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
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
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
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
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
For the first time in a decade, the Centers for Medicare and Medicaid (CMS) announced that premiums for Medicare Part B beneficiaries and the Part B deductible will both be lower than the previous year. Each year the Medicare Part B premium, deductible and coinsurance rates are determined according to the Social Security Act. The… Read More
Over the next month, health insurance carriers will distribute approximately $1B in medical loss ratio (MLR) rebates from 2021 to individual and group health insurance consumers. The following provides an overview of a employer plan sponsor’s obligation for handling these MLR rebates. The MLR is the percentage of premium dollars received by a health insurance… Read More
The Internal Revenue Service (IRS) has announced the inflation-adjusted 2023 minimum deductibles, out-of-pocket maximums, and contribution limits for heath savings accounts (HSAs) and qualified high-deductible health plans (HDHPs). Self-only coverage refers to plans for one individual, while family coverage refers to plans for two or more individuals. The out-of-pocket maximum includes copayments, deductibles, and coinsurance… Read More
A federal health insurance coverage price transparency rule takes effect on July 1, 2022, for all health insurance policies renewed between January 1, 2022, and July 1, 2022. For all other plans, the requirement will take effect upon renewal in 2022. The new rule applies to health insurance carriers and employers that offer group coverage… Read More
On January 10, 2022, the US Departments of Labor (US DOL) and Health and Human Services (HHS), and the Treasury issued FAQ guidance regarding the requirements for group health plans and health insurance issuers to cover over-the-counter (OTC) COVID-19 diagnostic tests. As of Jan. 15, 2022, the cost of these tests must be covered, even if they… Read More

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