A plan management best practice is to collect and store employee waivers when an employee chooses not to enroll on the group health plan, even if the insurer or TPA does not require employers to submit them. These waivers serve as documentation of the employer’s offer of coverage and the employee’s decision to decline it. [...]
Before December 31, 2024, self-insured plan sponsors are required to file a gag clause attestation with CMS using the HIOS system. For self-insured clients, uploading the attestation is a plan sponsor responsibility under the Consolidated Appropriations Act. However, Diversified Group will submit the attestations to CMS on behalf of our clients in time to meet the [...]
Recently, the IRS released Rev. Proc. 2024-25, which outlines the 2025 inflation-adjusted amounts for Health Savings Accounts and compatible High Deductible Health Plans. Adjusted amounts include HDHP calendar year minimum deductibles, out-of-pocket maximums, and the annual HSA contribution limits. Additionally, the annual adjustment for the ACA out of pocket limit was also released. 2025 2024 Change [...]
In Notice 2023-70, the IRS announced that for plans that end on or after October 1, 2023, and before October 1, 2024, the PCOR rate per covered individual is $3.22 per plan participant. The PCOR fee is calculated based on the average number of lives covered under the policy or plan. As a reminder, the IRS announced [...]
Trinity Health Care of New England and Cigna have finally reached a multiple year agreement that will reestablish Trinity Health Care of New England providers into the Cigna network retroactive to January 1, 2024. The agreement applies to St. Francis Hospital, Mount Sinai Rehabilitation Hospital and Trinity Health of New England Medical Group providers in [...]
Civil penalties were recently updated, adjusting for inflation, by the Department of Labor (DOL) for 2024. Federal law requires penalties be adjusted annually by January 15th. Employers found in violation will be assessed these increased penalties beginning after January 15, 2024. The year-over-year inflation increase for 2024 is 3.241%. Annual inflation adjustments are based on [...]
Employers have so many different options available to them to utilize when sending their enrollment data to Diversified Group (i.e. payroll, HRIS systems, etc.). To make sure we are doing the best job for you, Diversified is making changes to our policies and procedures surrounding eligibility documentation to ensure that we are meeting your [...]
The Consolidated Appropriations Act requires self-insured plan sponsors to file a gag clause attestation with CMS using the HIOS system no later than December 31st, 2023. A gag clause is any contractual term that prohibit health plan sponsors and plan issuers from having any agreements with a healthcare provider, a network, an association of providers, [...]
Before December 31, 2023, self-insured plan sponsors are required to file a gag clause attestation with CMS using the HIOS system. For self-insured clients, uploading the attestation is a plan sponsor responsibility under the Consolidated Appropriations Act. However, Diversified Group will submit the attestations to CMS on behalf of our clients in time to meet the [...]
Medicare Part D requires group health plan sponsors to disclose to individuals who are eligible for Medicare Part D and to the Centers for Medicare and Medicaid Services (CMS) whether the health plan’s prescription drug coverage is creditable. Plan sponsors must provide the annual disclosure notice to Medicare eligible individuals before Oct. 15, 2023 — [...]
