ERIC Submits Letter on Out of Pocket Limits to the Energy and Commerce Committee

The Honorable Fred Upton
Committee on Energy and Commerce
United States House of Representatives

The Honorable Frank Pallone, Jr.
Ranking Member
Committee on Energy and Commerce
United States House of Representatives

Dear Chairman Upton and Ranking Member Pallone:

On behalf of the members of the ERISA Industry Committee (ERIC), I write to ask for your support on a matter of significant and immediate importance to large employers.

ERIC is the only national trade association advocating solely for the employee benefit and compensation interests of the country’s largest employers, and we support the ability of our members to tailor health, retirement, and compensation benefits for millions of employees, retirees, and their families.

Recently the three government agencies that issue regulations under the Affordable Care Act (ACA), the Departments of HHS, Labor, and Treasury, crafted a rule with no basis in the law and made this policy change effective almost immediately, i.e., as of January 1, 2016.

This new policy proposal basically forces large employers to add an individual cost-sharing limit to family coverage, even though there is no provision in the ACA requiring this treatment, and some of our members will be forced to spend millions of dollars to make this change.

In addition to the lack of statutory justification, we take issue with this policy change for two reasons. First, it is not possible for employers to make a change of this magnitude in time for the start of the 2016 plan year.

Second, the Administrative Procedure Act prescribes how government agencies are to promulgate new rules. In general, the responsible agency must propose a regulation, accept comments during a set period of one or two months, and then finalize the regulation after weighing the comments from stakeholders.

No part of this process was followed when the Departments issued this policy change. Instead, the change was buried in the preamble to a lengthy set of rules on the ACA Exchanges, and its applicability to large employers was not clarified for several months.

Our attached letter asks for the immediate withdrawal of this rule, laying out the unjustified actions by the Departments in considerable detail.

We would appreciate the opportunity to meet with you and/or your staff to support efforts to nullify this governmental overreach. My colleague, Gretchen Young (202/627-1920), or I would be happy to discuss this in more detail.


Annette Guarisco Fildes
President & CEO
The ERISA Industry Committee

Members of the Senate Finance Committee
Members of the Senate Committee on Health, Education, Labor, and Pensions Members of the House Ways and Means Committee
Members of the House Committee on Education and theWorkforce