Legislative Updates from 2009

1/1/09
Centers for Medicare and Medicaid – CMS GHP reporting – A new mandatory reporting law, the Medicare, Medicaid and SCHIP Extension Act, now requires us to report information that the Secretary of the Department of Health and Human Services requires for purposes of coordination of benefits. Medicare Secondary Payer (MSP) mandatory reporting requirements are effective January 1, 2009, for group health plans, and will require the Social Security number for each plan participant.
Employer Involvement: Innovanté will request Social Security numbers upon enrollment for each subscriber and dependents, as well as request any missing numbers.

3/1/09
COBRA – As a result of the American Recovery and Reinvestment Act of 2009 (ARRA), changes will affect employers whose group health plans are subject to COBRA. The Act provides a 65% government subsidy to employees who are involuntarily terminated between September 1, 2008, and December 31, 2009. The employer must first provide this payment and then be reimbursed by the government. The government will provide a 65% subsidy for up to 9 months of the COBRA premium, effective March 1, 2009, for certain terminated employees.
Update: The involuntary termination period has been extended as of December 19, 2009. New legislation states that the involuntary termination must occur during the period that began September 1, 2008, and ends on February 28, 2010. The premium reduction applies to periods of health coverage that began on or after February 17, 2009 and lasts for up to 15 months.
Update: President Obama signed legislation on March 2, 2010, to extend until March 31 eligibility for the 65%, 15-month COBRA premium subsidy to individuals who have involuntarily lost their jobs. The Temporary Extension Act of 2010 (H.R. 4691) amends the American Recovery and Reinvestment Act of 2009 (ARRA). Without the extension, workers laid off after Feb. 28 would have missed out on the subsidy. The law is retroactive, so workers who were involuntarily terminated on March 1 and 2 are eligible for the subsidy.
Employer Involvement:The employer must initially provide the payment to the third party administrator based on the billing statement, and then the employer will be reimbursed by the government.

4/1/09
Children’s Health Insurance Plans Reauthorization Act (CHIPRA) – The Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA or Public Law 111-3) allows a state Children's Health Insurance Program (CHIP) to offer premium assistance to subsidize employer-provided coverage for eligible low-income children and families through FY 2013. The subsidy can be provided directly to the employee or can be paid to the employer. It will preserve coverage for the millions of children who rely on CHIP today and provides the resources for states to reach millions of additional uninsured children. This legislation will help ensure the health and well-being of our nation’s children.
Employer Involvement: No employer involvement required.

5/21/09
Genetic Information Nondiscrimination Act of 2008 - Enacted May 21, 2008, this Act is designed to prohibit the improper use of genetic information in health insurance and employment. The Act prohibits group health plans and health insurers from denying coverage to a healthy individual or charging that person higher premiums based solely on a genetic predisposition to developing a disease in the future. The legislation also bars employers from using individuals' genetic information when making hiring, firing, job placement, or promotion decisions.

10/3/09
Michelle’s Law – Amends and will apply to medically necessary leaves of absence. This law requires extended health coverage for a college student who is covered as a dependent if the student would have otherwise lost coverage because of a medically necessary leave of absence. This is effective for plan years beginning on or after October 3, 2009. The student must be enrolled as an eligible dependent under a fully insured or self-funded health plan and must be a student attending a post-secondary education institution. The student must be suffering from a serious injury or illness immediately before the first day of the medical leave. Written certification is required from the student’s treating physician indicating the leave of absence is medically necessary. If all requirements are met, the extended coverage period is the lesser of one year beginning on the first day of the medical leave of absence or until the date coverage would otherwise terminate.
Employer Involvement: A Plan Amendment is required to be compliant with the law. This is provided to you by your third party administrator.

10/3/09
Mental Health Parity Act (Wellstone Act) – Group health plans are now required to cover treatment of mental illnesses under the same terms and conditions that they cover all other illnesses, with two new areas of parity:

• Bans arbitrary numerical limits on coverage that does not also apply to medical and surgical coverage.
• Requires parity with financial limits, therefore prohibiting higher cost-sharing, deductibles, and out-of-pocket limits for mental illness than those applied to medical and surgical coverage. Health plans are not required to provide mental health coverage, but if they do, all of the above will apply.