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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 22 attorneys engaged exclusively in employee benefits, estate planning and employment law. Five 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
7121 Fairway Drive
Suite 203
Palm Beach Gardens, FL 33418


San Francisco Office

Tel: (415) 625-0002

Fax: (415) 358-8300

315 Montgomery Street

Suite 902

San Francisco, CA 94104





February 7, 2013 

 State and Federal Law Alert


Recently Released Health Care Reform FAQs Address Exchange Notice and HRAs


The DOL, HHS and IRS have issued the eleventh set of FAQs relating to the implementation of various provisions of the Patient Protection and Affordable Care Act ("PPACA"). The latest FAQs offer guidance on: (i) employers' obligation to notify employees about Exchanges; and (ii) the application of PPACA's prohibition against annual or lifetime dollar limits to health reimbursement arrangements ("HRAs").


Exchange Notices. PPACA requires employers to provide new and current employees with a written notice containing information about the existence of the Exchanges and an employee's eligibility for coverage through an Exchange. The FAQs explain that the original March 1, 2013 due date for this requirement has been extended, until late summer or fall of 2013, so that distribution efforts can be coordinated with the open enrollment period for the Exchanges.


DOL says it may provide model language for the Exchange notice.


HRAs and PPACA's Restriction on Lifetime or Annual Limits. PPACA generally prohibits group health plans from imposing annual or lifetime dollar limits on "essential health benefits." HRAs are group health plans that typically reimburse medical expenses up to a specified dollar amount. Thus, it is impossible for an HRA to comply with PPACA's prohibition on annual or lifetime dollar limits.


The final regulations implementing PPACA's prohibition on annual and lifetime dollar limits made a distinction between HRAs that are "integrated" with other employer health coverage and "stand-alone" HRAs that are not integrated. Specifically, the final regulations provide that when an HRA is integrated with other employer health coverage that complies with PPACA's annual and lifetime dollar limit prohibitions, the fact that benefits under the HRA are limited will not violate PPACA because the combined plans satisfy the requirements.


The FAQs offer the following additional guidance on when an HRA will be considered "integrated" with other employer health coverage: 

  • An employer-sponsored HRA is not considered integrated unless it specifies that coverage is available only to employees who are also covered by employer-provided health coverage that complies with the annual and lifetime dollar limit prohibitions.
  • An employer-sponsored HRA cannot be integrated with individual market coverage or with an employer-provided plan that provides coverage through individual policies.
  • An employer-sponsored HRA may be treated as integrated with other employer-provided health coverage only if the employee covered by the HRA is actually enrolled in the other coverage.  

Although PPACA's prohibition on lifetime or annual dollar limits has been in effect since 2010, the FAQs permit any amounts credited to an HRA before January 1, 2014, to be used after December 31, 2013, without violating PPACA, regardless of whether the HRA is integrated.      


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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.