SEARCH

Showing 144 results found

There Are Options When Your Healthcare Premium Blows Up

… those where maximum costs are capped. Under these programs, the employer is not responsible for paying excessive amounts if these projected costs do not materialize, yet there is downside protection if they do. Captive Insurance programs can also mitigate individual client risk. Another alternative is using Individual Coverage Health Reimbursement Arrangements (ICHRAs). These plans allow employers to provide employees with a fixed amount of money to purchase individual health insurance coverage. This empowers employees to choose a plan that best suits their needs while potentially reducing costs for both employers and employees. However, these plans are administratively complex, and selecting …

https://www.epicbrokers.com/insights/healthcare-premium-options/

Compliance Matters Newsletter | August 2023

… ACA), even if those services would otherwise be considered out-of-network. As a reminder, services subject to the prohibition against balance billing are air ambulance claims, emergency services, and services provided by an out-of-network provider at an in-network facility.    Additionally, the FAQs clarify that any contractual arrangement with an air ambulance provider, direct or indirect, makes the air ambulance provider a “participating provider” for purposes of the NSA. Separately, the FAQs indicate that facility fees fall under the definition of “items and services” which are protected under the NSA (and subject to in-network cost-sharing …

https://www.epicbrokers.com/insights/compliance-matters-newsletter-august-2023/

Compliance Matters Newsletter | June 2023

… HSAs. Revenue Procedure 2023-23 also updated the IRS maximum limit for an excepted benefit health reimbursement arrangement (HRA) in 2024. WEBINAR Join our 2023 Compliance Webinar Series Stay up to date on employee benefits compliance Find Out More  Additional Updates & Resources Reminder! PCORI Fee Due July 31 Employers who sponsored self-funded medical plans that ended sometime during 2022 are required to report and pay the ACA Patient-Centered Outcomes Research Institute (PCORI) fees no later than July 31. Fully insured plan sponsors can rely on their carriers to submit the fee on their behalf, but fully insured …

https://www.epicbrokers.com/insights/compliance-matters-newsletter-june-2023/

Large Claims Alarms Are Signaling Healthcare Cost Spikes

Viewpoints from Craig Hasday Regardless of your plan’s size or funding arrangement, prepare yourself. Large claims are coming. According to a QBE report, claims over $200,000 increased by 17% from 2020 to 2021. While it was harder to see through the crystal ball during the COVID-19 years, it is starting to get clearer again. This trend will continue. There are several factors in play. COVID-19 claims are expected to diminish, however, the cost of deferred care is emerging. Circulatory claims are on the rise, but more acutely, the cost of high-cost therapies is expected to …

https://www.epicbrokers.com/insights/large-claims-signaling-healthcare-cost-spikes/

Compliance Matters Newsletter | April 2023

… released several frequently asked questions (FAQs) that address whether certain costs related to nutrition, wellness and general health are medical expenses that may be paid or reimbursed under a health savings account (HSA), health flexible spending arrangement (FSA), Archer medical savings account (Archer MSA) or health reimbursement arrangement (HRA). The information has been available in the Internal Revenue Code (IRC) and various IRS publications for quite some time, but the FAQs provide clarifying guidance to the existing IRC. Section 213 of the IRC generally allows a deduction for expenses paid during the taxable year for medical care if certain …

https://www.epicbrokers.com/insights/compliance-matters-newsletter-april-2023/

EPIC Team Members Join Class of 2023 Power Brokers

… been focused on the review and transition of Professional Employer Organizations (PEOs) for employers. As companies and organizations grow, they often search for insurance arrangements with more flexibility and customization. McGrade’s work has been instrumental in guiding maturing businesses from the PEO model to more traditional insurance arrangements. Thompson Mackey, CCIC, CRM, ARM, CIC, Vice President, Risk Management based in Duluth, Georgia is 2023 Power Broker finalist in the Cyber category.  Mackey and his team built a process to analyze the insureds’ cybersecurity risk posture, challenge risk assumptions made by the insured, and quantifies potential security issues through …

https://www.epicbrokers.com/insights/epic-team-members-2023-power-brokers/

Compliance Matters Newsletter | March 2023

… emergency end dates on their plans. Department of Labor Issues 2023 Adjusted Penalty Amounts Federal regulations require the Department of Labor (DOL) to adjust its civil money penalties for inflation annually, by January 15. A variety of penalties are updated for enforcement in 2023. Proposed Rules Create Individual Contraception Coverage Arrangement The Affordable Care Act (ACA) requires most health plans to cover contraceptive services at no cost-sharing. In 2018, final regulations allowed certain entities – those with religious or moral objections to contraception – a path to avoid the contraception requirement, and voluntarily offer an accommodation for plan participants to provide …

https://www.epicbrokers.com/insights/compliance-matters-newsletter-march-2023/

Compliance Matters Newsletter | February 2023

… you-go” plans). Top-off payments are due by the end of February following the calendar year for which they apply. For 2022 Expenditures, the due date is no later than February 28, 2023. Broker Compensation Disclosure Compliance Continues As part of the Consolidated Appropriations Act of 2021, (CAA) certain arrangements with those Employee Retirement Income Security Act (ERISA) health plans that are entered into, extended, or renewed on or after December 27, 2021, must include specific disclosures about compensation. The requirements are modeled after similar disclosures for retirement plans. The requirements are ongoing. Brokers and consultants who are covered …

https://www.epicbrokers.com/insights/compliance-matters-newsletter-february-2023/