Benefits Buzz

Three Big Regulatory Changes Expected (Short-Term Medical, HRAs, Small Business Health Plans)

Posted on January 18th, 2018

Originally posted on October 13, 2017
President Donald Trump signed an executive order on October 12th instructing the Department of Labor (DOL), Department of Treasury (DOT), and Department of Health and Human Services (HHS), known as the tri-agencies, to review and potentially revise existing regulatory guidance. This includes:
  1. The Office of Management and Budget (OMB) is currently reviewing a set of proposed rules from the Department of Health and Human Services (HHS) which would allow short-term medical plans (STM plans) to be issued for durations of about one year (364 days). This duration had been previously allowed, but the Obama administration changed the maximum duration that short-term medical plans could be purchased to 90 days. The rules have been proposed in response to an executive order issued by President Donald Trump this past October.  The executive order essentially instructs the tri-agencies to consider reversing the Obama-era change. The rules are expected to be released to the public any day now. STM plans are typically lower premium plans, but that’s mostly because they can be medically underwritten and don’t have to cover essential health benefits. 
  2. A consideration to ease regulatory requirements that impact Health Reimbursement Arrangements (HRAs). These rules are also expected to be drafted by mid-February. It’s believed these rules will relax some of the regulations that were issued in IRS Notice 2013-54. Guidance from Notice 2013-54 limits the types of HRAs that can reimburse individual health insurance premiums and requires most HRAs to be integrated with a group health insurance plan.    
  3. A consideration to expand association health plans for small businesses. This would give smaller companies in the same line of business or in a similar geographic area the ability to band together and purchase coverage that is similarly available in the large group market. Association health plans only have to comply with some (but not all) of the Affordable Care Act (ACA) market reforms. 
The executive order does not mean that these changes have happened. However, the tri-agencies now have formal instructions from President Trump to review existing rules and decide if and/or how those rules should be changed. It still could be several months before we see proposed guidance from the tri-agencies. 

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