Health Care Reform Updates
Wisconsin's Adult Dependent Coverage Mandate Now 26
As previously discussed, the federal Patient Protection and Affordable Care Act (PPACA) created a number of inconsistencies with state law related to dependent care coverage.
After hearing concerns from employers about adhering to both state and federal laws, The Alliance worked with Representative Pat Strachota to draft a bill (LRB 0867) to federalize Wisconsin's adult dependent requirements so that employers would need to only follow one standard.
While the bill was not signed into law in complete form, parts of the bill were addressed in the state budget bill signed into law in June in an amendment written by Representative Strachota. This lowered Wisconsin's adult dependent coverage mandate to age 26, which was previously age 27. This will make coverage requirements consistent with federal law. The change is effective for plan years beginning on or after January 1, 2012.
However, the budget committee did not approve a corresponding tax code change that would have made the tax treatment of adult dependent coverage consistent with federal law. As of this time, employers still need to impute income and withhold state income tax for adult dependents who do not meet the definition of a qualifying child or qualifying relative under Wisconsin law. The Wisconsin Department of Revenue estimated the tax code change would cost $24 million in lost revenue, which made passage difficult during this budget cycle.
The Alliance is continuing to work with legislative leaders and the Department of Revenue on a solution to the tax code portion of this issue. More information on the "imputed income" requirements regarding adult dependents is available on the Wisconsin Department of Revenue website.
Rules Issued for Women's Preventive Care under PPACA, Original IFR Amended
On August 1, the Department of Health and Human Services (HHS) issued detailed guidelines for group health plans and health insurance issuers relating to coverage of preventive services under the Patient Protection and Affordable Care Act (PPACA). A fact sheet is also available at the HealthCare.gov portal.
The guidelines specifically address preventive health services that must be offered to women at no additional cost, such as:
- Well-woman visits
- Screening for gestational diabetes;
- Human papillomavirus (HPV) DNA testing for women 30 years and older;
- Sexually-transmitted infection counseling;
- Human immunodeficiency virus (HIV) screening and counseling;
- FDA-approved contraception methods and contraceptive counseling;
- Breastfeeding support, supplies, and counseling; and
- Domestic violence screening and counseling.
These guidelines supplement the interim final rules on general preventive care requirements issued in July 2010 and have the effect of expanding on the list of preventive health care services that must be covered on a first dollar basis. Specifically, all non-grandfathered health plans (both insured and self-insured plans) will need to include these services without cost sharing for plan years beginning on or after August 1, 2012.
You can read more about this in John Barlament's presentation and the executive summary from this month's Alliance Learning Circle, Covering the Bases of PPACA: Employee Benefits Compliance Update.