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LEGAL DISCLAIMER:
Information contained in this publication is not legal advice, and
should not be construed as legal advice. If you need legal advice upon which you can rely,
you should seek a legal opinion from your attorney.
deductibles, coinsurance or other out-of-pocket costs to
the early retired
participants.
The law sets aside five billion dollars to fund these reimbursements.
The Effective Date of the PPACA Group Health Reforms
Section 1004 of the PPACA set an effective date of the first plan year beginning six
months after the date of enactment or January 1, 2011 for calendar year plans.
However, Section 1251(d) had an extended effective date for plan coverage tied to
CBAs. This extended date is the date the last CBA relating to coverage terminates.
But, reading that Section in light of the amendments made by the reconciliation bill
and the definitions in the PPACA
supported the conclusions that the delayed CBA
effective date applied only to insured CBA plans. The path to this conclusion
involves looking at the definitions of the PHSA Section 2791 which are incorporated
into Title I (Sections 1001-1563) of the PPACA by PPACA Section 1301.
Rather than burden the text of this Client Bulletin
with this three page discussion
and examination of the definitions, interested readers may access this discussion by
“
clicking here.” As noted earlier, one emerging view is that certain items will not
be applicable to CBA related group health plans until the of the expiration of the
last CBA relating to coverage expires or the date the changes would otherwise be
applicable.
Conclusion
In summary, the detailed answers that we are all looking for are not quite
contained within these laws. We will report to you as more information or
clarifications of effective dates for CBAs and any other relevant guidance as it is
issued. We will also report on the effects of the PPACA on employers shortly. The
employer “pay or play” rules (i.e. offer coverage or pay a fee) don’t take effect until
January 1, 2014.
Additional Resources
The text of the H.R. 3590 is available by
“
The text of the
reconciliation bill is available by “clicking here.”
Other helpful general summaries
prepared by the House speaker’s staff are
available at:
These
summaries are generally for non-CBA plans as far as effective dates, but provide a
roadmap for what lies ahead.
The IFEBP has an excellent resource page gathering many industry summaries on
its health reform page located at:
ssion/EducationalOpportunities.htm. Go to the tab on the right side of the page
entitled Analysis Of Reform Provisions.
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