What Are Excepted Benefits?

“Excepted benefits” are health benefits that are limited in some way, such as stand-alone dental, long-term care, hospital indemnity, and Medicare supplement policies. Excepted benefits do not need to meet all of the PPACA requirements and they are not considered “minimum essential” benefits.  The agencies have proposed three changes to the excepted benefits rules:

  • The requirement that a stand-alone, self-funded dental or vision plan have a separate premium to qualify as an excepted benefit will no longer apply
  • Employee assistance programs (EAPs) will be considered excepted benefits if they do not offer significant medical benefits, they are separate from the group medical plan, and they are free to the employee
  • A new “limited wraparound” plan would be considered an excepted benefit for employers that provide affordable, minimum value coverage to most of their employees and want to provide coverage that wraps around marketplace coverage for employees who enroll in marketplace coverage because employer-provided coverage is unaffordable

For additional information, request our White Paper on Excepted Benefits here.

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