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Compliance Alert: Enforcement Action for Contraception Coverage

Quick Facts On June 27, 2022, the Departments released a letter encouraging group health plans to fully comply with requirements to cover contraception with no cost-sharing. Under the Affordable Care Act (ACA), all non-grandfathered individual and group health plans are required to provide preventive services coverage with no cost-sharing. The guidance is clear that medically appropriate or necessary contraception must be fully covered by the group health plan. Background On June 27, 2022, the Department of Health and Human Services (HHS), the Department of Labor (DOL) and the Department of the Treasury (collectively, the Departments) released a …

https://www.epicbrokers.com/insights/compliance-alert-contraception-coverage-enforcement/

Compliance Alert: Prescription Data Collection Reporting Is Coming Soon

… time by December 27, 2021, and then by June 1 of each year thereafter; however, In August 2021, the Departments delayed enforcement to December 27, 2022 for reports on 2020 and 2021 data. Subsequent reports will be due June 1. Reporting Requirements The IFR requires employer-sponsored health plans and carriers to annually submit certain information on prescription drug and other healthcare spending to the Departments. The instructions break down the required information into two categories, Plan Lists (P) and Data Lists (D). P1. Individual and Student Market plan list P2. Group Health plan list P3. Federal Employee Health Benefit

https://www.epicbrokers.com/insights/compliance-alert-prescription-data-reporting/

Compliance Alert: SCOTUS Decision on End-Stage Renal Disease

Quick Facts In June 2022, the Supreme Court of the United States (SCOTUS) ruled that group health plans may limit coverage for dialysis on a uniform basis for all plan participants without violating Medicare Secondary Payer (MSP) rules. The MSP rules apply to most group health plans. When coverage limitations apply uniformly to all participants requiring such treatments or services, and not just those with ESRD, the limitation does not violate MSP rules. Background In June 2022, SCOTUS released an opinion indicating that group health plans may limit coverage for dialysis on a uniform basis for all plan participants without …

https://www.epicbrokers.com/insights/compliance-alert-scotus-esrd-decision/

Improve Your Online Reviews With … Insurance?

Let’s say your organization has just completed an overhaul of your employee benefits plan. It’s fairly priced for singles and families. It offers extended leave for new parents or to take care of aging parents. It even provides voluntary benefits, a 401(k) program, and more. How will you use it to win the battle for top talent during the Great Reshuffle? Or perhaps you’ve reduced injuries (and claims) across the company as a result of moving to short training podcasts. You could add these statistics to your recruiting materials, but today that’s not enough. How …

https://www.epicbrokers.com/insights/improve-online-reviews-with-insurance/

Compliance Alert: PCORI Fee Reminder & Updated Form 720

… June 30th, 2022. Health insurance carriers pay the fee on behalf of fully insured plans, but employers are responsible for reporting and paying the fee for any self-funded group health plans, including health reimbursement arrangements (HRAs). The PCORI fee applies to most group health plans, but not to excepted benefits. The IRS published a chart that describes the different types of plans subject to the fee. The fee is paid using quarterly excise tax Form 720, Line 133, and must be paid by July 31st of the year following the last day of the plan year. Reporting the PCORI …

https://www.epicbrokers.com/insights/pcori-fee-reminder-updated-form-720/

Market Pulse Survey: Post Roe v. Wade Policies

How will your company respond to the recent Supreme Court ruling over reproductive rights? Take our ‘Post Roe v. Wade’ survey to see how other companies are addressing the reversal of this precedent Plan sponsors are left wondering about their next move regarding coverage changes that may be appropriate in view of this landmark decision. Help us determine what benefits employers are considering in this new Post-Roe era. All who respond by Wednesday, July 6 will receive a summary of the survey results. We’ll take a look at: Covered medical travel Reimbursement methods and levels for plan participants …

https://www.epicbrokers.com/insights/market-pulse-survey-post-roe-v-wade/

Special Compliance Alert: What Is the Impact of the Roe v. Wade Reversal?

… include travel of a plan participant to obtain access to an abortion in a state where abortion is legal. Fully insured plans must comply with state laws and will not cover abortions in states where abortion is prohibited. It is unlikely that self-funded plans will be able to use Employee Retirement Income Security Act (ERISA) preemption as an argument to cover abortions in states where abortion is prohibited. Background On June 24, 2022, The Supreme Court of the United States (SCOTUS) released a final decision in Dobbs v. Jackson Women’s Health Organization (Dobbs), a case out of Mississippi …

https://www.epicbrokers.com/insights/special-compliance-alert-roe-v-wade-reversal-impact/

EPIC Announces Strategic Hires in Northeast

… of CPCU and CIC. Barbush specializes in group casualty and single-parent captives. She has over 40 years of experience, dedicating the past 22 years exclusively to captive insurance with mid to large commercial clients with a focus on the construction industry. Floyd and Shingara both bring a background in employee benefits consulting. Floyd concentrates on mid and large-group markets and is a healthcare consortium and self-funded expert. He holds the designation of Advanced Charter Benefits. Shingara is a Certified Employee Benefits Specialist. His experience includes captives, self-insurance, and other risk financing techniques. Len Scioscia, EPIC Northeast …

https://www.epicbrokers.com/insights/northeast-strategic-hires/