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Agencies Issue Final Rule Expanding the Definition of Excepted Benefits

The Health Insurance Portability and Accountability Act (HIPAA) established certain categories of excepted benefits that are not governed by the HIPAA portability regulations. Employee benefits that qualify as excepted benefits under HIPAA are also not subject to the market reforms under the Affordable Care Act (ACA), including the prohibition on annual limits and preventive care coverage requirement. On Sept. 26, 2014, the Departments of Labor (DOL), Health and Human Services (HHS) and the Treasury (Departments) issued final regulations expanding one category of excepted benefits. The final regulations:

  • Address limited-scope vision and dental benefits and employee assistance program (EAP) benefits
  • The final regulations apply to group health plans and group health insurance issuers for plan years beginning on or after Jan. 1, 2015.

The Departments intend to publish regulations on limited wraparound coverage in the future.

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