Vol. 46, No. 3
In addition to promulgating new regulations, the Department of Labor (DOL) finalized the following interim rules, which are now in effect:
Newborns’ and Mothers’ Health Protection Act of 1996
The NMHPA requires group health plans that provide maternity or newborn coverage to offer mothers and newborns minimum hospital stays in connection with childbirth. The law also mandates that plans include a statement describing these requirements.
Under the final regulations, plans that are exempt from the requirements of the federal NMHPA must disclose any applicable state law requirements to which they are subject. The DOL provides a model statement that may be used to satisfy the NMHPA notice requirement, but this model may not necessarily satisfy the requirements of individual state laws.
Group Health Plan Material Reductions
Group health plans are now required to provide a summary of "material reductions" in covered services or benefits no later than 60 days after the modification or change has been adopted. Under the final regulations, only plan participants—not beneficiaries—are entitled to the summary.
A group health plan that is financed or administered by an insurer must disclose the name and address of the insurer, whether and to what extent benefits under the plan are guaranteed under a contract issued by the insurer and the nature of any administrative services.