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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/

The Inflation Reduction Act May Impact Employer Health Plans

Background On August 16, 2022, President Biden signed the Inflation Reduction Act (IRA) into law after the Senate and House narrowly approved the law. The new legislation does not directly affect group health plans, but plan sponsors should be aware of potential indirect impacts to their plans. Medicare can now negotiate drug prices Under the IRA, the Department of Health and Human Services (HHS) will establish a program to negotiate prescription drug prices for individuals covered by Medicare. The HHS Secretary will be responsible for negotiating with drug manufacturers to determine the fair price for drugs using factors outlined in …

https://www.epicbrokers.com/insights/inflation-reduction-act-impacts-employer-health-plans/

ERISA Preemption of State PBM Laws

… for state laws that regulate insurance, banking, or securities as provided for under the “saving clause” that allows insurers to be regulated by state law. States may regulate the insurers that provide services to an insurance plan, but not an employee benefit plan itself. The intent of ERISA preemption for employee benefit plans is to keep plan uniformity across the country. Courts use a test to determine whether a state law “relates to” an ERISA plan. As provided in §514, ERISA “shall supersede any and all State laws insofar as they may now and hereafter relate to any employee benefit …

https://www.epicbrokers.com/insights/erisa-preemption-state-pbm-laws/

Compliance Alert: ALE Affordability Considerations and Updates for 2023

… affordable coverage to full-time employees and their dependent children. In addition, individuals who are offered (or eligible for) minimum value, affordable coverage under an employer-sponsored group health plan are not eligible for a tax subsidy when purchasing individual health insurance through a public Exchange. Coverage is generally considered “affordable” if the employee contribution for employee-only (single) coverage does not exceed a set percentage (9.12% in 2023) of household income. Coverage is considered affordable for dependents as well, regardless of the contribution amount, so long as the employee-only (single) coverage is affordable. Coverage is also considered

https://www.epicbrokers.com/insights/compliance-alert-affordability-considerations-updates-2023/