May 18, 2018



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Fast Facts
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Trump Administration Details Prescription Drug Plan
The Healthcare Happy Hours Takes a First Look at the Prescription Drug Plan
NAHU Submits Comments on State Regulator ERISA Handbook
State Spotlight: Rekindling Its Relationship with a State-Based Exchange
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NAHU Submits Comments on State Regulator ERISA Handbook

NAHU submitted comments this week to the National Association of Insurance Commissioners (NAIC) in response to draft revisions to the NAIC ERISA handbook for state regulators. Our comments specifically called for the handbook to incorporate updated references with regards to the ACA’s requirements for large employers, multi-employer groups, association health plans, and other arrangements. We suggested that the handbook include detailed explanations and updated definitions where appropriate and ensure that these were in line with current law and regulations that are expected to take effect in the near term.


Summary of our comments:

  • Apply the 2017 Supreme Court decision in Advocate Health Care Network v. Stapleton with regards to church plan exemptions.
  • Defer until the final regulation on Association Health Plans is released prior to incorporating its application on Multiple Employer Welfare Arrangements into the handbook.
  • Incorporate references to federal guidance and the responsibility of the various types of group health plans involving multiple employers with regard to both coverage offers and information reporting.
  • Add additional explanation of the ACA’s employer shared responsibility provisions with clear explanations on the definitions and applications of “applicable large employers,” with regards to dependent-coverage requirements for large employers.
  • Update the wellness program information to include information about the Equal Employment Opportunity Commission rules regarding wellness programs and the applicability of the Genetic Information Nondiscrimination Act and the Americans with Disabilities Act. 
  • Indicate that the phase-in is in effect for all group health plans for the Summary of Benefits and Coverage (SBC) template and Uniform Glossary.
  • Address Qualified Small Employer Health Reimbursement Arrangements and reference guidance on how the prohibition on lifetime and annual dollar limits impact traditional HRAs.
  • Add information regarding the ACA’s guaranteed availability of coverage provisions addressing how they relate to state laws and regulation of small- and large-group market participation and eligibility requirements.
  • Add a definition of the term common-law employee due to the references throughout the handbook and indicate the legal differences between these and employees.
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