HHS blocks health plans lacking hospital coverage

Large employers offering health plans to workers that do not include substantial coverage of hospital and physician services will face fines of $3,000 or more per worker, according to recently released regulations from HHS.

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The Patient Protection and Affordable Care Act fails to specify essential health benefits, such as hospitalization, for large-employer plans, which led to some employers offering “sub-par insurance” to their workers, according to NPR.

The workers who were offered the plans without hospital benefits were left with few options for obtaining better health coverage, as they were deemed ineligible for tax credits to purchase more comprehensive coverage, according to the report.

Under the HHS regulations, employer plans that do not offer hospital benefits will not qualify as “minimum value” coverage and those employers will be subject to fines.

Supporting the move, HHS said a plan without hospital benefits “is not a health plan in any meaningful sense.”

If an employer signed contracts to offer plans lacking hospital coverage on or before Nov. 4, 2014, they will still be allowed to offer those plans this year, according to NPR. However, workers offered such coverage will have more options, as they will be permitted to receive tax credits to purchase more comprehensive insurance through the online marketplaces.

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