Compliance & legal
ACA essential health benefits
Ten categories of benefits that ACA-compliant plans must cover: ambulatory services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, prescription drugs, rehabilitative and habilitative services, lab services, preventive and wellness and chronic disease management, and pediatric services (including dental and vision).Last reviewed: · TMRW Benefits is a benefits brokerage, not a tax or legal advisor. Consult a CPA or attorney for situation-specific guidance.
More in Compliance & legal
ERISA (Employee Retirement Income Security Act of 1974)
Federal law governing most private-sector benefit plans.
COBRA (Consolidated Omnibus Budget Reconciliation Act)
Continue group coverage up to 18-36 months after losing eligibility.
ACA (Affordable Care Act)
2010 federal law restructuring U.S. health insurance markets.
HIPAA (Health Insurance Portability and Accountability Act of 1996)
Federal law protecting health information privacy.
Section 125 (Cafeteria plan)
IRS code allowing pre-tax benefits payments.
Premium-only plan (POP)
Simplest Section 125 plan. Pre-tax premiums only.
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