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HHS swiftly OKs waivers for 'mini-med' sponsors


WASHINGTON—Government regulators are moving quickly to act on requests by sponsors of “mini-med” health care plans seeking waivers to allow them to temporarily continue offering the arrangements.

The Department of Health and Human Services has already granted to 30 mini-med plan sponsors one-year waivers from a provision in the heath care reform law that first restricts and then bars health care plans from imposing annual dollar limits on coverage of essential services starting in 2014.

In nearly all cases, waiver applications have been approved within two weeks of their receipt. In some cases, HHS has approved waivers within days.

“HHS is committed to strengthening employer-based coverage for employees and retirees, while building a bridge to new competitive marketplaces in 2014,” an HHS spokeswoman said.

The waiver affecting the largest group of enrollees was granted to the United Federation of Teachers Welfare Fund in New York, whose mini-med plan has 351,000 enrollees, according to its filing. Other mini-med plan waivers were approved for CIGNA Healthcare for plans with 265,000 enrollees, Aetna Inc. for plans covering 209,423 enrollees and BCS Insurance Group for plans with 115,000 enrollees—including those provided to Oak Brook, Ill.-based fast-food restaurant chain McDonald's Corp.

The waivers are needed because most, if not all, mini-med plans run afoul of federal rules—mandated by the health care reform law—that set a minimum annual dollar limit on essential benefits that health care plans must provide in 2011, 2012 and 2013. The minimum limit is $750,000 in 2011, $1.25 million in 2012 and $2 million in 2013.

Starting in 2014, the law bars annual limits for essential benefits.

The minimum limits, though, are far more than the maximum benefits provided through mini-med plans, which typically are offered to low-wage, part-time or seasonal employees who, in many cases, could not afford coverage in other group plans offered to full-time employees.

According to a survey by consultant Mercer L.L.C. in New York, the median annual maximum benefit provided by sponsors of mini-med plans with at least 20,000 employees was $10,000 in 2009.

Seven percent of employers with at least 500 employees offer mini-med plans, according to Mercer.

Under the health care reform law, low-wage employees might qualify for government-subsidized coverage that will be available from insurers offering coverage through new state insurance exchanges starting in 2014, reducing the need for mini-med plans.

Until then, mini-med plan providers can obtain waivers from the required minimum annual benefit in situations where meeting those requirements would result in a significant decrease in access to benefits or significantly increase premiums, HHS said last month.

It isn't known how many other waiver requests from mini-med plan providers are pending.

The complete list of waivers is available at regulations/patient/appapps.html.