Federal Regulation Updates

In this week’s Compliance Update, we have provided updates on Mental Health Parity NQTLs and an upcoming webinar by the DOL; HSA contribution limits for 2022; ACA Section 1557 and recent IRS guidance on COBRA subsidies. There are many federal regulations to understand right now, so as always, we’ll do our best to break it down a bit for you.

DOL’s Mental Health Parity and Substance Use Disorder Parity Compliance Assistance webinar details for May 27, 2021

The U.S. Department of Labor (DOL) is offering a free webinar on Mental Health Parity and Addiction Equality Act (MHPAEA) and it’s changes due to the Consolidated Appropriations Act (CAA). New FAQs are also available, plus other resources. You can access their website and register here. Previously, we shared that we are prepared to assist clients in a few focused areas of the self-compliance tool, primarily to assist with a comparative analysis on portions of the NQTL’s, specifically those related to Utilization Review including pre-cert, medical necessity and concurrent care. If you have not reached out to other vendors supporting your plan such as your Pharmacy Benefit Manager or PPO Network, you may want to do so, in addition to attending the webinar.

IRS Announces 2022 Limits for HSA Contribution Limits, HDHP Minimum Deductibles and HDHP Out-of-Pocket Maximums

On May 20, 2021, the Internal Revenue Service (IRS) shared the increase for 2022 health savings account (HSA) contribution limits as well as out-of-pocket maximum limits for high deductible health plans (HDHPs). The publication is available here.

• The 2022 HDHP annual deductibles remain the same as in 2021, which are $1,400 for self-only coverage and $2,800 for family coverage. New for 2022, HDHP annual out-of-pocket expenses may not exceed $7,050 for self-only coverage or $14,100 for family coverage. The HSA annual contribution limit for individuals with self-only coverage under an HDHP has increased to $3,650 and individuals with family coverage can increase up to $7,300.

WebTPA will have these amounts updated in our cost sharing worksheet which is completed with our other renewal tracking documents, when 2022 renewal planning for most health plans begins in the third quarter of 2021. 

ACA Section 1557 Nondiscrimination Interpretation and Enforcement issued by HHS

On May 10, 2021, the U.S. Department of Health and Human Services (HHS) announced that, once again, Section 1557 of the Affordable Care Act and Title IX’s prohibitions on sex discrimination include discrimination on the basis of sexual orientation and gender identity. As the Office for Civil Rights (OCR) investigates complaints for possible discrimination in health care settings, due to an individual’s sexual preference or gender identification, they will apply HHS’ newest Section 1557 interpretation. For more information you can review the HHS press release here.

The new guidance specifically applies to employee health plans in which the sponsoring employer or the plan receives HHS funding. However, HHS Secretary Xavier Becerra has stated, “It is the position of the Department of Health and Human Services that everyone, including LGBTQ+ people, should be able to access health care, free from discrimination or interference, period.” Thus, employers should closely review any plan provisions that could be seen as discriminatory.  

IRS Issues Guidance on COBRA Premium Assistance

Since the American Rescue Plan Act (ARPA) of 2021 outlined the initial requirements for COBRA premium assistance to Assistance Eligible Individuals (AEI), many parties have hoped for additional guidance on the subject. The IRS issued Notice 2021-31 last week to address key issues in 86 Frequently Asked Questions. Common concerns include, but are not limited to, involuntary termination, gaps in COBRA coverage, and premium assistance credits. Below are a few highlighted FAQs but the full set of FAQs can be viewed here.

• Q-24. Involuntary termination under ARPA is the same as defined in the American Recovery and Reinvestment Act of 2009 (ARRA). “A severance from employment due to the independent exercise of the authority of the employer to terminate the employment, other than due to the employee’s implicit or explicit request, where the employee was willing and able to continue performing services.”
• Q-58. If an AEI elects retroactive COBRA coverage, the outbreak period extension applies to premium payments for the retroactive period of coverage. If they fail to pay the full amount due for the retroactive premiums, the plan can credit the premiums received to the earliest months of coverage. A coverage gap will exist until the period of subsidized coverage resumes on April 1, 2021.
• Q-78. If an AEI fails to report loss of eligibility for the COBRA subsidy, due to eligibility for coverage under another group plan, the Premium Payee is still entitled to the credit for the period of ineligibility