By this time, all health plan administrators should be aware of the required annual notices like the Women's Health and Cancer Rights Act notice and the Medicare Part D notice.  Plus we have updated our COBRA notices to comply with the COBRA subsidy requirements of the ARRA.  So now let's take stock of what changes are in store for 2010.

1. Mental Health Parity Act.  For plan years after 10/3/09, a group health plan that provides mental health and substance abuse benefits cannot have special caps for benefits related to treatment for these disorders.  Co-pays, deductibles, limits and out-of-pocket expenses cannot be more restrictive for these treatments than for medical or surgical benefits under the plan.

2. COBRA Subsidies under the ARRA.  Remember that the COBRA subsidy is currently set to end as of December 31, 2009, meaning that for qualifying events occurring after 1/1/2010, COBRA notice and election forms will NOT contain information about eligibility for the subsidy.  So plan administrators should be prepared to go back to standard COBRA notices (unless the subsidy is extended).

3. Children's Health Insurance Program Re-authorization (CHIP).  As of April 1, 2009, all plan must provide for the special 60 day enrollment period for employees and dependents who become eligible or cease being eligible for premiums assistance under Medicaid or state children's health insurance programs.  Plans have to be updated to include this special enrollment period.  There is also an annual notice requirement beginning 1/1/2010.

4. Michelle's Law.  For plan years after 10/9/09, a group health plan cannot terminate coverage for a dependent college student because of a loss of full-time student status where the loss of status is due to a medically necessary leave of absence.  Information about Michelle's Law must be provided with any notice explaining eligibility for coverage as a dependent student.

5.  Genetic Information Non-Discrimination Act.  For plan years after 5/21/09, the plan must provide that genetic information cannot be requested, required or purchased for underwriting purposes and will not be used for enrollment.  Also, participants cannot be required to undergo a genetic test and genetic information cannot be used to set contribution rates or premiums. 

But wait, there is more.

6. The HITECH Act.  As of 9/18/09, the HITECH Act requires plans to provides notices to participants of any unauthorized disclosures of unsecured protected health information.  As of 2/17/2010, business associates are responsible for their own compliance with HIPAA medical privacy, participants cannot receive marketing communications without prior consent and plans are required to provide PHI to participants in electronic format if the information maintained by the plan is kept in an electronic format.

7. The HEART Act.  Under the Heroes Earnings Assistance and relief Tax Act of 2008, a cafeteria plan or FSA may now permit a reservist called to active duty (for at least 180 days or indefinite call-up) to receive a distribution of the balance of the reservist's account.  Plan amendments are permitted through 12/31/09 and can be retroactive to reservists called up to duty on or after 6/18/08.  Plans expecting to provide this exemption in the 2010 plan year must be amended before the 12/31/09 deadline.

So technically these are not 2010 amendments but they are things to look at for the upcoming plan year to make sure the plan has appropriate amendments and notices.  If you have any questions about applicability to your plan, contact your service provider or counsel and they will walk you through the compliance process.