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Why You Need a Specialist to Control Pharmacy Spend

As pharmacy costs continue to escalate, payors are introducing new strategies to combat spiraling costs while balancing appropriate access. But costs continue to be shrouded in mystery with jockeying between the various intermediaries for a share of the profits. The rebate game has garnered focus as pharmacy benefit managers (PBMs) maximize rebate compensation (contributing to pharmacy cost inflation) while attempting to have tight reins on net costs. As drug costs go up, so do the rebates – increasing profits to the intermediaries in the transaction. The latest issue of Benefits Pro magazine highlights new versions of these maneuvers. Viewpoints from Craig …

https://www.epicbrokers.com/insights/you-need-a-specialist-to-control-pharmacy-spend/

Latest Stimulus Bill Means Major Changes to COBRA Continuation and Benefits

On March 11, 2021, President Biden signed the American Rescue Plan Act of 2021 (ARPA). ARPA is the latest COVID-19 relief stimulus bill and it includes several benefits-related provisions, which are discussed in more detail below. ARPA became effective on March 11, 2021. Before a bill like ARPA becomes law, it must pass in Congress (both the Senate and House of Representatives), then be signed by the President. The Senate passed ARPA on Saturday, March 6, 2021. The U.S. House of Representatives spent four days debating the bill and passed a final version that Congress sent to …

https://www.epicbrokers.com/insights/latest-stimulus-bill-means-major-changes-to-cobra-continuation-and-benefits/

Virtual Care – The New Normal?

… healthcare will be a thing of the past and that we’ll start to see those numbers decline in the coming months of 2021. I, however, am a little more optimistic. I see COVID-19 as a catalyst – and virtual care isn’t going away. The president of our national employee benefits practice saw the value in this healthcare delivery model sharing his views in an article he wrote five years ago. The telehealth wave allowed providers to expand their access and reduce wait times, which are getting longer every year. The national average wait time, found in a 2017 …

https://www.epicbrokers.com/insights/virtual-care-the-new-normal/

Webinar Recording Now Available: The Impact of the American Rescue Plan Act of 2021 (ARPA)

… running from April 1, 2021, through September 30, 2021. Individuals who previously experienced an involuntary termination or reduction in hours but did not elect COBRA, or dropped COBRA coverage but are still within their COBRA maximum coverage period, are allowed a chance to enroll or re-enroll. PLAY RECORDING 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/impact-of-american-rescue-plan-act-of-2021-arpa/

New COVID-19 Relief Law Is No Relief for HR Departments

… whose hours were reduced; provided, however, that this does not extend the 18-month COBRA benefit period. This subsidy will be offset entirely by a reduction in payroll taxes, but COBRA costs are based upon premium-equivalent rates for similarly situated active employees. Typically, those employees who are receiving COBRA benefits have more adverse medical claims experience than active employees. Perhaps the selection won’t be as adverse, but clearly, there is exposure to employers to absorb higher costs. And even worse, those former employees who initially waived coverage will have a second chance to enroll – but unlike current COBRA …

https://www.epicbrokers.com/insights/new-covid-19-relief-law-is-no-relief-for-hr-departments/

Covering Coronavirus: Risk Considerations Volume 2, Issue 5

EPIC Risk Advisory Bulletin Volume 2, Issue 5 In this issue, we take a focused look at: Supply Chain and Business Risks Cybersecurity Resources Federal Railroad Administration Requires Masks Could Home Tests Bring Business Travel Back? Insurance Products and Coverage Information Business Interruption Presumptive Compensability News of Note Human Resources and Employee Benefits DOL Issues Guidance on Unemployment Benefits OSHA Audit on Pandemic Handling Covering Coronavirus Hospitalization Bills Coronavirus Vaccine Developments Insights from Across the Firm The information presented here is intended to provide a high level overview of critical areas of concern for businesses around coronavirus. Consult your EPIC …

https://www.epicbrokers.com/insights/covering-coronavirus-risk-considerations-volume-2-issue-5/

DOL Releases New Guidance on the COVID-19 Outbreak Period

… must continue beyond March 1, 2021. On February 26, 2021, the Department of Labor (DOL), in conjunction with the other regulatory Agencies, released Disaster Relief Notice 2021-01 (Notice 2021-01), giving guidance on the extension of the Outbreak Period. The guidance explains the operation of the continued relief afforded employee benefit plans, plan participants, and beneficiaries due to the COVID-19 national outbreak. The Outbreak Period was set to expire on March 1, 2021. As explained in a previous post, the Employee Benefits Security Administration of the Department of Labor (EBSA), in coordination with the Department of the Treasury …

https://www.epicbrokers.com/insights/dol-releases-new-guidance-on-the-covid-19-outbreak-period/

The Shifting Infertility Landscape

Viewpoints from Adam Okun Each decade there seems to be another benefit provision that goes through a major overhaul. Timothy’s Law, in New York State, and the federal Mental Health Parity and Addiction Equity Act (MHPAEA) ushered in dramatic changes to out-of-network mental health coverage in the 2000s. Preventive care and no-cost contraception coverage was a defining feature of the Affordable Care Act (ACA). And soon thereafter arrived a variety of state mandates around autism and transgender benefits. One provision that is now seemingly going through its coming of age is infertility. It’s been several …

https://www.epicbrokers.com/insights/the-shifting-infertility-landscape/