ACA Update: Final Rule Issued on Excepted Health Benefits
Nov 13, 2014
On October 1, 2014, the Departments of the Labor, Health and Human
Services and Treasury published a final rule regarding excepted health
benefits. Excepted benefits are generally exempt from ACA’s market
reform, including limits on pre-existing conditions and guaranteed
The final rule is effective December 1, 2014 and applies to group health plans effective January 1, 2015 and later.
Stand-alone dental and vision plans are already considered excepted
benefits. The final rule expands the definition of excepted benefits to
include employee assistance plans (EAPs) if the EAP plan meets certain
The EAP is free to employees, and
EAP benefits are not coordinated with benefits in a group health plan, and
The EAP does not provide significant benefits in the nature of medical care or treatment
The final rule also clarified that self-insured plans that offered
dental and vision benefits without charging an employee contribution
also qualify as excepted benefits. Fully insured vision and dental
benefits, and self-insured vision and dental coverage that requires
employee contributions, previously qualified as excepted benefits.
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