Periodically, we invite you to visit this section of our site for information related to health insurance plans and mandated notices required by Federal Laws and Regulations.
Frequently Asked Questions About the Health Insurance Marketplace
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 through their group health plan for a limited period 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% of the cost of the plan.
COBRA generally requies that the health plans sponsored by employers with 20 or more employees in their prior year, offer employees and their families the opportunity for a temporary extension of health coverage (called continuation of 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 theDepartment of Labor's (DOL) web site.
Read more about COBRA
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 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
CHANGES TO OVER-THE-COUNTER REIMBURSEMENT RULES
uUnder the Patient Protection and Affordable Care Act (PPACA), the rules for reimbursement of over-the-counter (OTC) items have changed.
Topical and oral OTC items are no longer 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 medications, 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 without a doctor's note.
Items that will need to be covered with a doctor's orders may not longer be purchased using the WageWorks Card 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 OTC's will need a prescription from a physician indicating the specific medication needed.
Change to OTC Medications