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Take a Closer Look at the Complexities of PBM Satisfaction

Choosing, negotiating a contract, and navigating a relationship with a pharmacy benefit manager (PBM) isn’t one size fits all. No single PBM is “best” across the board, and customer needs and priorities vary based on many factors – organization type, plan size, member demographics, etc. Our Pharmacy Solutions team at Pharmaceutical Strategies Group (PSG) highlights the intricacy of plan sponsors’ relationships with their PBMs in their latest market research, the 2022 Pharmacy Benefit Manager Customer Satisfaction Report. It outlines high-level satisfaction ratings and dives even deeper into ratings for over 30 services and functions, a dozen clinical and cost …

https://www.epicbrokers.com/insights/complexities-pbm-satisfaction/

EPIC Continues Strategic Expansion - Acquires Larry Gordon Agency

Expanding National Footprint Across our Life Insurance, Executive Benefits, and Financial Advisory Distribution Businesses EPIC has acquired Larry Gordon Agency (“LGA”). The acquisition continues the strategic expansion of EPIC’s geographic footprint in the Midwest across its life insurance, executive benefits, and financial advisory distribution businesses under the Vanbridge Life and Executive Benefits umbrella. Established in 1965, the Larry Gordon Agency was one of the first independent brokerage agencies in the country and pioneered the concept of providing brokers with a diversified mix of life insurance options with access to multiple carriers. Today, LGA services its customers with industry-leading …

https://www.epicbrokers.com/insights/epic-acquires-larry-gordon-agency/

Securing Life Insurance After Surviving Breast Cancer

A common misconception is that any cancer history automatically makes an applicant uninsurable. Advances in breast cancer research, treatment and awareness have produced considerably more survivors who are now thriving and winning the battle. More good news – the opportunity for breast cancer survivors to secure life insurance has become more achievable than ever before. Viewpoints from Tom Dignan The insurance underwriting process is all about risk assessment and gathering the necessary medical information. Applicants are reviewed on a case-by-case basis since each breast cancer case is unique. Underwriters consider several aspects to determine mortality risk, such as family …

https://www.epicbrokers.com/insights/securing-life-insurance-after-surviving-breast-cancer/

Compliance Alert: Guide to Compliance Considerations for Level-Funded Plans

… funded plans PCORI Fees A level-funded plan sponsor is required to pay the Patient Centered Outcomes Research Institute (PCORI) fee each year. Occasionally, the level-funded plan vendor may include the PCORI fee in the monthly payment amount and submit the payment to the Internal Revenue Service (IRS) on the employer’s behalf. Wrapping the PCORI fee into the monthly payment amounts, which may be paid in part by employee contributions, can be problematic. Accordingly, in most cases, the level-funded plan sponsor is responsible for reporting and paying the PCORI fee each year. ACA Reporting Because it is

https://www.epicbrokers.com/insights/compliance-alert-guide-considerations-level-funded-plans/

Compliance Alert: IRS Issues Final Rules for Family Coverage Affordability Determination

Quick Facts Starting January 1, 2023, employer plan affordability for family members will be based on the required cost for the entire family to participate in the employer-sponsored plan. Affordability for the employee will still be based on the employee’s cost for single (employee-only) coverage. Applicable large employers (ALEs) can be liable for penalties under section §4980H if the employer plan is unaffordable for full-time employees. As part of a new Section 125 rule, a non-calendar year cafeteria plan may allow an employee to prospectively revoke an election of family coverage under a group health …

https://www.epicbrokers.com/insights/compliance-alert-irs-issues-final-rules-for-family-coverage-affordability-determination/

Compliance Alert: Updates to 2023 Health FSA & Qualified Transportation Limits

… commuter benefits. These limits are adjusted annually for inflation. Limits for Dependent Care Assistance Programs (DCAP) are set by statute and not adjusted annually for inflation. Background In Revenue Procedure 2022-38, the IRS sets forth a variety of 2023 adjusted tax limits. Among other things, the notice indicates that employee contribution limits toward health FSAs and qualified transportation fringe benefits will increase for 2023. The limit on annual employee contributions toward health FSAs is $3,050 in 2023, with the ability to carryover up to $610. The limit on monthly contributions toward qualified transportation and parking benefits for 2023 …

https://www.epicbrokers.com/insights/compliance-alert-updates-to-2023-health-fsa-qualified-transportation-limits/

Are Health Plans Satisfied with Their PBMs?

… from the report: PBM satisfaction declined from 8.2 in 2021 to 7.8 in 2022. The likelihood of recommending the current PBM also declined. On nearly every measure, health plans reported significantly lower satisfaction ratings than employers. PBMs have the most opportunity for improvement related to integration with other solutions, differentiating and customizing products, contract and service flexibility, trend management, and clinical outcomes reporting. DOWNLOAD THE REPORT Pharmaceutical Strategies Group (PSG) joined EPIC in 2021, bringing the knowledge and resources of one of the nation’s largest independent pharmacy benefit consulting firms into the EPIC Employee Benefits Consulting practice.

https://www.epicbrokers.com/insights/health-plans-pbms/

EPIC Welcomes New Hires in Northeast Region

… our growing Employee Benefits Practice. Grishman will help employers develop cost-effective solutions in his new role while improving the overall employee experience to drive organizational business productivity. Karagus will help establish new relationships with employers and strategize on practical ways for them to deliver the most impactful, budget-conscious benefits. Mark will focus on helping employers navigate health and welfare benefits, including evolving market strategies, the regulatory environment, employee healthcare education, and efficient plan administration. Milne’s new role is to help business owners achieve the best possible outcomes for their employee benefits programs by developing customized plans tailored …

https://www.epicbrokers.com/insights/epic-welcomes-northeast-region-new-hires/