Recently, the IRS released Rev. Proc. 2025-19, which outlines the 2026 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. 2026 2025 Change ACA [...]
We have important information regarding Massachusetts payor surcharges and the MA Managed Care Organization Payor Assessment Notice. The Commonwealth of Massachusetts, in accordance with statutory changes that were included in its fiscal year 2025 budget, terminated the Health Safety Net surcharge program for payments to acute hospitals and ambulatory surgical centers on January 1, 2025. [...]
On March 5th, 2025, a blog was published as a legislative alert on Senate Bill 10. Below is an update from Diversified Group as of March 13th, 2025. Diversified Group wanted to provide the latest developments regarding the ongoing discussions in the Connecticut Insurance and Real Estate Committee. The committee has been meeting to vote [...]
Senate Bill 10 is facing a public hearing on Thursday, March 6th from 10am at the state Capitol. This bill will drive up health insurance costs for employers in Connecticut. Anyone with self-funded cases in Connecticut should read the legislative alert from the CBIA below as well as the article that follows. SB 10 is [...]
The Consolidated Appropriations Act (CAA) requires that Group Health Plans report various information about their prescription drug costs and spending. The government calls the data submission of information on prescription drugs and spending the “”RxDC Report”. The government will use the data to provide insight into increased spending on prescription drugs with reporting on rebates, [...]
In Notice 2024-83, the IRS announced that for plans that end on or after October 1, 2024, and before October 1, 2025, the PCOR rate per covered individual is $3.47 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 applicable [...]
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 [...]
HIPAA Special Enrollment Events are a subset of the Section 125 Election Change Events that provide special enrollment rights. But, unlike Section 125, HIPAA’s events are only about enrolling in your group health plan, not dis-enrolling. HIPAA requires group health plans to provide special enrollment opportunities outside the plan's regular enrollment periods in certain [...]
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 [...]
