On January 30th, 2023, President Biden announced that both the public health emergency and the national health emergency declarations due to COVID-19 would expire simultaneously on May 11, 2023. Below outlines the impact to private health insurance once the emergencies expire. THE PUBLIC HEALTH EMERGENCY (PHE) The PHE was initially declared by the Department of [...]
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 drug costs 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 2022-60, the IRS announced that for plans that end on or after October 1, 2022 and before October 1, 2023, the PCORI rate per covered individual is $3.00 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 [...]
On December 23, 2022, U.S. Congress approved the Consolidated Appropriations Act, 2023 (CAA 2023). The healthcare provisions in this act extend the temporary telehealth safe harbor for High Deductible Health Plans (HDHP) first-dollar coverage through December 31, 2024. EXTENSION OF THE SAFE HARBOR FOR HDHPS TO COVER TELEHEALTH SERVICES Originally the CARES Act established a [...]
As you are aware, the Consolidated Appropriations Act, via the Transparency in Coverage Rules (TIC), requires health plans to have an online tool to compare prices for 500 designated “shoppable” services by January 1, 2023. The internet-based tool must allow plan enrollees to search for information by certain elements, such as billing codes, descriptive terms, [...]
On December 12th, the IRS issued final regulations around ACA’s Employer Mandate filing of 1095 and 1094 forms. Below are details of the new IRS final regulations and the impact on employers. Final regulations confirm end of good-faith transition relief The final regulations make clear that the current good-faith transition relief is no longer available [...]
On July 25, 2022, the Internal Revenue Service (IRS) issued Revenue Procedure 2022-34 which indexes the contribution percentages for 2023 for purposes of determining affordability of an employer’s plan under the Affordable Care Act (ACA). For plan years beginning in 2023, employer-sponsored coverage will be considered affordable if the employee’s required contribution for self-only coverage does not [...]
On June 24, 2022, the Supreme Court issued its much-anticipated decision in Dobbs v. Jackson Women’s Health Organization, which stated that there is not a constitutionally protected right to terminate a pregnancy. Employers are now faced with the task of determining how this decision will impact their workforce and their benefit offerings. Self-Insured Plans — as a self-insured [...]
In earlier communications from Diversified Group, you were notified of the requirements of the Transparency in Coverage (TiC) Rules that will be enforced beginning on July 1, 2022. The rules require plan sponsors to create two files — one to disclose in-network provider rates for covered items and services and another to disclose out-of-network allowed amounts [...]
In earlier communications from Diversified Group, you were notified of the requirements of the Transparency in Coverage (TiC) Rules that will be enforced beginning on July 1, 2022. The rules require plan sponsors to create two files — one to disclose in-network provider rates for covered items and services and another to disclose out-of-network allowed amounts [...]
