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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/

Market Pulse Survey: “Post-Pandemic” Return to Office Policies

Has your company implemented return-to-office policies as the pandemic evolves? Take our “Post-Pandemic” Return to Office survey to see how other companies are addressing this change With Labor Day behind us, some companies request, or even mandate, that remote workers return to the office. Many believe that the COVID-19 pandemic as we know it is over – or is at least a shadow of what it used to be. Take our brief survey today to let us know what your company is doing or plans to do over the coming months. We know that we are in …

https://www.epicbrokers.com/insights/market-pulse-survey-post-pandemic-office-policies/

Compliance Alert: Departments Release Guidance on Surprise Billing & Machine-Readable Files

Quick Facts On August 19, 2022, the Departments of Labor (DOL), Health and Human Services (HHS) and the Treasury released updated guidance on the prohibition against balance billing under the No Surprises Act (NSA) and the machine-readable files requirements under the Transparency in Coverage (TiC) rules. Under the NSA Final Rule, effective January 1, 2022, health plans (which include employer-sponsored health plans) and carriers must not balance bill patients for certain services including emergency care, non-emergency services provided at an in-network facility from an out-of-network provider, and air ambulance charges. Under the TiC Final …

https://www.epicbrokers.com/insights/departments-release-guidance-surprise-billing-machine-readable-files/

Compliance Alert: RxDC Reporting Obligations for Employer Plan Sponsors

Quick Facts Starting in 2022, employer-sponsored health plans must submit prescription drug and healthcare spending information to the Departments annually. The first report is due December 27, 2022, then annually on June 1. Employers may rely on a third-party reporting entity to submit information on their behalf. Employers must rely on their vendors to supply much of the information required for submission. Employers should take steps to ensure that reporting entities are fulfilling their obligations to report. Background As part of the Consolidated Appropriations Act of 2021 (CAA), employer-sponsored health plans will be required to submit certain …

https://www.epicbrokers.com/insights/rxdc-reporting-obligations-employer-plan-sponsors/

Warren Ables Joins EPIC

Further Expands Texas Employee Benefits Practice We’re thrilled to announce that Warren Ables has joined the firm as a Producer within our growing Employee Benefits Practice. In his new role with EPIC, Ables will be responsible for partnering with clients to develop employee benefit programs. His experience in employee benefits centered on creating and implementing innovative strategies with the goals of employee satisfaction and cost containment. With a background that includes messaging, marketing, and communications, Ables is known for his ability to distill complicated concepts into easily understood information. This allows him to work side-by-side with clients …

https://www.epicbrokers.com/insights/warren-ables-joins-epic/