Agencies publish final rules under the ACA

Regulations are effective January 19, 2016

Posted November 20, 2015

On November 18, the Internal Revenue Service, Employee Benefits Security Administration, and the Department of Health and Human Services published final rules in the Federal Register under the Affordable Care Act (ACA). The final regulations are effective on January 19, 2016.

Specifically, the final regulations address:

  • Grandfathered health plans, preexisting condition exclusions;
  • Lifetime and annual dollar limits on benefits;
  • Rescissions;
  • Coverage of dependent children to age 26;
  • Internal claims and appeal and external review processes; and
  • Patient protections under the Affordable Care Act.

The publication finalizes changes to the proposed and interim final rules based on comments and incorporates subregulatory guidance issued since publication of the proposed and interim final rules. The final rules apply to group health plans and health insurance issuers beginning on the first day of the first plan year (or, in the individual market, the first day of the first policy year) beginning on or after January 1, 2017.

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