Tuesday, September 7, 2010

HHS issues guidance on waiver from annual limit requirements for mini-med plans

Late last week, the Department of Health and Human Services (HHS) ruled that a plan or insurer may apply for a waiver from the annual limit requirements for the plan year beginning between September 23, 2010 and September 23, 2011.

Waiver applications must be submitted to HHS (by mail or e-mail) at least 30 days before the beginning of the plan year, and will be processed within 30 days of receipt. However, for a plan year that begins before November 2, 2010, the application must be submitted 10 days before the beginning of the plan year. HHS will process the application no later than 5 days in advance of such a plan year.

The waiver will only last one year and a plan or insurer must reapply for any subsequent plan year prior to January 1, 2014, when the waiver process will expire in accordance with future guidance issued by HHS.

The waiver must include:
• The terms of the plan for which a waiver is sought;
• The number of individuals covered by the plan;
• The current annual limits and rates of the plan;
• A brief description of why compliance with the restricted annual limits would result in a significant decrease in access to benefits or a significant increase in premiums paid by those covered, along with supporting documentation; and
• An attestation, signed by the plan administrator or CEO of the insurance issuer, certifying (1) that the plan was in force prior to September 23, 2010; and (2) that the application of the restricted annual limits would result in a significant decrease in access to benefits or a significant increase in premiums paid.

For more information, click to access the HHS Sub-Regulatory Guidance.

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