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Compliance Briefing Center

Legislation and Reform

Making it Easier for You
to Manage Benefits

WageWorks Provides Guidance on New Regulatory Requirements

GINA – The Genetic Information Nondiscrimination Act of 2008
On October 7, 2009, interim final regulations implementing Title I of GINA were published. Generally, GINA prohibits employers, health plans and health insurers to access an individual’s genetic information. These regulations create a huge umbrella that impacts virtually all individual and group health plans.

Title I of GINA focuses on nondiscrimination in health insurance and impacts health risk assessments used in virtually all employer wellness and disease-management programs. Review the questions asked in your health risk assessments, along with the timing of the assessment in relationship to open enrollment and if incentives are offered for those completing an assessment. All could be potential issues under the new regulations.

COBRA Subsidy
In December, Congress passed an extension to the COBRA subsidy rules. The Act extends the duration from nine to 15 months and requires another round of notices. It also clears up confusion in the original legislation so that anyone having a COBRA Qualifying Event on or before 2/28/2010 is eligible for the subsidy. Previously, both the Qualifying Event and the Loss of Coverage had to occur before 12/31/2009. The loss-of-coverage date no longer impacts eligibility for the American Recovery and Reinvestment Act (ARRA) premium subsidy.

Medicare Second Payer (MSP) reporting for Health Reimbursement Arrangements (HRAs)
The latest guidance from the Department of Labor (DOL) makes it clear that not all HRAs must report to the Centers for Medicare and Medicaid Services (CMS). HRAs not linked to a group health plan with an annual benefit of less than $1,000 are exempt. Embedded HRAs should be reported along with the health plan.

Embedded HRAs refer to HRAs that are a part of – and only reimburse – deductible or copayment amounts not paid by the associated group health plan.

WageWorks is working to develop processes for compliance with this reporting requirement, including obtaining the data necessary for reporting, registering and testing the file transfer process with CMS and communicating with affected clients.

Michelle’s Law
Group health plans (both fully insured and self funded) may not terminate coverage for a dependent based on student status at a postsecondary educational institution if that dependent becomes ill and would lose coverage based on enrollment status. If the student no longer attends school because he or she becomes seriously ill and it is medically necessary, coverage must continue until the earlier of: 1) one year from the first day of the medically necessary leave; or 2) the student would otherwise lose coverage for other reasons such as a maximum age limit has been reached.

Health plans with eligibility based on student status must be updated to reflect changes implemented by Michelle’s Law.