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Biden Administration Finalizes Two Major Regulations Affecting Medicare and Private Coverage in 2025

Last week, the Departments of Health and Human Services (HHS) released the final versions of the 2025 Notice of Benefits and Payment Parameters, and the Centers for Medicare and Medicaid Services (CMS) issued the 2025 Rate Announcement for the Medicare Advantage and Medicare Part D Prescription Drug Programs. These two measures will govern how private health insurance… Read More

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Basic Nondiscrimination Rules for Health & Cafeteria Plans

Most employee benefit plans that provide tax-advantaged benefits include nondiscrimination rules to discourage employers from providing more generous benefits to highly compensated and/or key employees. The Internal Revenue Code (IRC) sets out nondiscrimination requirements for cafeteria plans, medical plans (including health FSAs and HRAs), dependent care FSAs, and other benefit programs. Satisfaction of these tests… Read More

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Change Healthcare Cyberattack: Summary

In late February 2024, Change Healthcare, a major healthcare clearinghouse, experienced a cyberattack. A clearinghouse processes healthcare claims electronically, routing them between providers, insurers, and other entities involved in the billing process. This attack disrupted operations for Change Healthcare, causing significant downstream effects across the healthcare system. On March 5, 2024, HHS released a statement outlining their… Read More

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HSA, FSA & HRA Updates for 2024

​Annual health savings account (HSA) contribution limits for 2024 are increasing in one of the biggest jumps in recent years: The annual limit on contributions for self-only coverage will be $4,150 (a 7.8% increase from the $3,850 limit in 2023) and for family coverage, the contribution limit will jump to $8,300 (up 7.1% from $7,750)…. Read More

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“Affordability” Changes for 2024

Each year, the Internal Revenue Service (IRS) adjusts the percentage that is used to determine affordability under the Affordable Care Act (ACA). The IRS has just announced that for plan years starting on or after January 1, 2024, the affordability rate will be set at 8.39%. This represents a significant reduction from the current rate of 9.12%. Employers subject… Read More

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Gag Clause Prohibitions under the CAA

New compliance obligations that the Consolidated Appropriations Act of 2021 (CAA, 21) created for employer-sponsored plans can seem endless at times. One of the lesser-known parts of the CAA, 21 is the prohibition on “gag clauses” within provider agreements that restrict access to price and quality information. Under the CAA, 21, these gag clauses have… Read More

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NJ Temporary Workers Bill of Rights

New Jersey has passed a bill of rights for the state’s temporary workers requiring staffing agencies and their customers to provide several notifications to temporary workers. Under the law, a temporary worker is anyone who contracts employment with a temporary help service firm. It excludes agricultural crew leaders, secretaries, or administrative assistants. Still, it does… Read More

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UPDATED DEADLINE FOR THE END OF THE COVID-19 NATIONAL EMERGENCY

On April 10, 2023, President Biden signed a resolution ending the COVID-19 national emergency that had been in place since 2020. The Biden administration had previously announced a May 11, 2023 end date to both the national emergency and the public health emergency (PHE), but the signing of the bipartisan legislation terminates the national emergency as of April 10, 2023…. Read More

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End of Year Compliance Reminders!

Below is an overview of several items and deadlines plan sponsors should be mindful of as the year comes to a close: The Affordable Care Act’s Employer Mandate Premium Tax Credits and Cafeteria Plan Changes The Consolidated Appropriations Act (CAA) & COVID-19 Relief

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RxDC Reporting Deadline Extended + Other Limited Reporting Relief

On December 23, 2022, the Biden Administration issued Affordable Care Act FAQ #56, giving a little holiday gift to group health plans and issuers nationwide. The guidance establishes limited deadline and enforcement relief for the 2020 and 2021 Prescription Drug Data Collection (RxDC) submissions that were due by December 27, 2022, announcing a compliance safe harbor… Read More