Final Excepted Benefit Rules Lawmakers Assess ACA Changes

Final Excepted Benefit Rules Lawmakers Assess ACA Changes

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Final Excepted Benefit Rules Lawmakers Assess ACA Changes
Calendar17 March 2015

Final "excepted benefit" rules issued on Monday will allow employers to offer limited wraparound benefits to certain employees with individual health insurance policies (including subsidized public exchange coverage) or Basic Health Program coverage. The rules retain key requirements for limited wraparound benefits to qualify for exception but clarify some earlier proposals. Wraparound coverage must provide a defined set of benefits; account-based reimbursement arrangements won't qualify. Excepted-benefit status will extend to qualifying wraparound benefits first offered between Jan. 1, 2016, and Dec. 31, 2018, but sunset three years later or when the relevant collective bargaining contract ends.

In Congress, the Senate Finance Committee holds a hearing Thursday on the status of the ACA as policymakers wait to see how the Supreme Court rules in King v. Burwell on premium subsidies offered through federally-facilitated health insurance exchanges. In addition, details will likely emerge soon on a legislative plan to permanently change the Medicare physician payment formula; proposals to pay for the plan, which could involve ACA changes, will be crucial to its chances. Separately, congressional budget committee leaders are preparing initial details of their fiscal 2016 budget resolutions. The Republican budget blueprints are expected to seek changes to the ACA, although prospects for enactment are cloudy.

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