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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/

EPIC Welcomes Juliet Lucero

Lucero joins as Director of California Charter School Practice In her new position with EPIC, Lucero will work hand in hand with schools to identify the benefits strategies that will meet both short-term and long-term goals, while establishing fiscally responsible programs that address the evolving needs of school employees. Reporting to Matt Clemo, Executive Managing Principal and Southern California Employee Benefits leader, she will be based in the firm’s Newport Beach office. “We are pleased to welcome Juliet to the team,” noted Clemo. “Her hands-on Charter School experience will contribute to the provision of best-in …

https://www.epicbrokers.com/insights/epic-welcomes-juliet-lucero/

Alex Jerez Joins EPIC

Jerez Joins as Director, Northeast Charter School Practice In his new position with EPIC, Jerez will work hand in hand with schools to develop plans and programs that protect schools and their most valuable assets. His focus will be creating strategies that provide coverage for school property, children, teachers, course of construction, and active assailant threats. Reporting to Joffrey Clark, Charter School Practice Leader, he will be based in the firm’s Melville, New York office. “We are pleased to welcome Alex to the team,” noted Clark. “His hands-on Charter School experience will contribute to the provision of best …

https://www.epicbrokers.com/insights/alex-jerez-joins-epic/

EPIC Adds Cori Simpson

… a track record of leveraging data analytics to develop benefits strategies that achieve business imperatives and improve her clients’ population health and productivity. Cori brings a unique perspective to her consulting role: Cori has led consulting engagements with Fortune 100 clients encompassing human resources strategy, mergers and acquisitions, and broad benefits strategy including health and welfare, financial security and work/life issues. Cori held several positions focusing on strategies to optimize the balance between controlling company costs and providing the optimal compensation and benefits value to employees. During her time in the carrier business, Cori’s work achieved high service …

https://www.epicbrokers.com/insights/epic-adds-cori-simpson/