CMS Issues Guidance Extending Annual Limits Waiver

June 20, 2011

Background on Annual Limits Waivers
Some employers offer “limited benefit” plans for part-time employees or groups of employees that otherwise might not have access to affordable coverage.

Initial waivers were granted in September 2010 allowing these plans to continue if raising the limits would result in a significant decrease in access to benefits or significant premium increase.

The initial waivers were granted for one year. This new guidance makes waivers available until 2014 when coverage will be available through exchanges.

On June 17, 2011, the Centers for Medicare and Medicaid Services(CMS)issued guidance allowing health plans to extend their annual limits waiver approval through 2013.

The new guidance will help ensure that employers can continue to provide employees access to affordable health care coverage.The waiver extension request must be submitted by September 22, 2011, and "Annual Limit Updates" must be submitted by December 31, 2012 and December 31, 2013 to extend the waiver through 2013.

Any plan offered prior to September 23, 2010 that wants to keep annual limits but has never requested a waiver needs to do so by September 22, 2011.

The guidance also includes new disclosure requirements that require health plans with waivers to more clearly communicate the limits of the coverage to plan participants.

Cigna will submit a waiver request for our Cigna Voluntary Starbridge and Fundamental Care products. We will also support our clients desiring to extend the waivers on other plans. This is consistent with our efforts to keep access to affordable care available until the new exchange marketplace is established in 2014.

For More Information
Click here for the CMS news release.

Visit InformedOnReform.com for continued updates on annual limits waivers and other health care reform news.

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