IRS Offers Guidance on Market Reform Provisions of Affordable Care Act

The Internal Revenue Service is providing guidance on the application of the market reform provisions of the Affordable Care Act to health care arrangements such as health reimbursement arrangements, employer payment plans and flexible spending accounts.

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Notice 2013-54 provides guidance on applying the market reform provisions, along with other provisions, of the health care reform law to HRAs, FSAs and other employer payment plans for health insurance coverage. 

The notice also provides guidance on Section 125(f)(3) of the Tax Code, as well as employee assistance programs. 

The guidance in the notice is being issued in substantially the same form by the Labor Department, as well as the Department of Health and Human Services to reflect that HHS concurs with the guidance in the IRS notice.   

The Affordable Care Act contains a number of market reforms that apply to group health insurance plans.  Some of the market reforms addressed in the notice include the provision that a health insurance plan may not establish any annual limit on the dollar amount of benefits for any individual and the provision requiring group health plans to provide certain preventive services without imposing any cost-sharing requirements on patients.

The guidance includes answers to questions such as “How do the preventive services requirements apply to an HRA that is integrated with a group health plan?” and “Under what circumstances will an HRA be integrated with another group health plan for purposes of the annual dollar limit prohibition and the preventive services requirements?”

Notice 2013-54 will be published in Internal Revenue Bulletin 2013-40 on Sept. 30, 2013.


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