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Regulations: Group health plans, health insurance coverage

Final rules for group health plans, health insurance

The Treasury Department and IRS (jointly with the Department of Labor and the Department of Health and Human Services) this afternoon released for publication in the Federal Register final rules under the Affordable Care Act. The final regulations concern:


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  • Grandfathered health plans
  • Preexisting condition exclusions
  • Lifetime and annual dollar limits on benefits
  • Rescissions
  • Coverage of dependent children to age 26 years
  • Internal claims and appeal and external review processes
  • Patient protections

The regulations, in the form released to the Federal Register, were 379 pages, but 104 pages when actually published in the Federal Register. Read text of the regulations [PDF 867 KB]

The regulations are scheduled to be published in the Federal Register on Wednesday, November 18, 2015.  

The preamble states that these final regulations will apply to group health plans and health insurance issues beginning on the first day of the first plan year (or if in the individual market, the first day of the first policy year) beginning on or after January 1, 2017. 

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