Impact of health care reform law on expat health care plans remains unclear
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It remains to be seen how U.S.-based expatriate health care plans will be affected by the Patient Protection and Affordable Care Act.
Beginning in 2014, self-insured expatriate group health plans governed by the Employee Retirement Income Security Act will be required to meet the same coverage mandates under the health care reform law that apply to domestic group health plans, including cost-free preventative health services, guaranteed coverage renewal, additional nondiscrimination rules and the elimination of excessive waiting periods.
However, certain types of expatriate health plans have been temporarily exempted from the reform law's employer mandates for plan years ending on or before Dec. 31, 2015. The temporary exemptions only are available to fully insured health plans covering employees working abroad for at least six months, as well as covered dependents.
In a statement issued in March, the federal Treasury, Labor and Health and Human Services departments said the temporary exemptions had been granted in recognition of the “special challenges” firms face to have expatriate health plans comply with provisions of the health care reform law, including reconciling the new regulations' compatibility with foreign health and benefit laws.
“It may be difficult for certain preventive services to be provided, or even be identified as preventive, when such services are provided outside the United States by clinical providers that use different code sets and medical terminology to identify services,” the departments said in the statement. “Further, expatriate issuers may face challenges and delays in communicating with enrollees living abroad and, due to the complex nature of these plans, standardized benefits disclosures can be difficult for issuers to produce.”
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