximums and Wellness Program Rules
The DOL, HHS, and Treasury issued FAQs on a number of group health plan topics, including: ACA rules for group health plans’ out-of-pocket maximums; wellness program rules; coverage of breast cancer medications as ACA preventive services; fixed indemnity insurance and other supplements to health coverage as excepted benefits; and expatriate health insurance coverage under ACA.
Jan 10, 2014
Chart on the Individual Mandate Penalties
This chart provides more details on the penalties associated with not complying with the individual mandate.
Dec 12, 2013
Additional Medicare Tax FAQs
An FAQ associated with the Health Reform (Patient Protection and Affordable Care Act) Implementation and Communications Toolkit
Dec 9, 2013
IRS Issues Final Regulations on Additional Medicare Tax
The IRS issued final regulations implementing the Additional Medicare Tax, an additional 0.9% in Medicare tax that applies to higher-income individuals beginning with the 2013 tax year.
Dec 2, 2013
Health Care Legislation- The Impact on Employers: C-Suite Series
This short slide presentation provides the latest data on the impact of health care legislation on employers.
Nov 25, 2013
Final Mental Health Parity Rules: What's Changed and What's the Same
During this webinar, we provide an overview of the new regulations under the Mental Health Parity and Addiction Equity Act and how they apply to group health plans.
Nov 22, 2013
Comments to IRS on Proposed Regulations Related to Reporting on Minimum Essential Coverage
The National Business Group on Health, in response to proposed regulations under the Affordable Care Act related to reporting on minimum essential coverage, submitted comments recommending flexibility to report in a manner that accommodates plans' current administrative, payroll, and recordkeeping procedures.
Nov 8, 2013
Individual Mandate FAQ
An FAQ associated with the Health Reform (Patient Protection and Affordable Care Act) Implementation and Communications Toolkit
Nov 8, 2013
Lifetime Annual Dollar Limit FAQ
An FAQ associated with the Health Reform (Patient Protection and Affordable Care Act) Implementation and Communications Toolkit
Nov 4, 2013
Narrow Networks in Today’s Health Care Climate
Looks at narrow networks in the context of today’s health care environment, and provides examples of companies using them in unique ways as part of their overall health benefits strategy.
Nov 1, 2013
Patient Protection and Affordable Care Act: Timeline of Key Employer Provisions
A chart highlighting the timeline of key employer issues in the final health care law.
Sep 19, 2013
Final Health Reform Law Provisions
A chart that provides key details of the final health care law's provisions
Sep 17, 2013
Employer Mandate Delay, Your Company's Response
The purpose of this survey was to determine how the employer mandate delay would impact employers' plans for 2014, especially whether they would proceed with offering coverage to all employees working an average 30 hours or more per week. Forty-two members of the Business Group responded to this survey
Aug 8, 2013
Clinical Trial Requirement - HR Slides
Supporting documentation for the Health Reform (Patient Protection and Affordable Care Act) Implementation and Communications Toolkit
Jul 18, 2013
Clinical Trial Requirement - Q&A
Supporting materials for the Health Reform (Patient Protection and Affordable Care Act) Implementation and Communications Toolkit
Jul 18, 2013
HHS Issues Final Regulations on Individual and Employer Interactions with Exchanges under ACA
HHS has issued final regulations implementing certain Affordable Care Act provisions related to Affordable Insurance Exchanges, including rules for verifying individuals’ access to employer-sponsored coverage.
Jul 18, 2013
Agencies Issue Guidance on Affordable Care Act’s Individual Mandate, Exchanges, and Contraceptive Coverage
HHS, DOL, and IRS issued guidance implementing a number of ACA provisions, including: final regulations on the ACA’s individual mandate and certain Exchange functions; guidance on reporting related to premium tax credits, guidance on the interaction between employer-sponsored health coverage, government-sponsored health coverage, and the individual mandate; and final regulations on coverage of women’s preventive services.
Jul 3, 2013
IRS Issues New Form for Patient-Centered Outcomes Research Trust Fund Fees
The IRS has issued a revised form with instructions, for filing and paying Patient-Centered Outcomes Research Trust Fund fees.
Jun 4, 2013
Notice of Coverage Options FAQ
An FAQ associated with the Health Reform (Patient Protection and Affordable Care Act) Implementation and Communications Toolkit
May 10, 2013
DOL Issues Model Notice to Employees of Coverage Options Required by Affordable Care Act
The DOL issued guidance and model notices for the Notice to Employees of Coverage Options, which employers must distribute to employees by 10/1/2013. The DOL also issued a revised Model COBRA Continuation Coverage Election Notice that incorporates information about Exchanges.
May 9, 2013
Agencies Issue Additional Guidance on ACA Requirements for Plans and Insurers and Early Retiree Reimbursement Program
HHS, DOL, and Treasury issued Frequently Asked Questions providing additional guidance on several plan and insurer requirements under the Affordable Care Act. CMS also issued guidance for plan sponsors in anticipation of the January 1, 2014 end of the Early Retiree Reimbursement Program.
May 3, 2013
Agencies Issue FAQs on Summary of Benefit and Coverage
HHS, DOL, and Treasury issued Frequently Asked Questions providing guidance on additional Summary of Benefits and Coverage language for the second year of applicability.
Apr 25, 2013
Cost-Sharing Arrangements for ACA-Related Fees
The purpose of the survey was to determine how employers would share the cost of the transitional reinsurance program contributions and other ACA-related fees with health plan participants. In addition, respondents were asked if they have or will be sending out communications specific to these ACA-related fees. Fifty employers participated in this survey.
Mar 25, 2013
OPM Issues Final Regulations on Multi-State Plans for Exchanges
Recently, the Office of Personnel Management (OPM) issued final regulations implementing the Multi-State Plan Program (MSPP). These regulations provide a framework for multi-State plans (MSPs), which will become available beginning in 2014 for individuals and certain small employers through state insurance Exchanges.
Mar 12, 2013
HHS Issues Final Regulations on ACA Transitional Reinsurance Program
The Department of Health and Human Services has issued final regulations implementing a number of Affordable Care Act provisions, including those related to the ACA’s transitional reinsurance program. These regulations provide guidance for determining the amount and process for self-insured plans’ and insurers’ contributions to this program.
Mar 5, 2013
HHS Issues Final Regulations on Minimum Value, Essential Health Benefits, and Other ACA Rules
HHS issued final regulations implementing a number of Affordable Care Act requirements, including rules for: (1) determining whether employer-sponsored coverage provides “minimum value” for purposes of the ACA’s employer shared responsibility penalties, (2) cost-sharing limits for group health plans, and (3) the definition of “essential health benefits.”
Feb 22, 2013
Agencies Issue FAQs on Out-of-Pocket Maximums and Required Preventive Services under Affordable Care Act
HHS, DOL, and Treasury issued Frequently Asked Questions that provide additional guidance on various Affordable Care Act topics, including more details on compliance with preventive services coverage requirements.
Feb 21, 2013
Form W-2 Reporting of Cost of Health Care Coverage FAQ
An FAQ associated with the Health Reform (Patient Protection and Affordable Care Act) Implementation and Communications Toolkit
Feb 18, 2013
Multi-State Plan FAQs
An FAQ associated with the Health Reform (Patient Protection and Affordable Care Act) Implementation and Communications Toolkit
Feb 18, 2013
Premium Tax Credit FAQ
An FAQ associated with the Health Reform (Patient Protection and Affordable Care Act) Implementation and Communications Toolkit
Feb 18, 2013
Rescission FAQs
An FAQ associated with the Health Reform (Patient Protection and Affordable Care Act) Implementation and Communications Toolkit
Feb 18, 2013
Retiree Health Benefits FAQ
An FAQ associated with the Health Reform (Patient Protection and Affordable Care Act) Implementation and Communications Toolkit
Feb 18, 2013
Break Time for Nursing Mothers FAQ
An FAQ associated with the Health Reform (Patient Protection and Affordable Care Act) Implementation and Communications Toolkit
Feb 15, 2013
Dependent Child Coverage to Age 26 FAQ
An FAQ associated with the Health Reform (Patient Protection and Affordable Care Act) Implementation and Communications Toolkit
Feb 15, 2013
Grandfathered Health Plan FAQ
An FAQ associated with the Health Reform (Patient Protection and Affordable Care Act) Implementation and Communications Toolkit
Feb 15, 2013
Internal Appeals and External Review FAQ
An FAQ associated with the Health Reform (Patient Protection and Affordable Care Act) Implementation and Communications Toolkit
Feb 15, 2013
Medicaid Expansion FAQ
An FAQ associated with the Health Reform (Patient Protection and Affordable Care Act) Implementation and Communications Toolkit
Feb 15, 2013
IRS Issues Additional Final Regulations on Premium Tax Credit under Affordable Care Act
The IRS issued final regulations clarifying that for purposes of individuals’ eligibility for premium tax credits, affordability of employer-sponsored coverage is based on whether the portion of the annual premium the employee must pay for self-only coverage exceeds 9.5% of household income.
Feb 6, 2013
Agencies Issue FAQs on Notice to Employees and Other Affordable Care Act Issues
HHS, DOL, and Treasury issued Frequently Asked Questions that provide additional guidance on various Affordable Care Act topics, including a delay of the notice to employees regarding Exchanges until DOL issues regulations.
Jan 25, 2013
Employers' Use of IRS Safe Harbor for Variable Hour and Seasonal Employees
The purpose of this survey was to determine how many employers have variable hour and/or seasonal employees, and especially how many of those employers would be taking advantage of the IRS safe harbor. The survey also looks at health care reform-related communications in 2013 and potential workforce composition changes as a result of the ACA.
Jan 4, 2013
Comments to the U.S. Preventive Services Task Force (USPSTF) Recommending a Rigorous Scientific Review of Evidence for A and B Preventive Services
The National Business Group on Health sent comments to the U.S. Preventive Services Task Force (USPSTF) regarding a deep and growing concern regarding the current direction of A and B recommendations from USPSTF which is leading us down a path towards indiscriminate testing and exacerbating the problem of health care affordability in the U.S.
Dec 10, 2012
IRS Issues Final Regulations on Patient-Centered Outcomes Research Trust Fund Fees
The Internal Revenue Service released final regulations providing details on the types of group health plans subject to Patient-Centered Outcomes Research Trust Fund fees, how plan sponsors will calculate the fees based on the number of covered lives, and how the IRS will process fee payments. These final regulations confirm most of the rules from the April 2012 proposed regulations but provide some useful clarifications and additional guidance.
Dec 6, 2012
IRS Issues Guidance on "Free Rider" Assessment and 90-Day Waiting Period Limitation under ACA
The IRS has released guidance and requests for comment on determining whether employees are full-time for purposes of the "free rider" assessment and the 90-day waiting period limitation under the ACA.
Sep 5, 2012
U.S. Supreme Court Decision Rules Affordable Care Act Constitutional
The U.S. Supreme Court upholds all provisions of the Affordable Care Act.
Jun 28, 2012
Agencies Issue More Guidance on Summary of Benefits and Coverage under the Affordable Care Act
HHS, DOL, and Treasury have issued additional guidance, in the form of FAQs, on the ACAs Summary of Benefits and Coverage requirements.
May 15, 2012
Comments to DOL on Affordable Care Act Automatic Enrollment, Employer Shared Responsibility, and Waiting Period Requirements
The National Business Group on Health, in response to Frequently Asked Questions regarding the Affordable Care Act's automatic enrollment, employer shared responsibility, and waiting period requirements, submitted comments encouraging flexibility for plan sponsors in implementing these requirements.
Apr 9, 2012
More on HHS's Exchange Regulations under the Affordable Care Act
This Public Policy Alert focuses on HHS's final exchange regulations that set forth minimum standards for establishing and participating in Exchanges and basic standards that employers must meet to participate in the Small Business Health Options Program (SHOP).
Mar 22, 2012
Agencies Issue Additional Guidance on Summary of Benefits and Coverage under Affordable Care Act
HHS, DOL, and Treasury have issued additional guidance, in the form of FAQs, on the ACAs Summary of Benefits and Coverage requirements.
Mar 20, 2012
HHS Issues Final Regulations Implementing Exchanges under Affordable Care Act
The Department of Health and Human Services (HHS) recently released final regulations implementing Exchanges under the Patient Protection and Affordable Care Act.
Mar 13, 2012
Federal Agencies Issue Additional Guidance on Employer Free Rider Assessment, 90-Day Waiting Period Limitation, and Automatic Enrollment under Affordable Care Act
HHS, DOL, and Treasury have issued additional guidance on the employer free rider assessment, 90-day waiting period limitation, and automatic enrollment provisions of the Affordable Care Act.
Feb 10, 2012
Federal Agencies Issue Final Regulations on Summary of Benefits and Coverage Required under Affordable Care Act
HHS, DOL, and Treasury have issued final regulations, compliance guidance, and templates implementing the Summary of Benefits and Coverage requirement under the Affordable Care Act.
Feb 10, 2012
IRS Issues Additional Guidance on W-2 Reporting Requirement under the Affordable Care Act
The IRS has issued additional guidance on how employers should report the costs of health coverage on Forms W-2.
Jan 5, 2012
San Francisco Issues New Guidance on Health Care Security Ordinance
San Francisco's Office of Labor Standards Enforcement has issued guidance on new Health Care Security Ordinance provisions.
Jan 4, 2012
HHS Guidance Proposes to Let Each State Define Essential Health Benefits
The Department of Health and Human Services (HHS) issued a Bulletin outlining a proposed regulatory approach to defining "essential health benefits" under the Affordable Care Act.
Dec 19, 2011
Patient Protection and Affordable Care Act: Communicating with C-Suite
Dec 19, 2011
Patient Protection and Affordable Care Act: Communicating with Your HR Department
Dec 19, 2011
Centers for Medicare and Medicaid Services' (CMS) Final Rule Paves the Way for Release of Medicare Claims Data
CMS released a final rule on Medicare claims data sharing that allows qualified entities (employers, data warehouses/integrators, insurers, nonprofit organizations, consumer groups, etc.) to combine Medicare claims data with commercial claims data to evaluate physicians' efficiency and measure their performance on specific quality measures at the individual physician, physician group, or integrated delivery system levels.
Dec 12, 2011
Comments to the Centers for Medicare and Medicaid Services (CMS) on the Final Rule Establishing Accountable Care Organizations (ACOs)
The National Business Group on Health sent comments to the Centers for Medicare and Medicaid Services (CMS) on the final rule implementing Section 3022 of the Patient Protection and Affordable Care Act (ACA) establishing the Medicare Shared Savings Program and Accountable Care Organizations (ACOs).
Nov 29, 2011
Comments to the Director of the HHS Center for Consumer Information and Insurance Oversight Recommending HHS Require Transparency of Provider-Specific Price and Quality Information from Exchange Plans
The National Business Group on Health sent a letter to the Department of Health and Human Services to ensure the capability of the exchanges and exchange boards to meet the growing consumer demand for provider and facility-specific price and quality information.
Nov 21, 2011
External Review Checklist: Contract and Administration Issues Related to Independent Review Organizations (IROs)
This document provides a checklist of issues for plans to consider when contracting and working with IROs.
Nov 10, 2011
Summary Plan Description (SPD) Checklist: Internal Claims and Appeals and External Review
This document provides a checklist of provisions to include and issues to consider when amending SPDs to include internal claims and appeals and external review requirements under the Affordable Care Act.
Nov 10, 2011
On-Site Health Centers: Policies to Preserve and Promote an Effective Employer Solution
This policy paper discusses what on-site health centers (OHCs) are, what employers need to know to comply with the federal regulatory requirements in light of the Affordable Care Act and the Business Group's recommended policies to support and encourage OHCs and related programs.
Sep 1, 2011
State Options for Reform that Do Not Affect ERISA
Aug 23, 2011
New Regulations Requiring Coverage of Women's Preventive Services under PPACA
Recently, the Health Resources Services Administration (HRSA) released guidelines that require that non-grandfathered group health plans and insurers cover women's preventive services without cost-sharing under the Patient Protection and Affordable Care Act.
Aug 2, 2011
Patient Protection and Affordable Care Act: Timeline of Key Employer Provisions
Jul 29, 2011
Patient Protection and Affordable Care Act: Communicating with Retirees
Jul 25, 2011
Department of Health and Human Services (HHS) Releases Initial Rules Giving States Flexibility to Establish Insurance Exchanges
The Department of Health and Human Services (HHS) released initial rules which offer the states flexibility in establishing insurance exchanges that includes some important details for employers; however, other details await future guidance.
Jul 21, 2011
Quality and Safety
Jun 25, 2011
Federal Agencies Release Amended Rules and New Guidance for Internal Claims and Appeals and External Review Processes under PPACA
The Internal Revenue Service (IRS), Department of Labor (DoL) and Health and Human Services (HHS) issued an amendment to the interim final regulations and technical release for internal claims and appeals and external review processes.
Jun 24, 2011
Patient Protection and Affordable Care Act: Communicating with Employees
Jun 20, 2011
CMS to Release Medicare Claims Data
Recently, the government took the first step toward making Medicare claims data available to employers and consumers by issuing a proposed rule on the release and use of this information.
Jun 6, 2011
Comments to the Centers for Medicare and Medicaid Services (CMS) on the Medicare Shared Savings Program and Accountable Care Organizations (ACOs)
The National Business Group on Health submitted recommendations to the Centers for Medicare and Medicaid Services (CMS) on the proposed rule implementing Section 3022 of the Patient Protection and Affordable Care Act (ACA) establishing the Medicare Shared Savings Program and Accountable Care Organizations (ACOs) to ensure ACOs truly deliver on the promise of better care and better health at lower costs.
Jun 6, 2011
Vermont Law Aims to Establish Single-Payer Health Coverage
The law is currently not funded and would require a federal waiver to apply to ERISA plans.
May 13, 2011
IRS Says People May Use Health Accounts to Pay for Breast Pumps and Lactation Supplies
Recently, the IRS announced that people may use their health accounts [flexible spending accounts (FSAs), health reimbursement arrangements (HRAs), or health savings accounts (HSAs)] to pay for breast pumps and lactation supplies.
Feb 11, 2011
Internal Revenue Service (IRS) Permits the Use of Health Account Debit Cards for Prescribed Over-the-Counter (OTC) Medicines
The IRS revised recent rules to allow people to continue to use flexible spending account (FSA) and health reimbursement arrangement (HRA) debit cards to purchase prescribed OTC medicines and drugs.
Dec 28, 2010
Reminder, Beginning in 2011, Internal Revenue Service (IRS) Rules Restrict the Use of Health Accounts for Over-the-Counter (OTC) Medicines to Those with Prescriptions
Beginning January 1st, 2011 people may use health flexible spending accounts (FSAs), health savings accounts (HSAs), or health reimbursement arrangements (HRAs) to pay for OTC medicines only if they have prescriptions for them.
Dec 16, 2010
Patient Protection and Affordable Care Act: Medicare and Medicaid Health Care Payment, Quality and Delivery Reforms
A timeline chart of the Medicare and Medicaid health care payment, quality and delivery reforms in the Patient Protection and Affordable Care Act (Affordable Care Act)
Dec 13, 2010
Agencies Modify Regulations on Grandfathered Plans
Recently, the Departments of Labor (DoL), Health and Human Services (HHS), and Treasury (IRS) issued rules that modify the previous regulations on grandfathered plans.
Nov 16, 2010
Public Policy Alert: The Department of Labor Clarifies More Questions on Health Care Law
The Department of Labor (DoL) responded to a number of questions employers have on the grandfathered plan rules, the conflict between rescissions and COBRA, the preventive benefits requirements for non-grandfathered plans and the treatment of dental and vision plans.
Oct 19, 2010
Government Provides Some Relief and Added Flexibility on Internal Appeals Changes and Expands External Review
Recently, the Departments of Labor (DoL), Health and Human Services (HHS), and Treasury issued technical guidance in several forms with the goal of easing some of the requirements of the new health care law for health plans, including employer-sponsored health plans.
Sep 21, 2010
Internal Revenue Service Releases Guidance on Use of Health Accounts for Over-the-Counter Drugs in 2011
The Internal Revenue Service (IRS) released guidance on the Patient Protection and Affordable Care Act's (Affordable Care Act) provision that revises the definition of qualified "medical expenses" to exclude over-the-counter (OTC) medicines or drugs, unless prescribed by physicians, for employer-provided plans including health flexible spending accounts (FSAs), health reimbursement arrangements (HRAs) or Health Savings Accounts (HSAs).
Sep 10, 2010
Innovations In Plan Design: Better Health at a Lower Cost
An new value-based benefit design product introduced by health plans in the Oregon market is designed to achieve up to 10% reduction in premium while addressing underuse of effective care and overuse of preference and supply-sensitive interventions.
Jul 30, 2010
Department of Labor Issues Fact Sheet on New Break Time Requirements for Nursing Mothers
The Department of Labor (DoL) issued a Fact Sheet providing guidance for employers on the requirements of the Patient Protection and Affordable Care Act's (Affordable Care Act) amendment of the Fair Labor Standards Act (FLSA) that requires employers to provide break times to nursing mothers.
Jul 29, 2010
Federal Agencies Release Regulations on Health Plan Requirements for Preventive Services
Non-grandfathered plans must cover the preventive services with no cost-sharing.
Jul 15, 2010
Supreme Court Denies Review of San Francisco's Employer Health Coverage Ordinance
The U.S. Supreme Court recently announced that it will not review the U.S. Ninth Circuit Court of Appeals' decision that San Francisco's "pay or play" ordinance does not violate the Employee Retirement Income Security Act (ERISA).
Jun 28, 2010
Agencies Release Regulations on Annual and Lifetime Limits and Pre-Existing Conditions Exclusions
The Departments of Labor (DoL), Health and Human Services (HHS), and Treasury (IRS) released regulations on various aspects of the Patient Protection and Affordable Care Act (PPACA) including rules clarifying allowable annual and lifetime limits and prohibited pre-existing conditions exclusions.
Jun 24, 2010
Agencies Release Regulations on Grandfathered Plans
The Departments of Labor (DoL), Health and Human Services (HHS), and Treasury (IRS) released regulations earlier today on allowable benefit changes group health plans can make while continuing to maintain their grandfathered plan status.
Jun 14, 2010
Federal Agencies Release Rules for Extending Dependent Coverage to Age 26
The rules clarify allowable employee contribution differentials for adult dependent coverage, prohibited dependent eligibility criteria and employer notification requirements.
May 11, 2010
Public Policy Alert - Congress Passes Landmark Health Insurance Changes
The law has both immediate and long-term implications for employer-sponsored group health plans.
Mar 30, 2010
President to Sign SCHIP Expansion Today
President Barack Obama signed a law to extend and expand the State Children's Health Insurance Program (SCHIP) with implications for employer plan administrators beginning April 1st.
Feb 4, 2009
Joint Friend of the Court (Amicus) Brief in Support of ERISA Preemption of San Francisco Health Reform Ordinance
Friend of the Court legal brief submitted to the Ninth U.S. Circuit Court of Appeals supporting ERISA Preemption of San Francisco Health Reform Ordinance
Oct 31, 2008
9th Circuit Rules On San Francisco's Employer Health Coverage Mandate
Federal Appeals Court Rules that San Francisco's Employer Health Coverage Mandate Does Not Violate ERISA.
Sep 30, 2008
SEC Provides Inconsistent Advice on Excluding Health Care Resolutions from Proxy Materials
The SEC has recently sent inconsistent advisory opinions to companies on including resolutions on health care in proxy materials for annual shareholder meetings. The petitions are designed to pressure employers on health reform.
Jun 6, 2008
Joint Friend of the Court (Amicus) Brief Opposing Employer Mandates in San Francisco's Health Care Ordinance
Friend of the Court legal brief submitted to the Ninth U.S. Circuit Court of Appeals in support of the lower federal district court ruling that found that the employer "pay or play" mandate in San Francisco's universal health care plan violated the Employee Retirement Income Security Act of 1974 (ERISA).
Mar 28, 2008
San Francisco Employer Health Coverage Mandate Can Go Forward While Court Considers Appeal
Federal appeals court says San Francisco employer health coverage mandate can go forward while court considers appeal. The 9th Circuit expects to rule by fall and hints that it may say that city ordinance does not violate ERISA.
Jan 10, 2008
Comparative Effectiveness Research
Dec 1, 2007
Massachusetts Law Requires all Residents to Have Health Insurance; Employers Must Offer Coverage or Pay State
The Massachusetts Legislature passed a health care financing reform law that requires all state residents to have health coverage and requires employers to either offer coverage or pay the state.
Apr 5, 2006

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