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 [...]
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 [...]
Per the No Surprises Act (NSA), a component of the Consolidated Appropriations Act passed in December of 2020, beginning with renewals on or after January 1, 2022, health plans and health issuers offering group and individual health insurance coverage must issue a plain language notice regarding employee’s rights under the No Surprises Act. The notice [...]
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.
The No Surprises Act which passed under the Consolidated Appropriations Act (“The Act”) includes many provisions that apply to group health plans which go into effect for plan years beginning on or after January 1, 2022. One such provision requires updated medical ID cards, however, guidance is not anticipated until sometime in 2022. In the [...]
The CARES Act created a temporary safe harbor that allows (but did not require) a HDHP health plan with a health savings account (HSA) to cover telehealth and remote care services prior to the member reaching their plan’s deductible. The CARES Act provision extended the safe harbor for plan years beginning on or before December 31, 2021. Members [...]
In May 2021, the Department of Health and Human Services reversed a Trump administration position on the ACA’s section 1557. Background Under section 1557, health plans are prohibited from discriminating on the basis of race, color, sex, national origin, age and disability. Under the ACA, the definition of sex was clarified to include discrimination on [...]
The Consolidated Appropriations Act of 2021 (CAA) that was passed on December 27, 2020 is known primarily for its third round of direct payment stimulus checks. However, there were additional health benefit related provisions including: (1) expanded relief for health and dependent care flexible spending arrangements; (2) new reporting requirements for commission and similar compensation; [...]
In an effort to revive an important promise made to the American people prior to his election in 2016, President Trump recently signed 3 executive orders aimed at bringing the cost of prescription drugs more in line with what consumers in other countries pay. One order, directed at Medicare Part D plans, would require that [...]
Inflation-adjusted limits for contributions to health savings accounts and high deductible health plans for the coming year were just announced. According to the announcement, eligible individuals with self-only HDHP coverage will be able to contribute $3,600 to their HSA in 2021, an increase of $50 from 2020. Those with family coverage will be able to [...]
