- New-Federal Notices
- COBRA
- HIPAA Privacy
- Appeals
- Over-the-Counter Medication (FSA)
New-Opportunity to Enroll in connection with Extension of Dependent Coverage New-Lifetime Limit No Longer Applies and Enrollment Opportunity New-Medicaid and the Children's Health Insurance Program (CHIP) Offer Free or Low-cost Health Coverage to Children and Families Updated-Medicare Part D Notice (10/2011) |
| COBRA |
The Consolidated Omnibus Budget Reconciliation Act (COBRA) is a Federal Law that gives employees and their families who lose their certain health benefits the right to choose to continue benefits though their group health plan for limited periods of time under certain circumstances such as voluntary or involuntary job loss, reduction in the hours worked, transition between jobs, death, divorce, and other life events. Qualified individuals may be required to pay the entire premium for coverage up to 102 percent of the cost to the plan. COBRA generally requires that group health plans sponsored by employers with 20 or more employees in the prior year offer employees and their families the opportunity for a temporary extension of health coverage (called continuation coverage) in certain instances where coverage under the plan would otherwise end. COBRA outlines how employees and family members may elect continuation coverage. It also requires employers and plans to provide notice. You may view more information regarding COBRA by clicking on a link below or you may visit the Department of Labor's (DOL) web site to read more information. Other DOL Links on this topic Frequently Asked Questions COBRA Continuation Coverage Assistance under ARRA
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| HIPAA PRIVACY | |
The HIPAA Privacy Rule provides federal protections for personal health information held by covered entities and gives patients an array of rights with respect to that information. At the same time, the Privacy Rule is balanced so that it permits the disclosure of personal health information needed for patient care and other important purposes. You can click here to read more about HIPAA Privacy Rights
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| OTHER IMPORTANT NOTICES |
Changes to Over-the-Counter Reimbursement Rules Under the Patient Protection and Affordable Care Act (PPACA) the rules for reimbursement Over-the-Counter (OTC) items have changed. Effective January 1, 2011, topical and oral OTC items will no longer be eligible for reimbursement without a prescription or Letter of Medical Need from a physician. For example this includes such items as Digestive Aids, Allergy and Sinus drugs, Pain relief, Cold medicines, Cough medicines, Laxatives, Motion Sickness and Stomach remedies, Sleep Aids, Cold Sore, Anti-Diarrheal and Anti-Gas meds, Anti-Itch items, Baby Rash creams, Insect Bite treatments, Respiratory Treatments and Anti-Infective medications. Items like wrist splints, band-aids, magnifying readers, incontinence products and durable medical items such as crutches or a cane may continue to be reimbursed as is current practice and without a doctor’s note. Items that will need to be covered with a doctor’s order may no longer be purchased using the myFBMC CardSM because the approval systems cannot determine if there is a doctor’s note on file with administrators. Participants who wish to continue to purchase tax-free OTCs will need a note from a physician indicating the specific medication needed. For your convenience, blank Letter of Medical Need is available for download at www.myFBMC.com. This change applies January 1, 2011, regardless of when your plan year begins. Be sure to review your enrollment materials carefully and check www.myFBMC.com regularly for updates. |