1. Published On August 25th, 2014
Certain Affordable Care Act Provisions
Will No Longer Apply to U.S. Territories
Patti Goldfarb | Employee Benefits Advisors Group | (201) 255-6239 | pgoldfarb@ebagroup.net
The Department of Health and Human Services (HHS) notified U.S. territories (Puerto Rico, the U.S. Virgin Islands, Guam,
American Samoa and the Northern Mariana Islands) that the following Affordable Care Act provisions will no longer apply
to insured plans sitused in the territories:
• Guaranteed availability
• Medical loss ratio (MLR) rebates
• Community rating*
• Single risk pool*
• Rate review*
• Required coverage of essential health benefits (EHB)*
The change applies prospectively only, effective July 16, 2014.
HHS issued an identical letter to each territory. A link to the Puerto Rico letter can be viewed at:
http://www.cms.gov/CCIIO/Resources/Letters/Downloads/letter-to-Weyne.pdf
This document is designed to highlight various employee benefit matters of general interest to our readers. It is not intended to interpret laws or regulations, or to address specific client situations. You
should not act or rely on any information contained herein without seeking the advice of an attorney or tax professional. ERC082514-P-1