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As indicated in June 2013, healthcare reform created a new nonprofit corporation, the Patient-Centered Outcomes Research Institute (PCORI), to support clinical effectiveness research. This entity will be funded in part by fees (referred to as "PCORI fees" or "CER fees") paid in part by applicable sponsors of self-insured health plans. read more

Healthcare reform requires health insurers and self-funded group health plans to fund a Transitional Reinsurance Program from 2014 to 2016. The purpose of the program is to help offset the high medical costs of individuals enrolled in the non-grandfathered individual market. It is anticipated the individual market, which includes insurance purchased through the Health Insurance Exchange, will attract a disproportionate amount of individuals who have a tendency to incur high medical costs. Reinsurance contributions will help to offset these costs. read more

Traditionally, dental and vision benefits are not thought of as part of the major medical plan; however, depending on how an employer structures their benefit elections and the associated premiums, the dental and vision benefits may be subject to the same PPACA requirements as the medical plan (if they are considered "Bundled Benefits"). The impact is most directly felt with respect to the annual and lifetime dollar limits that are typically applied on dental and vision benefits. read more

The Departments of Labor, Treasury, and Health and Human Services jointly issued Final HIPAA Wellness Rules. These rules affect what employers can and cannot do with population health management program incentives for plan years on or after January 1, 2014. read more

All Plan Sponsors must determine if their Plan(s) meet Minimum Value. Minimum Value determinations will affect employers and their employees in terms of coverage decisions and the potential for employer penalties to be incurred if an employee participates in the exchange and qualifies for a subsidy. Whether the Plan(s) met Minimum Value or not is information that must be included in the Summary of Benefits and Coverage (SBC) as well as the Exchange Marketplace Notice (which must be distributed to all employees by October 1, 2013). read more