HHS Exempts 30 Groups From Reform Law Rule on Health Benefits Cap
Last month, HHS granted waivers to 30 companies and groups, exempting them for one year from a provision in the federal health reform law that prohibits caps on health benefits, Bloomberg reports.
Such caps set an annual limit on the amount a health plan covers, and the employee is responsible for all costs beyond the cap.
The 30 companies and groups include fast-food chains McDonald's and Jack in the Box, and the United Agricultural Benefit Trust. The groups receiving the waivers offer low-cost health plans -- often called "mini-med" plans -- to low-wage, seasonal or part-time workers. Nearly one million individuals will be affected.
Without the waivers, the companies would have had to provide at least $750,000 in coverage in 2011, up to $1.25 million in 2012, $2 million in 2013 and unlimited coverage in 2014.
Obtaining the Waiver
An HHS spokesperson said the waiver program was designed to ensure continuous coverage for the workers until 2014, when they can apply for tax credits to obtain insurance through the exchanges created by the overhaul.
The 30 companies and groups had to prove that without the waiver their employees' premiums would increase significantly or they could lose their coverage.
HHS also noted that the waivers were granted to ensure that the workers would not lose their coverage if their companies stopped offering the plans altogether.
At least one company -- McDonald's -- had warned the Obama administration that it would consider dropping its low-cost health plans unless it received a waiver.
Number of Affected Workers
According to Bloomberg, the United Federation of Teachers Welfare Fund in New York received the biggest single waiver, covering 351,000 individuals, while the United Agricultural Benefit Trust received a waiver for 17,347 individuals.
Jack in the Box and McDonald's received waivers for 1,130 and 115,000 workers, respectively (Armstrong, Bloomberg, 10/5).
This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.