['Employee Benefits']
['Health Plans']
10/01/2024
Copyright 2024 J. J. Keller & Associate, Inc. For re-use options please contact copyright@jjkeller.com or call 800-558-5011.
...
(a) Compliance with Federal and State law. An MSP issuer must comply with Federal and State laws relating to benefit plan material or information, including the provisions of this section and guidance issued by OPM specifying its standards, process, and timeline for approval of benefit plan material or information.
(b) General standards for MSP applications and notices. An MSP issuer must provide all applications and notices to enrollees in accordance with the standards described in 45 CFR 155.205(c). OPM may establish additional standards to meet the needs of MSP enrollees.
(1) Accuracy. An MSP issuer is responsible for the accuracy of its benefit plan material or information.
(2) Truthful, not misleading, no material omissions, and plain language. All benefit plan material or information must be:
(i) Truthful, not misleading, and without material omissions; and
(ii) Written in plain language, as defined in section 1311(e)(3)(B) of the Affordable Care Act.
(3) Uniform explanation of coverage documents and standardized definitions. An MSP issuer must comply with the provisions of section 2715 of the PHS Act and regulations issued to implement that section.
(4) OPM review and approval of benefit plan material or information. OPM may request an MSP issuer to submit to OPM benefit plan material or information, as defined in §800.20. OPM reserves the right to review and approve benefit plan material or information to ensure that an MSP issuer complies with Federal and State laws, and the standards prescribed by OPM with respect to benefit plan material or information.
(5) Statement on certification by OPM. An MSP issuer may include a statement in its benefit plan material or information that:
(i) OPM has certified the MSP option as eligible to be offered on the Exchange; and
(ii) OPM monitors the MSP option for compliance with all applicable law.
[78 FR 15591, March 11, 2013; 78 FR 25591, May 2, 2013; 80 FR 9659, Feb. 24, 2015]
READ MORESHOW LESS
['Employee Benefits']
['Health Plans']
Load More
J. J. Keller is the trusted source for DOT / Transportation, OSHA / Workplace Safety, Human Resources, Construction Safety and Hazmat / Hazardous Materials regulation compliance products and services. J. J. Keller helps you increase safety awareness, reduce risk, follow best practices, improve safety training, and stay current with changing regulations.
Copyright 2024 J. J. Keller & Associate, Inc. For re-use options please contact copyright@jjkeller.com or call 800-558-5011.