Massachusetts Payor Surcharges

2025-03-26T15:06:06+00:00

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. [...]

Massachusetts Payor Surcharges2025-03-26T15:06:06+00:00

Importance of Signed Employee Waiver Forms

2024-11-20T20:39:49+00:00

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. [...]

Importance of Signed Employee Waiver Forms2024-11-20T20:39:49+00:00

PCOR Fees Increasing in 2024

2024-05-01T15:17:41+00:00

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 [...]

PCOR Fees Increasing in 20242024-05-01T15:17:41+00:00

Supreme Court Overturns Roe vs Wade

2022-07-20T21:16:03+00:00

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 [...]

Supreme Court Overturns Roe vs Wade2022-07-20T21:16:03+00:00

Machine-Readable Files Link REMINDER

2022-07-18T18:13:02+00:00

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 [...]

Machine-Readable Files Link REMINDER2022-07-18T18:13:02+00:00

Update on Machine-Readable File Hosting/Public URL Link

2022-06-09T15:17:31+00:00

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 [...]

Update on Machine-Readable File Hosting/Public URL Link2022-06-09T15:17:31+00:00

PCOR Fees Due July 31, 2022

2022-05-09T17:32:08+00:00

PCOR fees are reported and paid annually using IRS Form 720 (Quarterly Federal Excise Tax Return). These fees are due each year by July 31 of the year following the last day of the plan year. This means that for plan years ending in 2021, the PCOR fees are due by July 31, 2022. For self-funded [...]

PCOR Fees Due July 31, 20222022-05-09T17:32:08+00:00

Machine-Readable File Hosting/Public URL Link

2022-05-06T13:41:43+00:00

IMPORTANT INFORMATION below regarding your obligation to provide a Machine-Readable File by July 1, 2022. Please read and respond accordingly. To meet the requirements of the Transparency in Coverage (TiC) Rules that will be enforced starting on July 1, 2022, plan sponsors must create two files — one to disclose in-network provider rates for covered items [...]

Machine-Readable File Hosting/Public URL Link2022-05-06T13:41:43+00:00

PCOR Fee Increases for Health Plans

2022-05-02T19:23:25+00:00

The IRS announced in Notice 2020-84 that the adjusted applicable amount for the Patient-Centered Outcomes Research Institute (PCOR) fee for policy or plan years ending on or after October 1, 2020 and before October 1, 2021 will be $2.66 per plan participant. In Notice 2021-04, the IRS published that the applicable amount for PCOR fees [...]

PCOR Fee Increases for Health Plans2022-05-02T19:23:25+00:00

2022 Important Compliance Dates

2021-10-25T17:18:58+00:00

This checklist is designed to help companies review the key reporting and notice requirements that may apply to their employer-sponsored group health plans under ERISA (the Employee Retirement Income Security Act). Please note that this list is for general reference purposes only and is not all-inclusive. Click to download entire checklist.

2022 Important Compliance Dates2021-10-25T17:18:58+00:00
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