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Hospital Coverage Must be Included in ACA Plans

Nov 06, 2014

​Group health care plans that do not provide coverage for hospital care will not pass the health care reform law's “minimum value” test, but the Internal Revenue Service is giving a one-year pass to existing or soon to be implemented plans excluding the coverage.

Ending months of uncertainty on the issue, the IRS on Tuesday said such plans do not provide the minimum value requirement and that regulators will shortly propose regulations to this effect. Read the full article ​here

While rules are yet to be issued, the crux of the notice provides the following:

  1. Plans without hospitalization are not going to meet minimum value (MV).
  2. Employers that relied on the HHS minimum value calculator AND who have contracts already executed predating this guidance date of November 3, 2014, will not be penalized but their plan will need to change at the end of the contract.
  3. Employees who have an offer of coverage that is MV but doesn't include hospitalization will still be able to access tax credits.
  4. Employers who have contracted for these plans must amend any communications that state that an employee cannot access tax subsidies if enrolled in one of these plans.

Click here to access the complete notice.

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