by James A. Woehlke, Esq., CPA
General Counsel / COO, MBL Benefits Consulting Corp.

The Patient Protection and Affordable Care Act (the ACA*) was enacted on March 23, 2010. The ACA includes a requirement that preventive care specifically identified in regulations is to be provided at no cost to participants. Cost-sharing may be imposed on other preventive care. This is not a requirement imposed on grandfathered plans. The Administration issued guidance on this requirement in the form of interim final regulations on July 19, 2010.

The regulations define preventive care with reference to those recommendations from the

• United States Preventive Services Task Force which were believed to have the greatest beneficial effect (for evidenced-based items, those rated A or B).
• Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention.
• Health Resources and Services Administration

The current list of recommendations and guidelines required to be covered under the regulations is posted at www.healthcare.gov/center/regulations/prevention.html. (In the first category above, there are 45 procedures.) It is expected that these groups will augment their recommendations from time to time; and, health plans will need to expand (or decrease) coverage accordingly.

The regulations address what is to occur when preventive care is provided but not separately billed, if, for instance, a preventive care procedure is administered as part of a routine office visit, which otherwise requires a co-pay.

If you have questions about the new preventive care requirements, please contact your MBL Benefits consultant or the author at jwoehlke@mblbc.com.

* For simplicity, the Patient Protection and Affordable Care Act and the Health Care and Education Affordability Reconciliation Act are collectively referred to as the Affordable Care Act, or ACA.

__________
Additional resources available at

Official publication of interim final regulations on preventive care coverage: http://federalregister.gov/a/2010-17242

From Proskauer Rose law firm, http://www.proskauer.com/publications/client-alert/health-care-reform-preventive-services-final-rules/.

From Venable LLP law firm, http://www.venable.com/files/Publication/cf848032-4911-4da3-b0e1-887f65921899/Presentation/PublicationAttachment/28f6dabc-8c97-4c04-9134-8d07c170586c/Preventive-Care-Coverage-Rules_8-30-10.pdf

Rev. 8/30/2010.

by James A. Woehlke, Esq., CPA
General Counsel / COO, MBL Benefits Consulting Corp.

On October 12, the IRS called for public comment on enhancing the current regulations on nondiscrimination in self-insured group health plans to cover the new requirements passed in the Affordable Care Act. After reviewing the maze of statutes that together impose the nondiscrimination requirement on nongrandfathered, fully-insured plans, the Notice summarizes the consequences when a plan fails the nondiscrimination rules as follows:

If a self-insured plan fails to comply with [the nondiscrimination rules], highly compensated individuals lose a tax benefit; if an insured group health plan fails to comply with [the nondiscrimination rules], the plan is subject to a civil action to compel it to provide nondiscriminatory benefits and the plan or plan sponsor is subject to an excise tax or civil money penalty of $100 per day per individual discriminated against.

Public comments are due November 4, 2010.

If you have questions about the impact of the nondiscrimination rules on your group plans, please contact your MBL Benefits consultant or the author at jwoehlke@mblbc.com.

__________
Additional resources available at

IRS Notice 2010-63: http://www.irs.gov/irb/2010-41_IRB/ar07.html

Rev. 10/28/2010.

by James A. Woehlke, Esq., CPA
General Counsel / COO, MBL Benefits Consulting Corp.

The Patient Protection and Affordable Care Act (the ACA*) was enacted on March 23, 2010. The ACA requires that both new and grandfathered group health plans be designed to cover participants’ children up to age 26. The Administration issued guidance on this requirement in the form of interim final regulations on May 13, 2010.

Prior to the ACA, it was typical for plans to tie dependent coverage to the same rules used for tax purposes. For instance, children were covered if they met certain residency or financial support requirements, or were full-time students up to age 23. Some states, however, had mandated expanded coverage for adult children. Effective for plan years beginning after September 23, 2010, if a group health plan offers coverage to participant’s children, the ACA now requires that coverage extend until the child reaches age 26.

This change is required both for grandfathered and new plans. However, for plan years beginning before 2014, a plan is permitted to deny coverage to a child under 26 if he or she is covered by another plan, other than the plan of the child’s other parent. In other words, if the child is covered by his or her own employer’s plan or that of a spouse, the parents’ plans may exclude the child until 2014.

The regulations identify criteria which are no longer permitted in defining eligibility of children, including

• financial dependency on the participant or primary subscriber (or any other person),
• residency with the participant or primary subscriber (or any other person),
• student status,
• employment,
• marital status,
• eligibility for other coverage,
• or any combination of the above.

Although, eligibility may not hinge upon a child’s marital status, there is no requirement that plans must cover spouses or children of participants’ children. The regulations also provide that the terms of the plan or policy for dependent coverage cannot vary based on the age of a child, except for children age 26 or older. Where states set a higher age or coverage requirement, as does New York, which requires plans to make coverage available to age 29, the state mandate will apply.

There are many individuals over age 23 but under 26 who lost coverage before the effective date of this ACA provision. The regulations provide transition rules for these people. They must be given notice of the opportunity to receive coverage and have an open enrollment period of at least 30 days to occur not later than the first day of the first plan year beginning on or after September 23, 2010.

If you have questions about the age 26 coverage requirement, please contact your MBL Benefits consultant or the author at jwoehlke@mblbc.com.

* For simplicity, the Patient Protection and Affordable Care Act and the Health Care and Education Affordability Reconciliation Act are collectively referred to as the Affordable Care Act, or ACA.

__________
Additional resources available at

Official publication of interim final regulations on coverage for children to age 26: http://www.federalregister.gov/articles/2010/05/13/2010-11391/interim-final-rules-for-group-health-plans-and-health-insurance-issuers-relating-to-dependent

From the Proskauer Rose law firm, http://www.proskauer.com/publications/client-alert/health-coverage-for-children-to-age-26/

Rev. 8/30/2010.

by James A. Woehlke, Esq., CPA
General Counsel / COO, MBL Benefits Consulting Corp.

The Patient Protection and Affordable Care Act (the ACA*) was enacted on March 23, 2010. The ACA identifies certain patient protections which need to be incorporated into new plans. These protections are not required for grandfathered plans. The Administration issued guidance on this (and several other) requirement(s) in the form of interim final regulations on June 28, 2010.

The ACA-mandated patient protections relate to selection of one’s personal health care provider and certain emergency services. The requirements regarding choice of health care providers apply only for nongrandfathered plans that participate in a network of providers.

There are three requirements relating to provider choice. First, if the plan participates in a network, the enrollee must be notified of the plan provisions regarding selection of a primary care doctor and must be permitted to select from any of the network providers who are available, that is, taking on new patients. The same notice requirement and selection rights pertain to the identification of a pediatrician for children. Regarding OB/GYN services, the participant must be permitted to select her own OB/GYN and not be required to use one selected for her. Also, OB/GYN services are deemed to be services of a primary care physician.

If a plan provides for emergency services, they may no longer require prior authorization for emergency services. The carrier may not require that emergency services be provided by an in-network provider. There may not be any additional administrative requirement or limitation on benefits that is more restrictive for in-network emergency care than out-of-network care. Also, there may not be a different cost-sharing (co-pay, deductible, etc.) for in-network and out-of-network emergency care. Out-of-network providers may, however, bill the patient for any amount not paid by the carrier. That being said, to avoid abuse, the regulations require that the carriers pay a “reasonable amount” before the patient becomes liable for any balance due. A reasonable amount per the regulations is the greater of

• the in-network amount that would have been paid for the services,
• the amount that would usually be paid for out-of-network services but substituting in-network cost-sharing provisions for the out-of-network provisions, and
• what Medicare would pay for the emergency services.

If you have questions about the new patient protection requirements, please contact your MBL Benefits consultant or the author at jwoehlke@mblbc.com.

* For simplicity, the Patient Protection and Affordable Care Act and the Health Care and Education Affordability Reconciliation Act are collectively referred to as the Affordable Care Act, or ACA.

__________
Additional resources available at

Official publication of interim final regulations on patient protections: http://www.federalregister.gov/articles/2010/06/28/2010-15278/patient-protection-and-affordable-care-act-preexisting-condition-exclusions-lifetime-and-annual

From the Proskauer Rose law firm, http://www.proskauer.com/publications/client-alert/health-care-reform-interim-final-regulations-released-for-preexisting-condition-exclusions/

Rev. 8/30/2010.

by James A. Woehlke, Esq., CPA
General Counsel / COO, MBL Benefits Consulting Corp.

The Patient Protection and Affordable Care Act (the ACA*) was enacted on March 23, 2010. The ACA requires that both new and grandfathered group health plans be designed without exclusions for pre-existing conditions. The Administration issued guidance on this (and several other) requirement(s) in the form of interim final regulations on June 28, 2010.

ACA prohibits health plans from denying coverage due to preexisting conditions effective for plan years beginning after 2013. In addition, they may not deny coverage to children under age 19 due to preexisting conditions for plan years beginning on or after September 23, 2010. Until the effective date, HIPAA rules that permit exclusions due to preexisting conditions remain in effect. Grandfathered group health plans must comply with this requirement.

If you have questions about the new pre-existing exclusion prohibition, please contact your MBL Benefits consultant or the author at jwoehlke@mblbc.com.

* For simplicity, the Patient Protection and Affordable Care Act and the Health Care and Education Affordability Reconciliation Act are collectively referred to as the Affordable Care Act, or ACA.

__________
Additional resources available at

Official publication of interim final regulations on pre-existing condition coverage: http://www.federalregister.gov/articles/2010/06/28/2010-15278/patient-protection-and-affordable-care-act-preexisting-condition-exclusions-lifetime-and-annual

From the Proskauer Rose law firm, http://www.proskauer.com/publications/client-alert/health-care-reform-interim-final-regulations-released-for-preexisting-condition-exclusions/

Rev. 8/30/2010.

by James A. Woehlke, Esq., CPA
General Counsel / COO, MBL Benefits Consulting Corp.

The Patient Protection and Affordable Care Act (the ACA*) was enacted on March 23, 2010. The ACA limits the ability of group health plans to cap coverage on either an annual or lifetime basis. The Administration issued guidance on this (and several other) requirement(s) in the form of interim final regulations on June 28, 2010.

The ACA prohibits lifetime caps in all plans effective for plan years beginning on or after September 23, 2010.

In addition, annual caps are prohibited on “essential health benefits”, but for plan years beginning before 2014 “restricted annual limits” are permitted on these benefits. Plans may continue to impose limits for nonessential health benefits. The regulations define essential health benefits with reference to as-yet-unissued regulations interpreting ACA § 1302(b), which lists the following benefits as being essential:

• Ambulatory patient services
• Emergency services
• Hospitalization
• Maternity and newborn care
• Mental health and substance use disorder services, including behavioral health treatment
• Prescription drugs
• Rehabilitative and habilitative services and devices
• Laboratory services
• Preventive and wellness services and chronic disease management
• Pediatric services, including oral and vision care

Until additional regulations are issued, plan sponsors are permitted to use a rule-of-reason approach with regard to what constitutes essential health benefits. However, plan sponsors are required to apply the definitions they use on a consistent basis.

The regulation sets the following interim “restricted annual limits”:

The limits operate on an individual basis; there is not a separate set of limits for families.

If a plan participant had exceeded a lifetime limit prior to the effective date of this ACA provision and otherwise still qualified for coverage, the participant must be notified that lifetime limits no longer apply and coverage is once again available. If not currently enrolled in the plan, the individual needs to be given the opportunity to re-enroll no later than the first day of the plan year beginning after September 22, 2010.

The prohibition on annual and lifetime limits applies to both new and grandfathered plans. If a grandfathered plan has no limit and subsequently imposes one, even one of the pre-2014 permitted limits, grandfathered status is lost.

If you have questions about the new limitations on annual and lifetime caps, please contact your MBL Benefits consultant or the author at jwoehlke@mblbc.com.

* For simplicity, the Patient Protection and Affordable Care Act and the Health Care and Education Affordability Reconciliation Act are collectively referred to as the Affordable Care Act, or ACA.

__________
Additional resources available at

Official publication of interim final regulations on annual and lifetime caps: http://www.federalregister.gov/articles/2010/06/28/2010-15278/patient-protection-and-affordable-care-act-preexisting-condition-exclusions-lifetime-and-annual

From the Proskauer Rose law firm, http://www.proskauer.com/publications/client-alert/health-care-reform-interim-final-regulations-released-for-preexisting-condition-exclusions/

Rev. 8/30/2010.

by James A. Woehlke, Esq., CPA
General Counsel / COO, MBL Benefits Consulting Corp.

Background
The Patient Protection and Affordable Care Act (the ACA*) was enacted on March 23, 2010. The ACA permits certain of its provisions to not apply to group health plans in existence on the effective date. These plans are called “grandfathered plans”. The Administration issued guidance on a plan’s status as a grandfathered health plan in the form of interim, final regulations on June 17, 2010.

Grandfathered plan status excuses grandfathered plans from certain, but not all, of the ACA’s requirements. Many feared grandfathered-plan status was so delicate that almost any change would cause a plan to lose its grandfathered status. The regulations issued June 17 put this fear to rest, permitting slightly more flexibility than many originally predicted.

Grandfathered plans are not subject to the following ACA requirements:

• Extended nondiscrimination rules
• Inclusion of access to out-of-network emergency services without cost-sharing or pre-certification
• Provision of certain preventive care without cost-sharing
• Inclusion of HIPAA wellness program rules pertaining to obstetrical and gynecological care
• Implementation of internal and external review processes
• Permit identification of any available primary care physician as the participant’s PCP

How Grandfathered Status is Lost
Generally speaking, grandfathered status is lost by changing a plan’s carrier or redesigning a plan to significantly increase the contributions required of employees. This presents employers with a planning decision relating to whether the avoidance of these mandates justifies the additional premium burden the employer would bear to maintain the grandfathered status. Performing this cost-benefit analysis will require some additional time and effort with each year’s renewal. Employers and their health care advisors need to factor that additional analysis into their renewal process. In addition, if the decision is made to maintain grandfathered status, the plan must provide notice to employees that the employer believes the plan is grandfathered and document the plan description as it existed on March 23, 2010, which description must be made available upon request. (See, Department of Health and Human Services sample notice at http://www.dol.gov/ebsa/grandfatherregmodelnotice.doc.)

Plan Changes Permitted for Grandfathered Plans
The statute and new interim final regulations permit the following plan changes without adversely affecting grandfathered status:

• Adding new and deleting terminated participants
• Certain collectively bargained-for changes
• Plan changes required by health care reform
• Cost adjustments to keep pace with medical inflation
• Adding benefits
• Making modest adjustments to existing benefits
• Voluntarily adopting new consumer protections under the new law
• Making changes to comply with state or other federal laws

Grandfathered status will be lost if (a) the plan changes insurance carriers or (b) significant changes are made which either reduce benefits or increase costs to the participants. These significant changes include:

• Significant reductions in coverage
• Any increase in percentage cost-sharing (i.e. co-insurance)
• Fixed cost-sharing increases greater than medical inflation plus 15%
• Certain reductions in employer cost-sharing
• Imposition of a new cap or reducing an existing cap

Significant Reductions in Coverage. If a plan eliminates all or substantially all benefits to diagnose or treat a particular condition, such as cystic fibrosis, grandfathered status is lost. The elimination of benefits for any necessary element to diagnose or treat a condition would also be considered a significant reduction causing loss of status. For example, if a plan provides benefits for the treatment of a mental health condition and that treatment would normally include medication and counseling, the later elimination of benefits for counseling will cause loss of grandfathered status.

Change to Percentage Cost-Sharing. Percentage cost-sharing automatically tracks with the rate of inflation for medical costs. Therefore, the regulations provide that any change in percentage-cost sharing will cause loss of status.

Change in Fixed Cost-Sharing. If a plan increases fixed cost-sharing, such as a deductible, copayment, or an out-of-pocket limit, grandfathered status is affected only if the change exceeds 15% plus the rate of medical inflation. For instance, if medical inflation is 10% and a $200 deductible is increased to $300, grandfathered status would be lost because the increase of $200 to $300 (a 50% increase) exceeds the 25% maximum under the assumed facts. However, for copayments, the regulations have a special rule that permits an increase of $5 plus medical inflation, in the event the 15% plus medical inflation limitation is exceeded. For example, a copayment increase from $10 to $15 in the previous example would exceed the inflation plus 15% limit, but be permitted under the special rule for copayments.

Reductions in Employer Cost-Sharing. Grandfathered status is also lost if the employer reduces its contribution for health coverage by more than 5%.

Imposition of a New Cap or Reducing an Existing Cap. Grandfathered plan status is lost if a plan adds either an annual cap or lifetime cap. Also, a plan with an existing cap will lose its grandfathered status if it reduces the cap.

If you have questions about your plan’s grandfathered status, please contact your MBL Benefits consultant or the author at jwoehlke@mblbc.com.

* For simplicity, the Patient Protection and Affordable Care Act and the Health Care and Education Affordability Reconciliation Act are collectively referred to as the Affordable Care Act or ACA.

__________
Additional resources available at

Official publication of interim final regulations: http://www.federalregister.gov/articles/2010/06/17/2010-14488/interim-final-rules-for-group-health-plans-and-health-insurance-coverage-relating-to-status-as-a

Department of Health and Human Services Fact Sheet: Keeping the Health Plan You Have: The Affordable Care Act and “Grandfathered” Health Plans, http://www.healthreform.gov/newsroom/keeping_the_health_plan_you_have.html

Department of Health and Human Services Model Grandfathered Health Plan Notice in Word format, http://www.dol.gov/ebsa/grandfatherregmodelnotice.doc.

Department of Health and Human Services Question and answer sheet on grandfathered status, http://healthreform.gov/about/grandfathering.html
Healthreform.gov information page on grandfathered plans, http://healthreform.gov/about/grandfathering.html

Proskauer Rose article on Grandfathered Plan Status, http://www.proskauer.com/publications/client-alert/health-care-reform-grandfathered-health-plan-interim-final-regulations/

Proskauer Rose Table on the Application of the ACA to grandfathered plans, http://www.proskauer.com/files/uploads/Images/Comprehensive-Chart-on-Part-A-Mandates.pdf.

Health Care Reform Law: Agencies Explain “Grandfathering” http://www.jacksonlewis.com/legalupdates/article.cfm?aid=2099

Venable LLP article on Grandfathered Plan regulations: http://www.venable.com/files/Publication/7948335d-f3ac-4e10-9727-3959d1aa6094/Presentation/PublicationAttachment/eb569e95-25e0-46ee-ab87-543244fc7fb9/grandfathered_health_plans_7-22-10.pdf

Rev. 8/30/2010.

­­

Available from U.S. Department of Labor

The Department of Labor has issued the following model notice to be distributed to plan participants. The notice is available at  http://www.dol.gov/ebsa/grandfatherregmodelnotice.doc.

To maintain status as a grandfathered health plan, a plan or health insurance coverage must include a statement, in any plan materials provided to a participant or beneficiary describing the benefits provided under the plan or health insurance coverage, that the plan or coverage believes it is a grandfathered health plan within the meaning of section 1251 of the Patient Protection and Affordable Care Act and must provide contact information for questions and complaints.

The following model language can be used to satisfy this disclosure requirement:

This [group health plan or health insurance issuer] believes this [plan or coverage] is a “grandfathered health plan” under the Patient Protection and Affordable Care Act (the Affordable Care Act).  As permitted by the Affordable Care Act, a grandfathered health plan can preserve certain basic health coverage that was already in effect when that law was enacted.  Being a grandfathered health plan means that your [plan or policy] may not include certain consumer protections of the Affordable Care Act that apply to other plans, for example, the requirement for the provision of preventive health services without any cost sharing.  However, grandfathered health plans must comply with certain other consumer protections in the Affordable Care Act, for example, the elimination of lifetime limits on benefits.

Questions regarding which protections apply and which protections do not apply to a grandfathered health plan and what might cause a plan to change from grandfathered health plan status can be directed to the plan administrator at [insert contact information].  [For ERISA plans, insert: You may also contact the Employee Benefits Security Administration, U.S. Department of Labor at 1-866-444-3272 or www.dol.gov/ebsa/healthreform.  This website has a table summarizing which protections do and do not apply to grandfathered health plans.] [For individual market policies and nonfederal governmental plans, insert: You may also contact the U.S. Department of Health and Human Services at www.healthreform.gov.]

by James A. Woehlke, Esq., CPA

As enacted, the Affordable Care Act* “grandfathered” group health plans in existence on March 23, 2010. Many feared grandfathered-plan status was so delicate that almost any change would cause a plan to lose its grandfathered status. The U.S. Departments of Health and Human Services, Labor, and Treasury published “interim final regulations” on June 17, which define the circumstances under which a plan will lose grandfathered status. The regulations permit slightly more flexibility than originally believed.

Grandfathered plans are not subject to the following requirements, which are imposed on new plans:

• Extended nondiscrimination rules
• Restrictions on cost sharing
• No cost sharing for preventive care
• Inclusion of HIPAA wellness program rules

The statute and new interim final regulations permit the following plan changes without adversely affecting grandfathered status:

• Adding new and deleting terminated participants
• Collectively bargained-for changes
• Plan changes required by health care reform
• Cost adjustments to keep pace with medical inflation
• Adding benefits
• Making modest adjustments to existing benefits
• Voluntarily adopting new consumer protections under the new law
• Making changes to comply with state or other federal laws

However, grandfathered status will be lost if (a) the plan changes insurance carriers, or (b) significant changes are made which either reduce benefits or increase costs to the participants. These significant changes include:

• Significant reductions in coverage
• Any increase in percentage cost-sharing
• Fixed cost-sharing increases greater than medical inflation plus 15%
• Certain reductions in employer cost-sharing
• Imposition of a new cap or reducing an existing cap

Significant Reductions in Coverage. If a plan eliminates all or substantially all benefits to diagnose or treat a particular condition, such as cystic fibrosis, grandfathered status is lost. The elimination of benefits for any necessary element to diagnose or treat a condition would also be considered a significant reduction causing loss of status. For example, if a plan provides benefits for the treatment of a mental health condition and that treatment would normally include medication and counseling, the later elimination of benefits for counseling will cause loss of grandfathered status.

Change to Percentage Cost-Sharing. Percentage cost-sharing automatically tracks with the rate of inflation for medical costs. Therefore, the regulations provide that any change in percentage-cost sharing will cause loss of status.

Change in Fixed Cost-Sharing. If a plan increases fixed cost-sharing, such as a deductible, copayment, or an out-of-pocket limit, grandfather status is affected only if the change exceeds 15% plus the rate of medical inflation. For instance, if medical inflation is 10% and a $200 deductible is increased to $300, grandfathered status would be lost because the increase of $200 to $300 (a 50% increase) exceeds the 25% maximum under the assumed facts. However, the regulations have a special rule for copayments that permit an increase of $5 plus medical inflation, in the event the 15% plus medical inflation limitation is exceeded. For example, a copayment increase from $10 to $15 in the previous example would exceed the inflation plus 15% limit, but be permitted under the special rule for copayments.

Reductions in Employer Cost-Sharing. Grandfather status is also lost if the employer reduces its contribution for health coverage by more than 5%.

Imposition of a New Cap or Reducing an Existing Cap. Grandfathered plan status is lost if a plan adds either an annual cap or lifetime cap. Also, a plan with an existing cap will lose its grandfathered status if it reduces the cap.

If you have questions about your plan’s grandfathered status, please contact your MBL Benefits consultant or the author at jwoehlke@mblbc.com.

* For simplicity, the Patient Protection and Affordable Care Act and the Health Care and Education Affordability Reconciliation Act are collectively referred to as the Affordable Care Act or ACA.

Additional resources on this subject can be found at

Official publication of interim final regulations: http://www.federalregister.gov/articles/2010/06/17/2010-14488/interim-final-rules-for-group-health-plans-and-health-insurance-coverage-relating-to-status-as-a

Department of Health and Human Services Fact Sheet: Keeping the Health Plan You Have: The Affordable Care Act and “Grandfathered” Health Plans, http://www.healthreform.gov/newsroom/keeping_the_health_plan_you_have.html

Department of Health and Human Services Model Grandfathered Health Plan Notice in Word format, http://www.dol.gov/ebsa/grandfatherregmodelnotice.doc.

Department of Health and Human Services Question and answer sheet on grandfathered status, http://healthreform.gov/about/grandfathering.html
Healthreform.gov information page on grandfathered plans, http://healthreform.gov/about/grandfathering.html

Proskauer Rose article on Grandfathered Plan Status, http://www.proskauer.com/publications/client-alert/health-care-reform-grandfathered-health-plan-interim-final-regulations/

Proskauer Rose Table on the Application of the ACA to grandfathered plans, http://www.proskauer.com/files/uploads/Images/Comprehensive-Chart-on-Part-A-Mandates.pdf.

Health Care Reform Law: Agencies Explain “Grandfathering” http://www.jacksonlewis.com/legalupdates/article.cfm?aid=2099

Venable LLP article on Grandfathered Plan regulations: http://www.venable.com/files/Publication/7948335d-f3ac-4e10-9727-3959d1aa6094/Presentation/PublicationAttachment/eb569e95-25e0-46ee-ab87-543244fc7fb9/grandfathered_health_plans_7-22-10.pdf

AmeriFlex clients and participants should be aware of a potential scam targeting participants with an AmeriFlex Convenience Debit Card.

We have received reports of at least one participant who received an automated phone call informing them that their account had been compromised, and it attempted to solicit personal information (including a Debit Card number) through an automated phone system.

The security of our clients’ and participants’ personal information is of the utmost importance to us, so we’d like to take this opportunity to provide you with some important reminders to help you avoid these types of scams. Please feel free to share with your participants:

AmeriFlex will never contact participants by means of an automated phone message to solicit personal information. If you receive an automated phone message from someone claiming to represent AmeriFlex and asking for personal or financial information, please hang up and notify us immediately. No legitimate institution will ever initiate contact with a customer in order to request personal information, including account numbers, Debit Card numbers, or SSNs.

If you receive a call of this nature from a person or an automated recording of someone claiming to represent AmeriFlex, please notify us so that we may document and report it. Do not provide any personal information and be sure to use the AmeriFlex toll-free number (888.868.3539, option 2, then option 3) when contacting us to report the incident.

We have received reports of similar incidents where a bank or credit union’s name is invoked, rather than AmeriFlex’s. Beware of any automated phone message, regardless of who it claims to represent, that attempts to solicit personal or financial information.

Please feel free to contact us if you have any other questions or concerns.

AmeriFlex

888.868.FLEX (3539)

http://www.flex125.com