86 FR 66662 — Prescription Drug and Health Care Spending IRCFinal Rules (FR)Nov 23, 2021
means incurred claims, as that term is defined in 45 CFR 158.140, excluding the adjustments specified in 45 CFR 158.140(b)(1)(i), 45 CFR 158.140(b)(2)(iv), and 45 CFR 158.140(b)(4), and including cost sharing but net of prescription drug rebates, fees, and other remuneration. Consistent with the definition in 45 CFR 15…
T.D. 9958 — This document sets forth temporary regulations implementing certain transparency requirements under section 204 of Division BB of Title II of the Consolidated … IRCTreasury DecisionsDec 6, 2021
… final rules, the term “total annual spending” means incurred claims, as that term is defined in 45 CFR 158.140, excluding the adjustments specified in 45 CFR 158.140(b)(1)(i), 45 CFR 158.140(b)(2)(iv), and 45 CFR 158.140(b)(4), and including cost sharing but net of prescription drug rebates, fees, and other remunerati…
88 FR 75744 — Federal Independent Dispute Resolution Operations IRCProposed Rules (FR)Proposed Nov 3, 2023
a reference to providers of air ambulance services in 26 CFR 54.9816-6T(d)(2), 29 CFR 2590.716-6(d)(2), and 45 CFR 149.140(d)(2).
Back to Citation
14. 26 CFR 54.9816-6T(d)(2)(i), 29 CFR 2590.716-6(d)(2)(i), and 45 CFR 149.140(d)(2)(i). Under the July 2021 interim final rules, plans and issuers are required to calculat…
IRCFinal Rules (FR)Nov 12, 2020
…2007.”Available at:
https://fas.org/sgp/crs/secrecy/RL34101.pdf.
Back to Citation
217.
See 45 CFR 158.221(b)(3) for “mini-med” plans and 45 CFR 158.221(b)(4) for “expatriate” plans;
see also
the Health Insurance Issuers Implementing Medical Loss Ratio (MLR) Requirements Under the Patient Protections and Affordabl…
IRCProposed Rules (FR)Proposed Nov 27, 2019
…are Act; Interim Final Rule; 75 FR 74863 at 74872 (December 1, 2010).
Back to Citation
85.
See 45 CFR 158.221(b)(5).
Also see the Student Health Insurance Coverage; Final Rule, 77 FR 16453 at 16458-16459 (March 21, 2012).
Back to Citation
86.
See 45 CFR 158.221(b)(7).
Also see
the Exchange and Insurance Market Stan…
86 FR 708 — Regulatory Capital Treatment for Investments in Certain Unsecured Debt Instruments of Global Systemically Important U.S. Bank Holding Companies, Certain Interm… IRCFinal Rules (FR)Jan 6, 2021
2 (FDIC) (“synthetic exposure”).
Back to Citation
32.
See 12 CFR 3.2 (OCC); 12 CFR 217.2 (Board); 12 CFR 324.2 (FDIC) (“investment in the capital of an unconsolidated financial institution” and “indirect exposure”).
Back to Citation
33.
See 12 CFR 44.4 (OCC); 12 CFR 248.4 (Board); 12 CFR 351.4 (FDIC).
Back to Citat…
PBGCRegulationsJan 1, 2017related by meaning
[Reserved]
PBGCRegulationsJul 1, 2019related by meaning
[Reserved]
86 FR 55980 — Requirements Related to Surprise Billing; Part II IRCFinal Rules (FR)Oct 7, 2021
…the median payment amount for the same or similar service in that geographic area, as defined in 45 CFR 149.140(a)(7), that is reflected in an independent database as defined in 45 CFR 149.140(a)(2) (had expected charges for services C or D been included in the good faith estimate, the median payment amount for the sam…
PBGCRegulationsJan 1, 2017related by meaning
[Reserved]
PBGCRegulationsJan 1, 2017related by meaning
[Reserved]
79 FR 78578 — Summary of Benefits and Coverage and Uniform Glossary IRCProposed Rules (FR)Proposed Dec 30, 2014
…efits
175
19.0
62
3,325
207,247
Legal
175
2.4
130
416
54,006
Sub-Total
8,313
645,245
TPAs
Large:
IT
158
88.8
84
14,034
1,178,745
Benefits
158
64.6
62
10,207
636,190
Legal
158
8.1
130
1,276
165,784
Sub-Total
25,517
1,980,719
Medium:
IT
526
67.8
84
35,656
2,994,766
Benefits
526
49.3
62
25,932
1,616,329
Legal
526
6.2
130
…
ERISARegulationsJan 1, 2017related by meaning
[Reserved]
IRCFinal Rules (FR)Aug 26, 2022
i)(B), 29 CFR 2590.716-8(b)(2)(iii)(B), and 45 CFR 149.510(b)(2)(iii)(B).
Back to Citation
9.
86 FR 55980, 55990 (Oct. 7, 2021).
Back to Citation
10. 26 CFR 54.9816-6T(d)(2)(i), 29 CFR 2590.716-6(d)(2)(i), and 45 CFR 149.140(d)(2)(i). Under the July 2021 interim final rules, plans and issuers are required to calculat…
91 FR 33900 — Federal Independent Dispute Resolution Operations IRCFinal Rules (FR)Jun 4, 2026
involved in an initial payment or notice of denial of payment according to the requirements at 29 CFR 2590.716-6(d)(1)(i) and 45 CFR 149.140(d)(1)(i). Back to Citation
50.
In the case of payments that are not on a fee-for-service basis (such as bundled or capitated payments), plans and issuers are required to calculat…
PBGCRegulationsJan 1, 2017related by meaning
[Reserved]
ERISARegulationsJan 1, 2017related by meaning
[Reserved]
PBGCRegulationsDec 7, 2023related by meaning
[Reserved]
ERISARegulationsJan 1, 2017related by meaning
[Reserved]
84 FR 213 — Department of Labor Federal Civil Penalties Inflation Adjustment Act Annual Adjustments for 2019 ERISAFinal Rules (FR)Jan 23, 2019
epeated
29 CFR 1903.15(d)(2)
$129,336
$132,598.
OSHA
Occupational Safety and Health Act
Posting Requirement
29 CFR 1903.15(d)(6)
$12,934
$13,260.
OSHA Occupational Safety and Health Act
Failure to Abate
29 CFR 1903.15(d)(5)
$12,934
$13,260.
WHD
Family and Medical Leave Act
FMLA
29 CFR 825.300(a)(1)
$169
$173.
WHD
Fair …