Health Care Reform
EBS-RMSCO, Inc. is your advocate and advisor to help you navigate and comply with Health Care Reform. The information below is for clients and brokers.
Annual & Lifetime Limits
Please click the link below to learn more about what is, and isn't included regarding annual and lifetime limits. Guidance is still pending on the essential benefits, but there is enough information to get started.
The Department of Labor has released model language on their website. This language is intended for use by employers to satisfy the notice requirements under the regulation.
Dependent Coverage to Age 26
Please click the link below to learn more about the guidance that was recently released regarding dependent coverage to age 26.
The Department of Labor has recently posted model language on their website. This language is intended for use by employers to satisfy the notice requirements under the regulation.
Early Retiree Reinsurance
Please click on the link below to learn more about the Early Retiree Reinsurance Program. After opening the presentation, at the bottom are the basic controls to rewind, fast forward, pause, etc.
Please click the link below to download a copy of this presentation.
An announcement was posted on the HHS website on 06/29/2010, please click below to view the news release.
Please click the link below to download a copy of this application.
EBS-RMSCO offers three programs to generate cost savings with respect to plan participants with chronic and high cost conditions. These programs include Medical Management, Steps to Success and Intervention through Data Mining . Summary descriptions for each program are listed below. You may use these program descriptions in completing Part II, C. of the Early Retiree Reinsurance Program application. You may use descriptions in response to Part II, E., Intended Use of Early Retiree Reinsurance Program Reimbursements, if you intend to purchase additional medical management services from EBS-RMSCO. Depending on what is applicable to your plan(s) please select one or more of the following descriptions(NOTE:Please contact you Account Executive or Client Service Representative if you have any questions)
The Milliman table to be used for clients with less than 300 early retiree participants.
General Health Care Reform Information
Please click on the link below to learn more about Health Care Reform and the effect some of its provisions will have on single-employer and collectively bargained plans. After opening the presentation, at the bottom are the basic controls to rewind, fast forward, pause, etc.
Please click the link below to download a copy of this presentation, which will include the narration notes.
The most up to date activity regarding Health Care Reform regulations.
Grandfathered Status
Guidance regarding grandfathered status was issued on 6/14/2010. Click the link below> to learn more about what is, and isn't permitted regarding retaining of your grandfathered status.
The Department of Labor has released a table of provisions (chart format) of the health reform provisions that are applicable to grandfathered plans. This chart includes provisions applicable to fully-insured plans, self-funded plans, as well as group and individual policies.
Click the link below to see what a recent Hewitt Associates survey reveals regarding employer perspectives on grandfathered status.
The Department of Labor has also released model disclosure language, which is taken from the interim final rule on grandfathered plans. Warning! There appears to be a formatting problem with the model language. We have alerted DOL to this problem. We hope the URL will be fixed in short order.
Over the Counter ( OTC)
Please click on the below to learn more about changes to the rules for the purchase of over-the counter products using funds from Flexible Spending Accounts and Health Reimbursement Accounts.