As tree leaves start to turn colors in October here in the Midwest at the International Foundation headquarters, our minds are turning to other changes in the air for some employers, administrators, health providers and health insurance providers nationwide. Section 1557 of the Affordable Care Act (ACA) may require your organization to post nondiscrimination compliance notices by October 17, 2016.
Is your organization subject to this deadline? Must you make changes to your health plan to be in compliance? Read on for background on this rule and for resources to help you comply if you are subject to the rules.
Section 1557 of ACA prohibits discrimination on the basis of race, color, national origin, sex (including gender identity), age or disability in many health programs and activities.
Covered entities under Section 1557 must notify members and the public of their compliant nondiscrimination policy. The notifications should take place by October 17, 2016. However, if a health plan needs to make changes to its plan design in order to comply with Section 1557, the changes must take effect on the first day of the first plan year beginning on or after January 1, 2017, and nondiscrimination notifications must occur within 90 days of that effective date.
[ACA University Webcast: Form 1094-C and Form 1095-C Updates for 2016]
Covered entities under Section 1557 include entities that receive federal financial assistance from the U.S. Department of Health and Human Services (HHS). This includes, but is not limited to, health insurance issuers, health care providers, many third-party administrators (TPAs), and some group health plans and plan sponsors.
Generally, employers with self-administered (not third-party administered) health plans that are self-funded (not insured) and are not receiving any federal financial assistance from HHS are not subject to Section 1557.
However, one example of federal financial assistance that could apply to self-funded, self-administered health plans, therefore making them subject to Section 1557, would be Medicare Part D Retiree Drug Subsidies from HHS.
If you are unsure whether your organization is subject to Section 1557, please seek legal counsel. And do so before those leaves are on the ground! (This article is not intended as legal advice or comprehensive coverage of Section 1557 requirements.)
Resources you’ll need from HHS:
Other helpful resources explaining Section 1557 requirements:
HHS Issues Final Rule on ACA Nondiscrimination Provisions (Section 1557), Groom Law Group, May 25, 2016
Is Your Health Plan Covered Under the New Section 1557 Nondiscrimination Rules? Graydon Head, September 12, 2016
Summary of HHS’s Final Rule on Nondiscrimination in Health Programs and Activities, Issue Brief, Henry J. Kaiser Family Foundation, July 14, 2016
Lois Gleason, CEBS
Manager, Reference/Research Services at the International Foundation