Jenner & Block

Client Alert: Limited Excepted Benefits under Health Care Reform – What It Means to You?

The Department of Labor, Internal Revenue Service and Department of Health & Human Services recently issued proposed rules regarding the definition of “excepted benefits” (benefits that are not subject to the portability and nondiscrimination provisions of HIPAA and Health Care Reform).  These proposed regulations aim to fix what many viewed as a problematic discrepancy between the treatment of insured limited-scope plans and those limited-scope plans that are self-insured.  Under the previous regulatory framework, limited-scope dental and vision plans that were self-insured would be forced to satisfy additional conditions not required of their fully-insured counterparts. Under the proposed rulemaking, these additional requirements would be stricken, thereby making the requirements consistent between insured and self-insured coverage.