Health plans that are trying to offer a stripped down Minimal Value plan to save costs and avoid penalties need to be careful. The Fed is cracking down on these types of plans by requiring in-patient hospitalization services as part of the coverage. Please see below release via IRS Guidewire.
Group Health Plans That Fail to Cover In-Patient Hospitalization
Services
VIA IRS GUIDEWIRE:
Notice 2014-69 advises
employers and other taxpayers that employer-sponsored health plans that fail to
provide substantial coverage for in-patient hospitalization services or for
physician services do not provide minimum value within the meaning of § 36B and
that the IRS, the Treasury Department, and the Department of Health and Human
Services (HHS) expect shortly to propose regulations to this effect. The
notice also advises that IRS, Treasury, and HHS are considering whether the
continuance tables underlying the Minimum Value Calculator produce valid
actuarial results for plans with these designs. Employers offering plans that
fail to cover in-patient hospitalization or physician services should exercise
caution in relying on the Minimum Value Calculator to demonstrate that these
plans provide minimum value for any portion of a taxable year after publication
of final regulations.
