US Issues: How will EAPs be regulated at the federal level?

In early 2014 three US regulatory agencies, the IRS, EBSA, and HHS, announced plans to more fully write a definition of “excepted benefits” under the Affordable Care Act (ACA), a definition that could help or harm EAPs. EAPs could even be excluded from the list of excepted benefits.

EASNA submitted written comments on this issue, explaining our views on the issue. We said that EAP services are correctly classified as an excepted benefit as outlined in the Department of Labor’s Technical Release No. 2013-03. We said we believe that EAPs offer a worker service, not a health benefit, that promotes a productive workforce. To encourage healthier employees, many employers offer EAPs to assist in developing healthier behaviors.

If EAP programs were not recognized as excepted benefits, medical care benefits provided through an EAP (such as mental health treatment) would generally be subject to the requirements of the ACA governing health insurance (such as the ban on annual limits) and could render a covered employee ineligible to receive premium tax credits through the exchange for individual coverage.

On October 1, 2014, after considering statements submitted by dozens of individuals and organizations, these three federal agencies issues a final rule. The regulations, which appeared in the Federal Register October 1, will take effect 60 days later, and apply to group plans and group plan insurance issuers for plan years beginning on or after January 1, 2015. The package, Amendments to Excepted Benefits, affects one category of benefits that are free from most of the requirements that apply to major medical coverage: “limited excepted benefits.” The category includes dental benefits, vision benefits, long-term care (LTC) benefits and some other types of benefits, such as employee assistance plans (EAPs).

Look for additional information on this issue later this year. Would you like to become part of the Advocacy Committee working on this issue? Call EASNA Executive Director Pamela Valenzuela, CAE, at 703-370-7435.