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HHS Notice of Benefit & Payment Parameters for 2023 Proposed Rule Addresses Non-Discrimination

On January 5, 2022, the Department of Health and Human Services (HHS) published the Notice of Benefit and Payment Parameters for 2023 Proposed Rule (NBPP). The Centers for Medicare & Medicaid Services (CMS) proposed standards for issuers and Marketplaces, as well as requirements for agents and brokers. The proposed rules are intended to provide a more stable and predictable regulatory framework and facilitate a more efficient and competitive market. The rules build on the Affordable Care Act (ACA) to expand access to quality, affordable health coverage and care by lowering premiums, strengthening markets, and enhancing the consumer experience. There are two …

https://www.epicbrokers.com/insights/hhs-benefit-payment-parameters/

Ukraine Russia Situation Updates

… employers to closely watch the situation on the ground and monitor the location of any employees who are assigned to or working in the affected region. Proactively managing employees is the best course of action to ensure that they are aware of support systems in place. Many employers have global employee assistance programs (EAPs) in place on a standalone basis or through their international/expatriate medical programs. These programs provide important services and counseling for overseas employees. Most EAPs include mental health support, for employees and family members who are struggling during these challenging times. Several global EAP providers are …

https://www.epicbrokers.com/insights/ukraine-russia-situation-updates/

Battle Lines Are Being Drawn on the No Surprises Act

The No Surprises Act was signed into law in the final days of the Trump administration and went into effect on January 1, 2022. Millions of consumers faced exorbitant healthcare billings, of which they had no knowledge or control, and insurance carriers had little power to regulate abusive billing practices. Hitting close to home, I just discovered one of my clients got a $500,000 air ambulance bill. And the Kaiser Family Foundation reported that several studies found one in five emergency room visits and 9% to 16% of in-network hospitalizations included surprise bills. In these instances, the law …

https://www.epicbrokers.com/insights/viewpoints-no-surprises-act/

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

Quick Facts Agencies clarify requirements for plan coverage of over-the-counter (OTC) COVID-19 tests.  Provides plans and insurers with a safe harbor limiting out-of-network exposure.  Addresses fraud protection and participant notification.  The cost (or portion of the cost) of a test paid or reimbursed by a plan or insurer cannot be reimbursed by a health Flexible Spending Account (FSA), Health Savings Account (HSA) or Health Reimbursement Account (HRA).  Background On January 10, 2022, The Department of Labor (DOL), Secretary of Health and Human Services (HHS), and Department of the Treasury (Treasury) collectively referred to as “the …

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

Medicare Six-Month Lookback and HSA Contributions

… Individuals do not have a choice to forego the automatic backdating, although this is being considered by the Centers for Medicare and Medicaid Services (CMS). Delaying Medicare Enrollment Individuals who have not yet applied for Social Security retirement benefits must affirmatively apply for Medicare Part A and/or Part B benefits to enroll in Medicare. Consequently, Medicare-eligible individuals may postpone their Medicare entitlement to continue making HSA contributions. CMS, the department that administers the Medicare Program, has confirmed that a Medicare-eligible individual seeking to continue HSA contributions should not apply for Medicare benefits or Social Security retirement benefits …

https://www.epicbrokers.com/insights/medicare-six-month-lookback-and-hsa-contributions/

Coverage of Preventive Services Without Cost-Sharing

Quick Facts The Affordable Care Act’s (ACA’s) Public Health Service Act (PHSA) §2713 contains a list of items considered preventive healthcare which must be covered with no cost-sharing. The list continues to be updated by designated departments/agencies based on newly available medical treatments and best practices. In 2020, the Families First Coronavirus Response Act (FFCRA) and the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) required additional diagnostic testing and related services with no cost-sharing. Background Non-grandfathered group health plans are required to provide the following preventive services without imposing any copayments, coinsurance …

https://www.epicbrokers.com/insights/coverage-of-preventive-services-without-cost-sharing/

What Happens to Unused Health FSA Funds?

Quick Facts The Internal Revenue Service’s (IRS’s) Use-or-Lose rule states that Flexible Spending Account (FSA) funds must be spent by the participant within the FSA’s plan year. Unused funds at the end of the plan year are forfeited to the plan. Exceptions to the rule include a carryover or grace period feature. Funds left in an FSA from a carryover will impact Health Savings Account (HSA) eligibility. There are four IRS and Employee Retirement Income Security Act (ERISA) approved options for utilizing forfeited funds. Background FSAs are subject to the Use-or-Lose rule, meaning …

https://www.epicbrokers.com/insights/what-happens-to-unused-health-fsa-funds/

Derek Poirier Joins EPIC

Poirier Strengthens West Region’s Employee Benefits Operations We are pleased to announce that Derek Poirier has joined the firm as Senior Principal. In his new position with EPIC, Poirier is responsible for new business development, and the design, placement, and management of employee benefits insurance programs and solutions for mid-market and large clients. Reporting to Matt Clemo, Executive Managing Principal and Southern California Employee Benefits leader, he will be based in the firm’s Newport Beach office. “We are happy to have Derek join our rapidly growing Orange County practice,” noted Clemo. “His vast experience and industry expertise …

https://www.epicbrokers.com/insights/derek-poirier-joins-epic/