Internal Revenue Bulletin: 2010-43 |
October 25, 2010 |
Table of Contents
- T.D. 9495
- T.D. 9496
- T.D. 9494
- AGENCIES:
- ACTION:
- SUMMARY:
- DATES:
- ADDRESSES:
- FOR FURTHER INFORMATION CONTACT:
- SUPPLEMENTARY INFORMATION:
- I. Background
- II. Overview of the Regulations: PHS Act Section 2719, Internal Claims and Appeals and External Review Processes (26 CFR 54.9815-2719T, 29 CFR 2590.715-27109, 45 CFR 147.136)
- a. Scope and definitions
- b. Internal claims and appeals process
- 1. Group health plans and health insurance issuers offering group health insurance coverage
- 2. Health insurance issuers offering individual health insurance coverage
- c. State standards for external review
- d. Federal external review process
- e. Culturally and linguistically appropriate
- f. Secretarial authority
- g. Applicability date
- III. Interim Final Regulations and Request for Comments
- IV. Economic Impact and Paperwork Burden
- A. Summary—Department of Labor and Department of Health and Human Services
- B. Executive Order 12866—Department of Labor and Department of Health and Human Services
- 1. Need for Regulatory Action
- 2. PHS Act Section 2719 — Claims and Appeals Process (26 CFR 54.9815-2719T, 29 CFR 2590.715-2719, 45 CFR 147.136)
- a. Summary
- b. Estimated Number of Affected Entities
- c. Benefits
- d. Costs and Transfers
- i. Internal Claims and Appeals
- iv. Additional requirements for issuers in the individual insurance market
- v. External appeals
- 3. Summary
- C. Regulatory Flexibility Act—Department of Labor and Department of Health and Human Services
- D. Special Analyses-Department of the Treasury
- E. Paperwork Reduction Act
- 1. Department of Labor and Department of the Treasury
- a. Department of Labor and Department of the Treasury: Affordable Care Act Internal Claims and Appeals and External Review Disclosures for Non-Grandfathered Plans
- 2. Department of Health and Human Services
- a. ICR Regarding Affordable Care Act Internal Claims and Appeals and External Review Disclosures for Non-grandfathered Plans
- b. ICR Regarding Affordable Care Act Recordkeeping Requirement for Non-grandfathered Plans
- F. Congressional Review Act
- G. Unfunded Mandates Reform Act
- H. Federalism Statement—Department of Labor and Department of Health and Human Services
- V. Statutory Authority
- DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Chapter 1
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