Benefits Update - May 2012, No. 2


In This Issue:

- Guidance On MLR Rebates For Insured Plans By Callan Carter (San Francisco)

One of the provisions in the recent healthcare reform law is the medical loss ratio (MLR) that requires insurance companies to spend a certain proportion of their income on healthcare benefits for their customers. If an insurance company does not meet its MLR standard, it is required to issue a rebate to its policyholders. (The MLR standards do not apply to self-insured medical plans.) In 2011, the Labor Department issued a Technical Release, which provided guidance on how sponsors of group health plans covered by ERISA should handle such rebates....

- HHS Begins HIPAA Privacy and Security Audits By Callan Carter (San Francisco)

As you may recall, the HITECH Act required Health and Human Services (HHS), the federal agency in charge of administering HIPAA, to affirmatively conduct periodic audits to ensure that covered entities and business associates are complying with HIPAA’s privacy and security rules. Before HITECH, HHS was mostly responding to complaints and not conducting random audits of HIPAA compliance....

- FAQs Regarding Summary Of Benefits And Coverage

In response to the February 14, 2012 final rules and regulations issued by the Labor Department regarding the summary of benefits and coverage (SBC) provisions of Health Care Reform, the DOL, in conjunction with Health and Human Services and the Treasury Department issued a new set of 24 Frequently Asked Questions to address some of the pertinent questions raised to date and to help consumers, employers and individuals understand the new law....

Please see full update below for more information.

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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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