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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

 

 

October 10, 2013 

 State and Federal Law Alert

 

Guidance on Exchange Notices and 90-Day Waiting Period Limit 

 

The DOL has issued its sixteenth set of Frequently Asked Questions ("FAQs") on the implementation of the Patient Protection and Affordable Care Act ("PPACA"). This set of FAQs address questions relating to the distribution requirements for the Notice of Coverage Options (also called the Exchange Notice) and PPACA's 90-day waiting period limit for coverage.

 

Exchange Notices. PPACA requires employers to provide the Exchange Notice, which explains the coverage options available under the Health Insurance Exchanges (also called Health Insurance Marketplaces) that will open January 1, 2014. Employers must provide Notices to all employees, regardless of whether the employees are enrolled in, or eligible for, its group health plan. The DOL has previously issued Technical Release 2013-02, which provided employers with guidance on this topic along with model Notices employers can use to satisfy this obligation. (See the Alert of 5/16/13 for further details.)

 

The FAQs explain that an employer can satisfy its obligation to furnish Notices to its employees by engaging a third party to distribute the Notice. Third parties would include insurance companies, third party administrators and multiemployer plans. If the third party fails to provide Notices to all of the employer's employees, however, the employer remains obligated to provide the Notice to the excluded employees. For example, if the third party only provides Notices to employees who are enrolled in the employer's group health plan, the employer must provide the Notice to all employees who are not in the plan.

 

90-day Waiting Period Limit. PPACA also mandates that group health plans and health insurance issuers offering group health coverage cannot impose waiting periods that exceed 90 days. The FAQs confirm that plans and issuers may continue to rely on the guidance provided in the proposed rules until 2014. (See the Alert of 3/28/13.)

 

The FAQs acknowledges that the DOL will issue final rules on this topic sometime in the near future. To the extent that these final rules contain provisions that are more restrictive than those found in the proposed rules, such provisions will not become effective before January 1, 2015, in order to provide plans and issuers with sufficient time to comply.

 

FAQ Part XVI can be accessed at: http://www.dol.gov/ebsa/pdf/faq-aca16.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.