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Employer Health Plan Medicare Part D Disclosure to CMS

Quick Facts Employers with group health plans that provide prescription drug coverage to individuals who are eligible for Medicare Part D must disclose to the Centers for Medicare & Medicaid Services (CMS) certain information about the coverage. The disclosure must be submitted to CMS on an annual basis and at certain other designated times. The disclosure to CMS is due within 60 days after the start of each plan year (March 1, 2022, for calendar year plans). The CMS disclosure is different than the notices of creditable or non-creditable coverage that plan sponsors must issue to Medicare-eligible individuals annually …

https://www.epicbrokers.com/insights/employer-health-plan-medicare-part-d-disclosure-cms/

San Francisco HCSO Top-Off Payments Due February 28, 2022

Quick Facts The San Francisco Health Care Security Ordinance (HCSO) requires covered employers to pay a certain amount – an Expenditure – toward their covered employees’ healthcare costs. If a covered employer does not meet the required Expenditure under a pay-as-you-go plan, it must use another permissible method – called a “top-off” payment – to make up the shortfall. The HCSO provides guidance for calculating Expenditures for both level-funded plans and plans that pay claims as incurred (“pay-as-you-go” plans). Top-off payments are due by the end of February following the calendar year for which they …

https://www.epicbrokers.com/insights/sfhsco-top-off-payments-due-february-28-2022/

Market Pulse Survey: Time Off Policies

Thinking of revisiting your time off policies? It might be a key to addressing employee burnout and fatigue Take our Time Off Policy Survey to see what other companies are doing in response to the Great Resignation, or what some are now calling the Great Sabbatical. Now more than ever, it’s critical to ensure benefits, including time off policies, are competitive. Attracting and retaining talent has never been more challenging, and with many employees reporting burnout or fatigue, there’s no better time to take a fresh look at your time off policies. All who respond by Thursday, February …

https://www.epicbrokers.com/insights/market-pulse-survey-time-off-policies/

Is the Mark Cuban Cost Plus Drug Company the Answer to Rising Drug Costs?

Mark Cuban, of Shark Tank and Dallas Mavericks ownership fame, is the most recent entry into the “squeeze-the-margin-out-of-pharmacy” game. In October he launched The Mark Cuban Cost Plus Drug Company (MCCPDC), a pharmacy benefit manager. This month the online pharmacy launched with a promise of only a 15% flat margin and pharmacist fee on 100 generic drugs. Cuban isn’t the first billionaire to try to solve the challenges of drug pricing. Amazon acquired PillPack in 2018 and announced its entry into retail pharmacy. Long before that, Walmart launched a $4 generic drug price in …

https://www.epicbrokers.com/insights/mark-cuban-cost-plus-drug-company-rising-drug-costs/

DOL Provides Q&As for CAA Broker Compensation Disclosure Requirements

The Consolidated Appropriations Act (CAA), signed into law on December 27, 2020, included a requirement that starting December 27, 2021, brokers and consultants supplying services to Employee Retirement Income Security Act (ERISA) group health plans disclose to plan fiduciaries (typically the plan sponsor), in writing, direct and indirect compensation they receive for providing services to such plans. This disclosure requirement was effective for “contracts or arrangements entered into, extended, or renewed on or after December 27, 2021.” See our Compliance Insights article, “Employee Benefits Broker Compensation Disclosure Requirements Are Coming Soon,” for more information. On Thursday, December 30, 2021, the …

https://www.epicbrokers.com/insights/dol-provides-qas-caa-broker-compensation-disclosure-requirements/

Supreme Court Blocks OSHA’s COVID-19 Emergency Temporary Standard for Employers

… or testing requirements. Finally, the SCOTUS ruling has no effect on recent guidance requiring health plans to pay for over-the-counter (OTC) COVID tests. For more information on recent COVID-19 home test requirements visit our Guidance Released for Health Plan Coverage of OTC COVID-19 Tests page. EPIC Employee Benefits Compliance Services For further information on this or any other topics, please contact your EPIC consulting team. Learn About Our Employee Benefits Compliance Services EPIC offers this material for general information only. EPIC does not intend this material to be, nor may any person receiving this information construe …

https://www.epicbrokers.com/insights/supreme-court-blocks-osha-emergency-temporary-standard-employers/

The Emotional Wellbeing Toolkit

… we’ll provide: Assessment tools Strategies & resources Ideas for wellbeing conversations Effective communication strategies Visit the Human Resources Today website to sign up for a free recording! Get to Know Our Speakers Suzannah Gill, JD EPIC Benefits Strategy Consultant and a former ERISA attorney Suzannah is at the forefront of benefits trends and strategies. She provides resources and guidance to her clients to position themselves as employers of choice with well-managed benefit plans. Suzannah was named one of Employee Benefits Advisor’s 20 Rising Stars in Benefits Advising in 2018, was featured in BenefitsPro Magazine as a “Face of …

https://www.epicbrokers.com/insights/the-emotional-wellbeing-toolkit/

Guidance Released for Health Plan Coverage of OTC COVID-19 Tests

Quick Facts On January 10, 2022, guidance was released requiring group health plans and insurers to cover over-the-counter (OTC) COVID-19 diagnostic tests without cost-sharing or provider authorization. Coverage for COVID-19 OTC tests begins Saturday, January 15, 2022. Plans may choose to reimburse sellers of COVID-19 home test kits directly or reimburse plan participants directly for the purchase. The guidance applies to self-funded, fully insured, grandfathered and individual health plans. Background On January 10, 2022, the Department of Labor (DOL), Department of Health and Human Services (HHS) and the Treasury Department (“The Departments”) released …

https://www.epicbrokers.com/insights/guidance-health-plan-coverage-otc-covid-19-tests/