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 [...]
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, [...]
After the repeal of the Affordable Care Act’s Individual Mandate, which was effective January 1, 2019, several states began the process of implementing statewide individual mandates. Currently there are six states that have passed some form of the individual mandate. To date, California, the District of Columbia, Massachusetts, New Jersey, Rhode Island, and Vermont have [...]
This article was published on March 21, 2020 in MyHealthGuide, written by Hobson D. Carroll, FSA, MAAA, President, MedRisk Actuarial Services, Inc. After the President signed the Families First Coronavirus Response Act wherein testing for the virus may not attract any element of cost-sharing (think: preventive care), there has begun an additional new drum roll [...]
The ACA’s PCOR fee had expired with the 2019 plan year, although non-calendar year plans were still required to remit their fees on July 31, 2020. However, as part of the year end budget/spending bill, Congress authorized an extension of the Patient Centered Outcomes Research Institute Fee (PCOR) for another ten years through 2029. The ACA [...]
The article below was published on October 24, 2017 by Self-Insurance Institute of America, Inc., written by Wrenne Bartlett. The Self-Insurance Institute of America, Inc. (SIIA) is pleased to announce that Governor Andrew Cuomo has signed A.8264 into law, allowing grandfathered stop-loss contracts for groups of 51-100 to renew until January 1, 2019. As background, [...]
The article below was published on August 19, 2017 by Green Bay Press-Gazette, written by Mike Ferguson. Photo Source: Minerva Studio, Getty Images Wisconsin lawmakers are at an impasse over the state budget. Senate leaders can't agree with their Assembly counterparts on how to fund road repairs, schools, and various agencies. Resolving this [...]
The article below was published on May 1, 2017 by the Employee Benefit Adviser, written by Brian Kalish. Nearly half of all employees are covered by a self-insured group health plan. Many companies that offer these plans have separate stop-loss insurance policies to protect them against the risk of catastrophically high claims. Some states and [...]
The article below is from Crain's New York Business, written by Caroline Lewis Park Slope Food Coop is among the employers that could be forced to join the small-group health insurance market Photo: Flickr/Wally Gobetz Faced with rising premiums in the group health insurance market, the Park Slope Food Coop opted five years [...]
Article written by Michael W. Ferguson, as seen in the New York Post New York’s state legislators are thinking small — literally. The state’s definition of “small business” expanded Jan. 1, thanks to legislation passed in 2013. Many firms that thought of themselves as medium-size are now legally considered “small.” One consequence: They’re barred from [...]
