The summary of benefits and coverage (SBC), maximum out-of-pocket limits (MOOPs), and a rule on “nondiscrimination in health programs” were among the problem areas most frequently cited by employer groups in suggesting administrative changes to Affordable Care Act (ACA) implementation.
A health plan’s lack of a full plan document, and an erroneous reference to such a document in the summary plan description (SPD), did not defeat the plan’s claim for reimbursement from a beneficiary’s medical malpractice settlement, a federal appeals court ruled.
The keys for plan sponsors to avoid penalties under the Health Insurance Portability and Accountability Act (HIPAA), as well as other liability that may come with data breaches, were discussed by HIPAA experts in a recent webinar.
The U.S. Department of Labor (DOL) released a draft model form for plan participants and others to use when asking group health plans to explain their limits on mental health coverage.
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