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On Nov. 17, 2021, federal agencies released an interim final rule requiring health plans and issuers to report information regarding the cost of prescription drugs and certain medical expenses. This rule is a continuation of the Biden administration’s efforts to promote greater transparency in health care spending. Overview of the Interim Final Rule This rule…

Many employee benefits are subject to annual dollar limits that are periodically updated for inflation by the IRS. The following commonly offered employee benefits are subject to these limits: High deductible health plans (HDHPs) and health savings accounts (HSAs);Health flexible spending accounts (FSAs);401(k) plans; andTransportation fringe benefit plans. The IRS typically announces the dollar limits…

HRAs reimburse employees for certain medical costs. Depending on the plan, such expenses may include doctor visits, medical procedures and prescriptions. An employee must be enrolled in their employer’s group health plan to qualify for an HRA. ICHRAs are a bit different. These accounts can reimburse employees for certain medical expenses, insurance premiums or both.…

Health care is rarely straightforward for the average consumer. Many individuals need help making sense of their options both during open enrollment and when receiving health services. In fact, 8 out of 10 people said they faced challenges when receiving care, according to a recent study from Quantum Health. According to the study, the vast…

Recently, President Joe Biden announced sweeping COVID-19 vaccination mandates. Federal employees must now be vaccinated as a condition of employment. And, soon, private employers with 100 or more employees will need to implement the same measure or allow weekly negative COVID-19 testing as substitutes for vaccination. Little is currently known about the upcoming emergency temporary…

According to a PricewaterhouseCoopers (PwC) report, medical costs are projected to increase 6.5% in 2022. That’s why employers must think strategically but creatively about how they can lower their health benefits expenses. Here are three strategies to help. 1. Control Drug Spending Employers can educate employees on the price differences between name-brand and generic medications.…

On Aug. 20, 2021, the Departments of Labor (DOL), Health and Human Services (HHS) and the Treasury (Departments) issued frequently asked questions (FAQs) regarding the implementation of the No Surprises Act and transparency provisions of the Consolidated Appropriations Act, 2021 (CAA). The FAQs provide that Departments will defer enforcement of the rules regarding: Publishing transparency…

Each year, Medicare Part D requires group health plan sponsors to disclose to individuals who are eligible for Medicare Part D and to the Centers for Medicare and Medicaid Services (CMS) whether the health plan’s prescription drug coverage is creditable. Plan sponsors must provide the annual disclosure notice to Medicare-eligible individuals before Oct. 15, 2021—the…

On July 23, 2021, the IRS published a proposed rule that would expand the requirement to file certain information returns electronically, including those under the Affordable Care Act’s (ACA) reporting requirements in Internal Revenue Code Section 6055 and Section 6056. For Form 1094 series, Forms 1095-B and 1095-C, Form 1099 series and Form 5498 series,…

The most successful open enrollment campaigns start engaging employees months before enrollment begins. That means organizations should review their offerings sooner rather than later so there’s ample time to develop and execute a successful campaign. Use this general timeline to help your organization prepare for a successful open enrollment period. 8-12 Weeks Before Open Enrollment…