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HHS continues to rapidly approve mini-med plan waivers


WASHINGTON—Government regulators continue to act quickly on requests by sponsors of “mini-med” health care plans seeking waivers to allow them to temporarily continue to offer the arrangements with the number of approved applications tripling during the last month.

As of Nov. 1, the most recent date for which public information is available, the Department of Health and Human Services had approved requests from 117 mini-med plan sponsors with a total of 1,175,471 plan enrollees for one-year waivers. That’s up from 30 waivers that had been approved as of Sept. 30 for plans having a total of 968,765 enrollees.

Several restaurant chains are among the latest mini-med plan sponsors to receive waivers. They include Ruby Tuesday Inc. of Maryville, Tenn.; Orlando, Fla.-based Darden Restaurants, which operates such brands as Olive Garden and Red Lobster restaurants; and two Mexican-style restaurant chains, Uncle Julio’s Corp., of Irving, Texas, and Macayo Restaurants L.L.C. of Phoenix.

HHS previously approved a waiver request for 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 waiver affecting the largest group of enrollees was granted in September to the United Federation of Teachers Welfare Fund in New York, whose mini-med plan has 351,000 enrollees, according to its filing.

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.

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.

Sponsors are required to notify mini-med enrollees that they have received the waivers.

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