Source: https://www.federalregister.gov/documents/2010/06/28/2010-15277/requirements-for-group-health-plans-and-health-insurance-issuers-under-the-patient-protection-and
Timestamp: 2018-02-21 23:52:16
Document Index: 800533845

Matched Legal Cases: ['§\u200954', '§\u200954', '§\u200954', '§\u200954', '§\u200954', 'art 54', '§\u200954', '§\u200954', '§\u200954', '§\u200954', '§\u200954', '§\u200954', '§\u200954', '§\u200954', '§\u200954', '§\u200954', '§\u200954', '§\u200954']

Federal Register :: Requirements for Group Health Plans and Health Insurance Issuers Under the Patient Protection and Affordable Care Act Relating to Preexisting Condition Exclusions, Lifetime and Annual Limits, Rescissions, and Patient Protections
Requirements for Group Health Plans and Health Insurance Issuers Under the Patient Protection and Affordable Care Act Relating to Preexisting Condition Exclusions, Lifetime and Annual Limits, Rescissions, and Patient Protections
A Proposed Rule by the Internal Revenue Service on 06/28/2010
Written or electronic comments and requests for a public hearing must be received by September 27, 2010.
75 FR 37242
REG-120399-10
1545-BJ57
2010-15277
https://www.federalregister.gov/d/2010-15277 https://www.federalregister.gov/d/2010-15277
Start Preamble Start Printed Page 37242
Elsewhere in this issue of the Federal Register, the Treasury Department and the IRS are issuing temporary regulations under the Patient Protection and Affordable Care Act (the Affordable Care Act) relating to preexisting condition exclusions, lifetime and annual limits, rescissions, and patient protections. Those temporary regulations are being issued at the same time that the Employee Benefits Security Administration of the U.S. Department of Labor and the Office of Consumer Information and Insurance Oversight of the U.S. Department of Health and Human Services are issuing substantially similar interim final regulations under the Employee Retirement Income Security Act of 1974 and the Public Health Service Act. The temporary regulations provide guidance to employers, group health plans, and health insurance issuers providing group health insurance coverage. The text of those temporary regulations also serves as the text of these proposed regulations.
Send submissions to: CC:PA:LPD:PR (REG-120399-10), Room 5205, Internal Revenue Service, P.O. Box 7604, Ben Franklin Station, Washington, DC 20044. Submissions may be hand-delivered to: CC:PA:LPD:PR (REG-120399-10), Courier's Desk, Internal Revenue Service, 1111 Constitution Avenue, NW., Washington, DC 20224. Alternatively, taxpayers may submit comments electronically via the Federal eRulemaking Portal at http://www.regulations.gov (IRS REG-120399-10).
The collections of information contained in this notice of proposed rulemaking have been submitted to the Office of Management and Budget for review in accordance with the Paperwork Reduction Act of 1995 (44 U.S.C. 3507(d)). Comments on the collection of information should be sent to the Office of Management and Budget, Attn: Desk Officer for the Department of the Treasury, Office of Information and Regulatory Affairs, Washington, DC 20503, with copies to the Internal Revenue Service, Attn: IRS Reports Clearance Officer, SE:W:CAR:MP:T:T:SP, Washington, DC 20224. Comments on the collection of information should be received by August 27, 2010. Comments are specifically requested concerning:
The collections of information are in § 54.9815-2711T(e)(2), § 54.9815-2712T(a)(1), and § 54.9815-2719AT(a)(4) (see the temporary regulations published elsewhere in this issue of the Federal Register). The temporary regulations require that group health plans and group health insurance issuers: (1) Notify individuals otherwise eligible for coverage who have previously reached a lifetime limit that the lifetime limit no longer applies and of the right to enroll in the coverage; (2) notify any individual whose coverage the plan or issuer intends to rescind 30 days in advance of the rescission; and (3) for plans or health insurance coverage that require or provide for covered individuals to designate a primary care provider, notify individuals of their rights regarding such designation under section 2719A of the Public Health Service Act (which is incorporated by reference into section 9815 of the Code) and of the right to obtain obstetrical and gynecological services without a referral. The likely respondents are business or other for-profit institutions, and nonprofit institutions. Responses to these collections of information are mandatory.
The temporary regulations published elsewhere in this issue of the Federal Register add §§ 54.9815-2704T, 54.9815-2711T, 54.9815-2712T, and 54.9815-2719AT to the Miscellaneous Excise Tax Regulations. The proposed and temporary regulations are being published as part of a joint rulemaking with the Department of Labor and the Department of Health and Human Services (the joint rulemaking). The text of those temporary regulations also serves as the text of these proposed regulations. The preamble to the temporary regulations explains those temporary regulations and these proposed regulations.
It has been determined that this notice of proposed rulemaking is not a significant regulatory action as defined in Executive Order 12866. Therefore, a regulatory assessment is not required. It has also been determined that section 553(b) of the Administrative Procedure Act (5 U.S.C. chapter 5) does not apply to this proposed regulation. It is hereby certified that the collections of information contained in this notice of proposed rulemaking will not have a significant impact on a substantial number of small entities. Accordingly, a regulatory flexibility analysis is not required.Start Printed Page 37243
Section 54.9815-2711T(e) of the temporary regulations requires both group health insurance issuers and group health plans to notify individuals otherwise eligible for coverage who have previously reached a lifetime limit that the lifetime limit no longer applies and of the right to enroll in the coverage. Under the temporary regulations, if a health insurance issuer satisfies this notice obligation, it is satisfied not just for the issuer but also for the group health plan. For group health plans maintained by small entities, it is anticipated that the health insurance issuer will satisfy this notice obligation for both the plan and the issuer in almost all cases. For this reason, this information collection requirement will not impose a significant impact on a substantial number of small entities.
Section 54.9815-2712T(a)(1) of the temporary regulations requires group health plans and group health insurance issuers to provide 30 days advance notice to any individual whose coverage would be affected before the plan or issuer can rescind the coverage. If a health insurance issuer satisfies this notice obligation, it is satisfied not just for the issuer but also for the group health plan. For group health plans maintained by small entities, it is anticipated that the health insurance issuer will satisfy this notice obligation for both the plan and the issuer in almost all cases. For this reason, this information collection requirement will not impose a significant impact on a substantial number of small entities.
Under § 54.9815-2719AT(a)(4) of the temporary regulations, a group health plan or health insurance coverage that requires or provides for covered individuals to designate a primary care provider must notify individuals covered under the plan of their rights to choose any primary care provider in the plan's network who is available to accept the individual, to designate a pediatrician in the network for a child, and to obtain obstetrical and gynecological services without a referral. If a health insurance issuer satisfies this notice obligation, it is satisfied not just for the issuer but also for the group health plan. For group health plans maintained by small entities, it is anticipated that the health insurance issuer will satisfy this notice obligation for both the plan and the issuer in almost all cases. For this reason, this information collection requirement will not impose a significant impact on a substantial number of small entities.
Paragraph 1. The authority citation for part 54 is amended by adding entries in numerical order to read as follows:
Section 54.9815-2704 also issued under 26 U.S.C. 9833.
Section 54.9815-2711 also issued under 26 U.S.C. 9833.
Section 54.9815-2712 also issued under 26 U.S.C. 9833. * * *
Section 54.9815-2719A also issued under 26 U.S.C. 9833. * * *
Par. 2. Section 54.9815-2704 is added to read as follows:
§ 54.9815-2704
[The text of proposed § 54.9815-2704 is the same as the text of § 54.9815-2704T published elsewhere in this issue of the Federal Register].
Par.3. Section 54.9815-2711 is added to read as follows:
§ 54.9815-2711
[The text of proposed § 54.9815-2711 is the same as the text of § 54.9815-2711T published elsewhere in this issue of the Federal Register].
Par. 4. Section 54.9815-2712 is added to read as follows:
§ 54.9815-2712
[The text of proposed § 54.9815-2712 is the same as the text of § 54.9815-2712T published elsewhere in this issue of the Federal Register].
Par. 5. Section 54.9815-2719A is added to read as follows:
§ 54.9815-2719A
[The text of proposed § 54.9815-2719A is the same as the text of § 54.9815-2719AT published elsewhere in this issue of the Federal Register].
[FR Doc. 2010-15277 Filed 6-22-10; 11:15 am]