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New Guidance Expands ACA-Approved List of Women’s No-Cost, Preventive Services

Recent updates from the Health Resources and Service Administration (HRSA) will result in a more comprehensive list of preventive and screening guidelines for women and children, the Department of Health and Human Services (HHS) announced on December 30, 2021. The additions, including for the first time a requirement for certain group health plans to cover electric breast pumps, increase the number of preventive services available to women with no cost-sharing. Under the Affordable Care Act (ACA), signed into law in March 2010, certain preventive services and screenings covered by non-grandfathered health plans are available without a copay, deductible …

https://www.epicbrokers.com/insights/new-guidance-womens-preventive-services/

So, What’s the True Value of Wellness Programs?

… a variety of chronic diseases, disorders and premature deaths, which now contribute to an assessed 90% of today’s $3.8 trillion in annual healthcare costs. Viewpoints from Erin Milliken But let’s take a step back from the financial lens and dig deeper into the meat of those intangible benefits. Wellness programming, including preventive care, addresses the physical, mental and emotional health related to employee productivity, workplace loyalty and morale. In the era of the Great Resignation, every employer can use a leg up in recruiting top talent, retaining employees, drumming up greater workplace engagement and enhancing productivity. Some …

https://www.epicbrokers.com/insights/wellness-programs-true-value/

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/