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Federal Register/Vol. 83, No. 150/Friday, August 3, 2018/Rules and Regulations 38212 Federal Register / Vol. 83, No. 150 / Friday, August 3, 2018 / Rules and Regulations DEPARTMENT OF THE TREASURY Labor concerning employment-based Education Reconciliation Act of 2010 health coverage laws may call the (PPACA).9 Internal Revenue Service Employee Benefits Security PPACA reorganizes, amends, and Administration (EBSA) Toll-Free adds to the provisions of Part A of title 26 CFR Part 54 Hotline, at 1–866–444–EBSA (3272) or XXVII of the PHS Act relating to group visit the Department of Labor’s website [TD 9837] health plans and health insurance (http://www.dol.gov/ebsa). In addition, issuers in the group and individual RIN 1545–BO41 information from the Department of markets. PPACA added section 715 of Health and Human Services (HHS) on ERISA and section 9815 of the Code to DEPARTMENT OF LABOR private health insurance for consumers incorporate provisions of Part A of title can be found on the Centers for XXVII of the PHS Act (generally, Employee Benefits Security Medicare & Medicaid Services (CMS) sections 2701 through 2728 of the PHS Administration website (www.cms.gov/cciio) and Act) into ERISA and the Code. information on health reform can be 29 CFR Part 2590 found at www.HealthCare.gov. B. President’s Executive Order SUPPLEMENTARY INFORMATION: RIN 1210–AB86 On October 12, 2017, President DEPARTMENT OF HEALTH AND I. Background Trump issued Executive Order 13813 entitled ‘‘Promoting Healthcare Choice HUMAN SERVICES This rule finalizes amendments to the and Competition Across the United definition of ‘‘short-term, limited- States.’’ 10 This Executive Order states 45 CFR Parts 144, 146, and 148 duration insurance’’ for purposes of its in relevant part: ‘‘Within 60 days of the exclusion from the definition of [CMS–9924–F] date of this order, the Secretaries of the ‘‘individual health insurance coverage’’ Treasury, Labor, and Health and Human RIN 0938–AT48 in 26 CFR part 54, 29 CFR part 2590, Services shall consider proposing and 45 CFR part 144. Short-Term, Limited-Duration regulations or revising guidance, Insurance A. General Statutory Background and consistent with law, to expand the Enactment of PPACA availability of [short-term, limited- AGENCY: Internal Revenue Service, duration insurance]. To the extent The Health Insurance Portability and Department of the Treasury; Employee Accountability Act of 1996 (HIPAA) 1 permitted by law and supported by Benefits Security Administration, added title XXVII to the Public Health sound policy, the Secretaries should Department of Labor; Centers for Service Act (PHS Act), part 7 to the consider allowing such insurance to Medicare & Medicaid Services, Employee Retirement Income Security cover longer periods and be renewed by Department of Health and Human Act of 1974 (ERISA), and Chapter 100 to the consumer.’’ Services. the Internal Revenue Code (the Code), C. 2017 Tax Legislation ACTION: Final rule. providing portability and Section 5000A of the Code, added by SUMMARY: This final rule amends the nondiscrimination rules with respect to PPACA, provides that all non-exempt definition of short-term, limited- health coverage. These provisions of the applicable individuals must maintain duration insurance for purposes of its PHS Act, ERISA, and the Code were minimum essential coverage (MEC) or exclusion from the definition of later augmented by other laws, pay the individual shared responsibility individual health insurance coverage. including the Mental Health Parity Act 2 payment.11 This action is being taken to lengthen of 1996, the Paul Wellstone and Pete On December 22, 2017, the Domenici Mental Health Parity and President signed tax reform legislation the maximum duration of short-term, 3 12 limited-duration insurance, which will Addiction Equity Act of 2008, the into law. This legislation includes a Newborns’ and Mothers’ Health provision under which the individual provide more affordable consumer 4 choices for health coverage. Protection Act, the Women’s Health shared responsibility payment under and Cancer Rights Act,5 the Genetic section 5000A of the Code is reduced to DATES: Information Nondiscrimination Act of Effective date: These final regulations 2008,6 the Children’s Health Insurance 9 The Patient Protection and Affordable Care Act, are effective on October 2, 2018. Program Reauthorization Act of 2009,7 Public Law 111–148, was enacted on March 23, Applicability date: Insurance policies Michelle’s Law,8 and the Patient 2010, and the Health Care and Education Reconciliation Act of 2010, Public Law 111–152, sold on or after October 2, 2018 must Protection and Affordable Care Act, as meet the definition of short-term, was enacted on March 30, 2010. These statutes are amended by the Health Care and collectively referred to as PPACA. limited-duration insurance contained in 10 82 FR 48385. this final rule in order to be considered 11 1 Public Law 104–191, 110 Stat. 1936 (August 21, The eligibility standards for exemptions can be such insurance. 1996). found at 45 CFR 155.605. Section 5000A of the FOR FURTHER INFORMATION CONTACT: 2 Public Law 104–204, 110 Stat. 2944 (September Code and Treasury regulations at 26 CFR 1.5000A– 26, 1996). 3 provide exemptions from the requirement to Amber Rivers or Matthew Litton, maintain MEC for the following individuals: (1) 3 Public Law 110–343, 122 Stat. 3881 (October 3, Department of Labor, (202) 693–8335; Members of recognized religious sects; (2) members 2008). of health care sharing ministries; (3) exempt Dara Alderman, Internal Revenue 4 Public Law 104–204, 110 Stat. 2935 (September Service, Department of the Treasury, noncitizens; (4) incarcerated individuals; (5) 26, 1996). individuals with no affordable coverage; (6) (202) 317–5500; David Mlawsky, 5 Public Law 105–277, 112 Stat. 2681–436 individuals with household income below the Centers for Medicare & Medicaid (October 21, 1998). income tax filing threshold; (7) members of Services, Department of Health and 6 Public Law 110–233, 122 Stat. 881 (May 21, federally recognized Indian tribes; (8) individuals Human Services, (410) 786–1565. 2008). who qualify for a hardship exemption certification; 7 Public Law 111–3, 123 Stat. 64 (February 4, and (9) individuals with a short coverage gap of a Customer Service Information: 2009). continuous period of less than 3 months in which Individuals interested in obtaining 8 Public Law 110–381, 122 Stat. 4081 (October 9, the individual is not covered under MEC. information from the Department of 2008). 12 Public Law 115–97, 131 Stat. 2054. VerDate Sep<11>2014 19:47 Aug 02, 2018 Jkt 244001 PO 00000 Frm 00002 Fmt 4701 Sfmt 4700 E:\FR\FM\03AUR2.SGM 03AUR2 amozie on DSK3GDR082PROD with RULES2 Federal Register / Vol. 83, No. 150 / Friday, August 3, 2018 / Rules and Regulations 38213 $0, effective for months beginning after may be elected by the policyholder October 31, 2016, the Departments December 31, 2018. without the issuer’s consent) that is less finalized the June 2016 proposed rule than 12 months after the original without change in a final rule published D. Short-Term, Limited-Duration effective date of the contract.’’ 15 in the Federal Register entitled Insurance Short-term, limited-duration ‘‘Excepted Benefits; Lifetime and Short-term, limited-duration insurance is generally exempt from the Annual Limits; and Short-Term, insurance is a type of health insurance Federal market requirements applicable Limited-Duration Insurance.’’ 19 coverage that was primarily designed to to health insurance sold in the On June 12, 2017, HHS published a fill temporary gaps in coverage that may individual market because it is not request for information in the Federal occur when an individual is considered individual health insurance Register entitled ‘‘Reducing Regulatory transitioning from one plan or coverage coverage. For example, short-term, Burdens Imposed by the Patient to another plan or coverage. Section limited-duration insurance is not Protection and Affordable Care Act & 2791(b)(5) of the PHS Act provides subject to the requirement to provide Improving Healthcare Choices to ‘‘[t]he term ‘individual health insurance essential health benefits and it is not Empower Patients,’’ 20 which solicited coverage’ means health insurance subject to the prohibitions on public comments about potential coverage offered to individuals in the preexisting condition exclusions or changes to existing regulations and individual market, but does not include lifetime and annual dollar limits. It is guidance that could promote consumer short-term limited duration also not subject to requirements choice, enhance affordability of 13 insurance.’’ However, the PHS Act regarding guaranteed availability and coverage for individual consumers, and does not define short-term, limited- guaranteed renewability. affirm the traditional regulatory duration insurance. In 1997, the To address the issue of short-term, authority of the states in regulating the Department of the Treasury, the limited-duration insurance being sold as business of health insurance, among Department of Labor, and the a type of primary coverage, as well as other goals. Several commenters stated Department of Health and Human concerns regarding possible adverse that changes to the October 2016 final Services (together, the Departments), selection impacts on the risk pools for rule may provide an opportunity to issued regulations implementing the PPACA-compliant plans, the achieve these goals. Consistent with portability and renewability Departments published a proposed rule many comments submitted on
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