Final Rule to be Published Designating Self-Funded Student Health Coverage as Minimum Essential Coverage on Temporary Basis


On February 1, 2013, the Centers for Medicare & Medicaid Services (CMS) posted a Notice of Proposed Rule Making [pdf] (CMS-9958-P) that, among other provisions, would designate self-funded student health coverage as minimum essential coverage under the Affordable Care Act (ACA). Within the notice, CMS requested comments on this action. On March 15, 2013, on behalf of the association’s membership, ACHA submitted comments acknowledging the proposed inclusive action by the Department of Health and Human Services (HHS), and pledging continued commitment and vigilance in promoting high-quality coverage for the nation’s college students.

However, reacting to the many comments filed in response to the proposed regulation, HHS has concluded that self-funded student health plans should not be permanently designated as minimum essential coverage. In the soon to be published final regulation, HHS indicates that such plans will be treated as minimum essential coverage for a one-year transitional period with the option to renew that status:

"In this final rule we designate self-funded student health coverage as minimum essential coverage for plan or policy years beginning on or before December 31, 2014. For coverage beginning after December 31, 2014, sponsors of self-funded student health plans may apply to be recognized as minimum essential coverage through the process outlined in § 156.604 of the final rule." (See text on pages 80-81 of the soon to be published regulation [pdf]).

Additionally, HHS indicates that "…In addition, the Department of the Treasury intends to publish guidance under section 36B of the Code about whether individuals who are eligible to enroll in self-funded student health plans will be treated as eligible for qualified health plan coverage subsidized by the premium tax credit."

ACHA will be assessing these new developments and will continue to keep you apprised as regulations implementing the ACA are released.