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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/

Compliance Matters Newsletter | January 2023

… Telemedicine fees must be at least fair market value (FMV) when offered in conjunction with a high deductible health plan (HDHP). Temporary relief from the FMV rules has been in effect since 2020. Congress recently passed legislation extending relief for two more years. HRAs & HSAs Can Be Compatible Health Reimbursement Arrangement (HRA) design will determine whether high deductible health plan (HDHP) participants can also maintain eligibility to contribute to a health savings account (HSA). A general-purpose HRA offering will make all participants ineligible to contribute to an HSA. A post-deductible HRA or limited-purpose HRA will not interfere …

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

Compliance Alert: §4980H Employer Mandate Requirements & Penalties

… health plan or group health insurance coverage offered by an employer to an employee that is: (a) a governmental plan, or (b) any other plan or coverage offered in a state’s small or large group market. In addition, IRS regulations clarify that self-funded employer coverage, including a health reimbursement arrangement (HRA), qualifies as an eligible employer-sponsored plan. Minimum Value The requirement to provide “minimum value” is a higher standard than the requirement to offer a MEC plan. A plan provides minimum value if the plan’s share of the total allowed cost of benefits provided to an

https://www.epicbrokers.com/insights/compliance-alert-%c2%a74980h-employer-mandate-requirements-penalties/

Compliance Alert: Internal Revenue Service Updates PCORI Fee for 2023

… method. There are special rules that apply for employers offering multiple self-funded plans or a Health Reimbursement Arrangement (HRA) integrated with a fully insured plan. Multiple Self-Funded Plans – If one plan sponsor maintains more than one self-funded health plan with the same plan year, the arrangements can be treated as a single plan for purposes of the fee. HRAs – An employer who sponsors an HRA integrated with a fully insured medical plan is required to pay the fee only with respect to each HRA participant/employee and are not required to count dependents or beneficiaries. EPIC …

https://www.epicbrokers.com/insights/compliance-alert-internal-revenue-service-updates-pcori-fee-2023/