The Power of A

A story in today’s Washington Post highlights the importance of associations in being involved in the regulatory process.  Many of the provisions of the Patient Protection and Affordable Care Act have regulatory requirements, and as deadlines in the legislation approach, it is critical that impacted nonprofits make their concerns known to the appropriate agencies as they write regulations and rules.

The example the article uses is the exemption for existing employer-provided plans from some requirements under the new health care law, or so-called “grandfathered plans”.  If an employer has an existing plan for employees in place in 2010, then according to the bill the plan would be exempt from some provisions including the prohibition on insurers charging co-payments and annual limits on out-of-pocket costs.

The key, however, is how federal regulators will define what changes an insurance plan can make before it loses its grandfathered status.  If an insurer raises rates or an employer changes from one insurance plan to another, theoretically this could cause an employer’s plan to lose grandfathered status and be required to comply immediately with a host of new provisions.

The regulations should be written soon, as many businesses are planning for their 2011 open enrollment season.  The concern is that any change done at the end of 2010 could unwittingly endanger an employer’s status for 2011 and beyond.

You can follow the implementation of the health care provision at this site, as well as other associations such as the Society for Human Resource Management.

The Department of Health and Human Services (HHS) could release as early as today an interim final rule on the provision in the health care reform bill allowing dependents up to age 26 to remain on a parent’s health care plan.

The provision was originally included in the health care bill to help people in their mid-twenties, the demographic least likely to have insurance, to have an affordable option besides a federal COBRA plan.  Current law varies by state, but most dependents must be off a parent’s insurance by age 21 or 22.  The insurance expansion has a deadline of September 23, but sixty-five insurers as of last week are already offering to keep older dependents on through age 26.

The concern for employers is how the provision will be implemented.  For an association or business offering insurance, it is unclear how dependents aged 22-26 will be classified - with other dependents or at a different rate.

The IRS has already issued guidance on the tax implications of the provision.  In their April 27 guidance, the IRS stated that insurance offered to under-27 children is generally tax-free for the employee and those employees in employer-provided cafeteria plans can begin making pretax contributions for this benefit.  You can read a thorough analysis of the provisions at the Society of Human Resource Management health care page.

Some of the expected provisions from the HHS guidance include: children can be on a parent’s plan even if they are married, don’t live at home, or are not a dependent for tax reasons.  They are prohibited until 2014 from joining a parent’s plan if they have an offer of insurance through their employer.

ASAE will post details on the HHS rule here once it becomes available.

As this year’s extended flu season continues, aided by numerous cases of H1N1 (or “swine”) flu, employers are grappling with the best way to balance the personal health of their employees, the public health risks of the contagious illness, and their own business operation plans in the face of critical absences from the office.  The Washington Post yesterday highlights some of the issues employers are facing during flu season, as well as some proposed solutions.

Workplace associations, many of whom are themselves facing this problem, have created a number of resources from a variety of perspectives to help all employers adapt to this environment.  The Society for Human Resource Management (SHRM) has created an “H1N1 (Swine) Flu Resources” page that allows members to receive and read up-to-date information on the disease.  Additionally, it provides a community for employers to share their thoughts on how to handle flu season and an email address for them to ask questions or share solutions to staffing issues.  SHRM also recently released “Doing Business During an Influenza Pandemic” a guide for businesses of all sizes to help cope with widespread flu outbreaks.

A major concern for epidemiologists are childcare facilities and schools, as germs and virus spread quickly in areas with high concentrations of children.  The American Academy of Pediatrics has an “H1N1 Swine Flu Information” website that covers not only medical facts about the disease, but resources and links for how to prevent the spread of H1N1 in the workplace and in workplaces with children.  For colleges and universities, the American Council on Education has created a Pandemic Flu Preparedness Resource while the National Association of College and University Attorneys has an updated Disaster Preparedness and Response page.

Does your association have a plan in place for H1N1 illness among staff?

Quick Hits

Military credit unions ask Congress for an exemption from an asset fee… Senator Chris Dodd (D-CT) will unveil his banking reform bill today… Some Democrats express concern over the projected costs of the proposed health care bills.