Agencies Issue Proposed Regulations for Expat Health Coverage

The IRS, DOL and HHS have issued proposed regulations under the Expatriate Health Coverage Clarification Act of 2014 (EHCCA) spelling out how the Affordable Care Act market reform, coverage and reporting requirements apply to expatriate health plans, expatriates and foreign nationals working in the United States.


Defining Key Terms


1. Workers in the U.S.

Individuals whose skills and expertise caused an employer to temporarily transfer or assign them to the U.S., who are reasonably determined to require access to health insurance in multiple countries, and to whom the employer periodically offers “other multinational benefits” (such as tax equalization).

2. Workers outside the U.S.

Individuals working outside the U.S. at least 180 days in a consecutive 12 month period that overlaps with the plan year

3. Charitable Workers

Members of groups formed for traveling or relocating internationally to do certain nonprofit work (and not formed primarily for the sale of health insurance), if determined by HHS to require access to health insurance in multiple countries.


Expatriate Health Plan:

A health plan where “substantially all” (i.e., at least 95%) of the primary enrollees are qualified expatriates and substantially all of the benefits provided are not “excepted benefits.”


Excepted Benefits:

These are limited scope benefit plans that are exempt from certain requirements under HIPAA’s portability provisions, health reform and other federal laws. Most dental, vision, EAP, AD&D and wrap-around supplemental coverage can be classified as excepted benefits.


For additional information regarding the proposed regulations and comment period, click here:

Expatriate Health Plans, Expatriate Health Plan Issuers, and Qualified Expatriates; Excepted Benefits; Lifetime and Annual Limits; and Short-Term, Limited-Duration Insurance


Click here to download this Expert Update to see a chart summarizing the key elements of the proposed regulations.

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