DOL FAQs on ACA Implementation (Part XXIII): Excepted Benefits

DOL has issued the FAQs about Affordable Care Act Implementation Part XXIII (FAQs have been prepared jointly by the Departments of Labor (DOL), Health and Human Services (HHS), and the Treasury (collectively, the Departments))

The Departments have become aware of health insurance issuers selling supplemental products that provide a single benefit. At least one issuer is characterizing this type of coverage as an excepted benefit. These issuers claim that the products meet the criteria for supplemental coverage to qualify as an excepted benefit outlined in the Departments’ guidance and are designed to fill in the gaps of primary coverage in the sense that they are providing a benefit that is not covered under the primary group health plan.

The Departments intend to propose that coverage of additional categories of coverage would be considered to be designed to ‘fill in the gaps’ of the primary coverage only if the benefits covered by the supplemental insurance product are not an essential health benefit (EHB) in the State where it is being marketed…. Read More»

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