Guidance on “Skinny Plans” Concept

Unfortunately, the federal government is scrambling around at the last minute to provide “guidance" for next year on a statute that was enacted in 2010. Please excuse the third e-alert of the last week, but we feel compelled to alert you about yet another eleventh-hour “development.”

Specifically, on November 4, the regulators issued Notice 2014-69, stating that so-called “skinny health plan” designs not providing hospitalization and/or physician coverage do not meet the 60% Minimum Actuarial Value test of the Affordable Care Act (even if running those designs through the HHS calculator results in a score higher than 60%).

Therefore, employers considering adopting such a plan to satisfy this particular ACA requirement should not do so.

(The Notice contains a limited and somewhat complex grandfather rule, for one year, for some skinny plans already in place/in progress.)

The Notice was silent on the question of whether these “Non-Hospital and/or Non-Physician Services Plans” constitute Minimum Essential Coverage under the ACA, leading some commentators to suggest that they do so.

Please let us know if you have any question on this latest guidance, or on any other ACA issue.

Categories: Regulations