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The Wagner Law Group Description 

The Wagner Law Group, A Professional Corporation, is a nationally recognized ERISA & employee benefits, estate planning, employment, labor & human resources practice. 

 

Established in 1996, The Wagner Law Group has 23 attorneys engaged exclusively in employee benefits, estate planning and employment law. Seven of our attorneys are AV rated by Martindale-Hubbell as having very high to preeminent legal abilities and ethical standards. The firm is among the largest ERISA boutiques in the country. Our practice is national in scope, with clients in more than 40 states and several foreign countries.

 

 

Contact Info

The Wagner Law Group

 

  Integrity | Excellence

  

Massachusetts Office 

Tel: (617) 357-5200 

Fax: (617) 357-5250 

99 Summer Street 

13th Floor

Boston, MA 02110


Florida Office 

Tel: (561) 293-3590
Fax: (561) 293-3591
7108 Fairway Drive
Suite 125
Palm Beach Gardens, FL 33418

   

San Francisco Office

Tel: (415) 625-0002

Fax: (415) 358-8300

315 Montgomery Street

Suite 904

San Francisco, CA 94104

 

www.wagnerlawgroup.com

 

 

November 21, 2013

 

 State and Federal Law Alert

 

HHS Adopts Transition Rule Allowing Renewal of Noncompliant Health Insurance Policies

 

 

The Department of Health and Human Services ("HHS") has adopted a transition rule allowing insurers to continue to offer certain health insurance policies that were scheduled to be cancelled by January 1, 2014, due to noncompliance with PPACA. The transition rule was outlined in a letter that HHS sent to state insurance commissioners on November 14, 2013.

 

Relief Provided under Transition Rule. Policies covered by the transition rule need not comply with PPACA's: (i) premium rating; (ii) guaranteed availability; (iii) guaranteed renewability; and (iv) essential health benefits rules. Individual policies eligible for the transition rule relief can also avoid compliance with PPACA's prohibition on: (i) preexisting condition exclusions for adults; and (ii) discrimination based on a health factor. Small group policies, however, must still comply with these two PPACA reforms.

 

Transition Rule Eligibility. HHS's transition rule applies to individual and small group policies renewed for a policy year starting between January 1, 2014 and October 1, 2014. To qualify for the relief provided by the transition rule, the coverage must have been in effect on October 1, 2013.

 

Insurers must also send informational notices to all affected individuals and employers. In instances where insurers have already sent cancellation notices to individuals and employers, informational notices must be provided as soon as reasonably possible. Insurers that have not yet furnished cancellation notices must send the information notices at approximately the time that the cancellation notices would have otherwise been sent.

 

Informational Notice Content. The informational notice must inform affected individuals and employers of:

  • any changes in the options available to them;
  • the PPACA reforms that are not included in the coverage offered;
  • the potential right to enroll in a health plan offered through a Health Insurance Marketplace (i.e., an Exchange) and the possibility of qualifying for financial assistance;
  • the method to access such coverage through an Exchange; and
  • the right to enroll in coverage that complies with the specified market reforms outside of an Exchange. 

The HHS letter outlining the transition rule can be accessed at: http://www.cms.gov/CCIIO/Resources/Letters/Downloads/commissioner-letter-11-14-2013.PDF

      

 

This Newsletter is protected by copyright. Material appearing herein may be reproduced with appropriate credit.

  

Pursuant to Internal Revenue Service Circular 230, we hereby inform you that any advice set forth herein with respect to US federal tax issues is not intended or written by The Wagner Law Group to be used and cannot be used, by you or any taxpayer, for the purpose of avoiding penalties that may be imposed on you or any other person under the Internal Revenue Code.

 

This Newsletter is provided for information purposes by The Wagner Law Group to clients and others who may be interested in the subject matter, and may not be relied upon as specific legal advice.  This material is not to be construed as legal advice or legal opinions on specific facts. Under the Rules of the Supreme Judicial Court of Massachusetts, this material may be considered advertising.