December 6, 2012

Proposed Regulations Issued Under ACA

By Matthew P. Amodeo, Jennifer R. Breuer, Kristy M. Hlavenka, Robert W. McCann, Ilisa Halpern Paul and Robyn S. Shapiro

On November 20, the Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services (DHHS) issued three proposed rules as part of the ongoing implementation of the Affordable Care Act (ACA): one addressing how insurers can vary premiums based on certain rating factors (age, tobacco use, family size and geography); a second defining essential health benefits; and a third governing employer-based wellness programs. These proposed rules impact small group and individual insurance plans and will be effective for plan years starting on or after January 1, 2014.

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