Market Stabilization Final Rule Issued: On April 14, the Department of Health and Human Services (HHS) issued a market stabilization final rule under the Affordable Care Act, containing new reforms aimed at lowering premiums, stabilizing the individual and small group health markets and increasing choices for 2018.
The rule includes a variety of changes including adjustments to the annual open and special enrollment periods, shortening the open enrollment period but allowing individual states to supplement that period as necessary.
Also among the changes is expanded pre-enrollment verification of eligibility, aimed at curbing abuse of open enrollment where a lack of verification allowed individuals to sign up for coverage for which they were not qualified.
The rule further amends the “guaranteed availability” rules to allow insurers to withhold coverage in cases where there are outstanding unpaid premiums.
Other revisions include adjustments to the formulas used to determine the actuarial value of Qualified Health Plans (QHPs) and a greater voice for the states in determining the network adequacy of QHPs.
The rule does not directly affect plans in the large group market.
OSHA Ongoing Recordkeeping Rule Overturned: On April 3, President Trump signed into law House Joint Resolution 83, nullifying a recordkeeping final rule issued by the Occupational Safety and Health Administration (OSHA). The overturned final rule did not create any new or additional recordkeeping requirements, but rather clarified the ongoing obligation of an employer to maintain work-related injury or illness records.
At issue was OSHA’s clarification stating that an employer was obligated to record a qualifying injury or illness throughout the five-year record storage period, even if the incident was not originally recorded during the first six months after its occurrence.
The effective impact of the nullification is that OSHA will have to limit the scope of its recordkeeping investigations to the previous six months, rather than the previous five years.
Employers should not interpret this development as an opportunity to bypass existing OSHA recordkeeping rules.
For more information on either of these developments and how they affect your business, contact Consolidated.