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The Wagner Law Group

The Wagner Law Group is a nationally recognized practice in the areas of ERISA and employee benefits, estate planning, employment, labor and human resources and investment management.


Established in 1996, The Wagner Law Group is dedicated to the highest standards of integrity, excellence and thought leadership and is considered to be amongst the nation's premier ERISA and employee benefits law firms. The firm has seven offices across the country, providing unparalleled legal advice to its clients, including large, small and nonprofit corporations as well as individuals and government entities worldwide. The Wagner Law Group's 32 attorneys, senior benefits consultant and five paralegals combine many years of experience in their fields of practice with a variety of backgrounds. Seven of the attorneys are AV-rated by Martindale-Hubbell and six are Fellows of the American College of Employee Benefits Counsel, an invitation-only organization of nationally recognized employee benefits lawyers.  Seven of the firm's attorneys have been named to the prestigious Super Lawyers list for 2017, which highlights outstanding lawyers based on a rigorous selection process.




Contact Info

The Wagner Law Group


  Integrity | Excellence



Tel: (617) 357-5200 

Fax: (617) 357-5250 

99 Summer Street 

13th Floor

Boston, MA 02110


Washington, D.C.

Tel: (202) 969-2800


Fax: (202) 969-2568

 800 Connecticut Avenue, N.W.

Suite 810

Washington, D.C. 20006



Tel: (847) 990-9034

Fax: (847) 557-1312

190 South LaSalle Street

Suite 2100

Chicago, IL 60603



Palm Beach Gardens 

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



Tel: (813) 603-2959

Fax: (813) 603-2961

101 East Kennedy Boulevard

Suite 2140
Tampa, FL  33602 


San Francisco

Tel: (415) 625-0002

Fax: (415) 358-8300

300 Montgomery Street

Suite 600

San Francisco, CA 94104


St. Louis

Tel: (314) 236-0065

Fax: (314) 236-5743
25 W. Moody Avenue
St. Louis, MO  63119 







   Agencies' Proposed Rule Expands Duration of Short-Term Health Insurance


February 28, 2018




HHS, DOL and IRS (the "Agencies") have jointly issued a proposed rule that expands the availability of short-term, limited-duration health insurance.  The proposed rule would allow consumers to buy individual health insurance plans that provide coverage for any period of less than 12 months, rather than the current maximum period of less than three months. 

Background.  Short-term, limited-duration insurance is designed to provide temporary coverage for individuals transitioning between health insurance policies.  Short-term insurance plans often provide some protection to those who enroll by paying a percentage of hospital and doctor bills after the policyholder meets the specified deductible. 

In October 2016, the Agencies issued a final rule that restricts the maximum term of a short-term limited-duration insurance policy to less than three months.  In response, certain stakeholders expressed concerns that this limit could cause harm to some consumers, limit consumer options, and ultimately have little positive impact on insurance risk pools. 

Short-term, limited-duration health insurance coverage is exempt from the definition of individual health insurance coverage under the ACA.  Therefore, it is not subject to the ACA's individual market requirements that apply to individual health insurance plans (e.g., the mandate to cover Essential Health Benefits, the prohibition on imposing pre-existing condition exclusions, etc.).



Proposed Rule.  The following are highlights from the proposed rule:


  • Compliance with the ACA's Individual Mandate.  The proposed rule confirms that short-term, limited-duration  health insurance coverage is not considered to provide Minimum Essential Coverage under the ACA.  Therefore, a consumer whose health insurance coverage during the 2018 tax year is through a short-term policy may be subject to the ACA's Individual Mandate Penalty (which requires nearly all Americans to be insured or pay a penalty).  However, this will not be an issue after 2018 because Congress has effectively eliminated the individual mandate starting in 2019 as part of its tax overhaul bill. 
  • Extension of the Maximum Permissible Coverage Period. The proposed rule amends the definition of short-term, limited-duration insurance such that insurers could begin to offer any coverage period of less than 12 months, including any extensions that may be elected by a policyholder.  As with the current regulations, this insurance may not be renewed after the maximum period of coverage.


  • Notice requirements. The proposed rule revises the notice that must be provided with enrollment materials for short-term, limited-duration insurance.  Specifically, the proposed rule requires the use of one of two revised notice versions depending on whether the coverage start date is before January 1, 2019. 


NOTE:  This is because starting in 2019, when the ACA's individual mandate penalty is reduced to zero, certain language contained in the first version of the notice will no longer apply.




Both versions of the notice are intended to notify consumers that short-term, limited-duration policies are not required to comply with certain federal health insurance mandates, principally those contained in the ACA.







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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.