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November 13, 2014
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What are referred to as "minimum value" or "skinny" health plans have been ordered to include physician services and hospitalization by way of a new regulation, but the issuing federal agencies have now given a reprieve to certain plans already in effect.
By way of background, the Affordable Care Act (ACA) mandated that all health insurance plans include "essential services" but never listed which services were mandatory, so some insurers and plan administrators devised health plans without hospitalization or physician services by using a Minimum Value (MV) Calculator created by the Department of Health and Human Services (HHS).
(Basically, so long as these "skinny" plans paid 60 percent of all services they offered, the MV Calculator would pass them.)
Minimum value plans that relied on the MV Calculator and were subject either to a written binding employer agreement or actual enrollment of employees prior to Nov. 4, 2014 (when the new regulation was issued) will be allowed to keep operating through their 2015 plan year. However, once the year is up, the new plans must conform to the requirements for physician and hospitalization services.
Sound complicated? Get our Affordable Care Act Compliance Kit to understand the details and nuances of the ACA.
