Employers are waiting for agency guidance on many pieces of the health care reform puzzle. Here are some of the big issues for which guidance has been promised but not yet issued:

  • Form W-2 Reporting. The IRS was expected to release additional guidance by the end of 2010 on the new Form W-2 requirement to report health care coverage costs. This requirement was initially effective for the 2011 Form W-2, but was delayed by the IRS in October 2010.
  • “Mini-SPD” Standards. The agencies are required by statute to provide guidance on the new 4-page summary of benefits and coverage by March 2011. Plans will then have to produce the summaries, with distribution prior to March 23, 2012. Also notable: Employers need not comply with the 60-day advance notice of material modifications until this “mini-SPD” guidance is issued.
  • Essential Health Benefits. Knowing exactly what constitutes an essential health benefit is essential in deciphering lifetime and annual limits. At the request of HHS, the Institute of Medicine formed a Committee on the Determination of Essential Health Benefits that will make recommendations on the criteria and methods for determining an “essential health benefit” package. The Committee’s first meeting was held January 12-14, 2011; the next is scheduled for March 2-3, 2011. While the Committee will not define specific services in the essential health benefit package, it will provide guidance on the policy principles and criteria for HHS to consider when developing the package. Recommendations from the Committee are expected by September 2011. In the meantime, group health plans are subject to a “good faith” compliance standard until the agencies issue final regulations.
  • Automatic Enrollment. Employers are not required to comply with the new automatic-enrollment rules—which require employers with more than 200 full-time employees to enroll new hires in their health plans—until guidance is used. The DOL expects to complete rulemaking by 2014.
  • Non-Discrimination. The agencies are currently taking comments on the new non-discrimination rules applicable to fully-insured group health plans. Compliance with the new rules is not required until guidance is issued.