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Nearly 1,400 Mini-Med Plans Get Health Care Reform Waivers

May 18, 2011
Related Topics: Finance/Taxes, Benefit Design and Communication, Health and Wellness, Latest News

The Department of Health and Human Services has approved 1,372 one-year waivers—mainly for “mini-med” plan sponsors—from having to meet a health care reform law requirement eliminating annual limits on essential benefits.

The waivers approved to date affect 3.1 million enrollees, HHS officials said May 13.

Waiver approvals peaked in December 2010 when just more than 500 requests were cleared. Just under 200 were approved in January, 125 in February, 129 in March and 221 in April.

Well-known employers whose applications for waivers were approved in April include Dillard’s Inc., the Little Rock, Arkansas-based department store chain, whose plan has 1,676 enrollees; and McCormick & Schmick’s Seafood Restaurants Inc., a Portland, Oregon-based restaurant chain, whose plan has 966 enrollees.

The waiver affecting the largest group of enrollees was granted last September to the United Federation of Teachers Welfare Fund in New York, whose mini-med plan has 351,000 enrollees, according to its filing.

The waivers are needed because most, if not all, mini-med plans run afoul of federal rules that set a minimum annual dollar amount on essential benefits that health care plans must provide in 2011, 2012 and 2013 under the health care reform law. The minimum is $750,000 in 2011, $1.25 million in 2012 and $2 million in 2013.

Starting in 2014, the law bars annual limits for essential benefits.

However, the minimum amounts for essential benefits are greater than the maximum benefits provided through mini-med plans, which typically are offered to low-wage, part-time or seasonal employees.

Under the law, low-wage employees might qualify for government-subsidized coverage that will be available from insurers through new state insurance exchanges starting in 2014, reducing the need for mini-med plans.

Until then, mini-med plan providers can obtain waivers in situations where meeting the minimum annual benefit requirements would result in a significant decrease in access to benefits or a significant increase in premiums, HHS said.   

Filed by Jerry Geisel of Business Insurance, a sister publication of Workforce Management. To comment, email


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