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Resumption of Medicaid Redetermination Rules Will Be Problematic for Employers

… a qualifying event. Many new hires were not recertified and could be ineligible for Medicaid under state guidelines. States will be required to develop a plan to avoid disruption, which would undoubtedly include information on electing enrollment under their employer’s plan. Employees who became accustomed to extremely generous Medicaid benefits will now be subject to employer plan cost-sharing. Although superior in many ways, the increase in cost burden may lead to employee dissatisfaction. Employers are advised to get ahead of this change. They should review plan waivers and assess potentially impacted employees. EPIC advisors can help you design …

https://www.epicbrokers.com/insights/medicaid-redetermination-rules-problematic-employers/

EPIC Welcomes Kevin Davis

… time you meet him. We are very excited to bring a consultant of his experience and caliber into the region as we continue to expand within the greater Philadelphia market,” says Tim Fitzpatrick, Northeast Region Employee Benefits Sales Leader. Kevin is a member of the National Association of Health Underwriters and serves on the Lehigh Valley Business Coalition on Healthcare Education and Wellness Committee. He is also a board member of Habitat for Humanity of Lehigh Valley, supporter of PBS39 and ArtsQuest, and serves as a ministry leader at Calvary Chapel in Quakertown. Learn more about our Employee Benefits Practice.

https://www.epicbrokers.com/insights/epic-welcomes-kevin-davis/

Compliance Matters Newsletter | February 2023

Check out this month’s Compliance Matters newsletter, your one-stop shop for benefits compliance news! The employee benefits landscape is in a state of constant change. Get timely, accurate news regarding impactful legislative changes – and the resulting requirements, exposures and opportunities. Employee Benefits Compliance Alerts San Francisco HCSO Top-Off Payments Due February 28, 2023 The San Francisco Health Care Security Ordinance (HCSO) requires covered employers to pay a certain amount – an Expenditure – toward their covered employee’s healthcare costs. If a covered employer does not meet the required Expenditure under a pay-as-you-go plan, it must …

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

Who Is Watching Health Insurance Disruption for You?

… agreed to pay out $2.67 billion in a settlement and to change some of their market practices. While the court granted final approval to the Settlement on August 9, 2022, some class members objected to the Settlement and appealed the Court’s decision. The settlement cannot become final – and benefits cannot be distributed – until all appeals are resolved. While there is currently no timeline for the resolution of these appeals, I have little doubt that this signals more consolidation of health insurance companies to come. The non-traditional channels are also changing. Amazon’s acquisition of One Medical, together …

https://www.epicbrokers.com/insights/health-insurance-disruption/

EPIC Welcomes Colin Nickerson

Nickerson Joins the Southeast Region as Vice President, Employee Benefits Consulting EPIC is excited to announce that Colin Nickerson has joined the firm as Vice President, Employee Benefits Consulting. In his new role, Colin will be responsible for business development and sales strategy in the Southeast. “We are fortunate to have Colin join our consulting team, where he will leverage EPIC’s advanced data analytics to help clients develop a sustainable employee benefits strategy. His background and experience will add great value to his clients and to our organization,” says Jim Baker, Regional Director, Employee Benefits. Colin joins EPIC from …

https://www.epicbrokers.com/insights/epic-welcomes-colin-nickerson/

Way to Wellness Newsletter | February 2023

Shorter Workouts for the Win! According to the American Council on Exercise, several shorter periods of exercise throughout the day may add up to the same benefits that single, longer workouts provide. These “micro-workouts” can provide aerobic fitness, muscle tone and even weight loss. Share these micro-workout ideas to help break down “I don’t have time” barriers and get employees moving: Copy the Employee-Facing Email Shorter Workouts for the Win! Download the Word file, then copy and paste the graphic and text into a fresh email to deploy to your workforce. Post the Monthly Wellness Tips …

https://www.epicbrokers.com/insights/way-to-wellness-newsletter-february-2023/

Health Claim Data Is Power

… is too small to be credible,” or they provide incurred data with completion factors that aren’t specified. They’ll also stall so the most recent data isn’t available until months later. The federal government is onto this, first taking action by requiring hospital pricing transparency and now pharmacy benefits manager (PBM) transparency. Transparency reduces the margins and profits of these types of intermediaries and allows plan sponsors to make decisions using relevant and timely data points. EPIC partners with Innovu, a data aggregator, to get timely data feeds from third-party administrators (TPAs) and PBMs – with line-item …

https://www.epicbrokers.com/insights/health-claim-data-is-power/

Stay Close to Your Self-Insurance Advisor

… first is individual coverage, or specific stop loss, which restricts the plan’s monetary risk of any individual claimant to a pre-established limit. The second is aggregate stop loss, which limits risk exposure for all claimants to a pre-set maximum. After the elimination of annual and lifetime maximum benefits for covered individuals, introduced by the Affordable Care Act in 2010, things got riskier. Today’s stop-loss environment has become very complicated, and an employer should choose their broker/consultant carefully. Up until a few years ago, it was rare for individual claims to exceed $1 million, but …

https://www.epicbrokers.com/insights/stay-close-to-your-self-insurance-advisor/