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Compliance Alert: CMS Extends Transition Policy for Non-ACA Compliant Plans

… s market reforms that took effect in 2014. The ACA includes key reforms that created new coverage standards for health insurance policies effective as of 2014. For example, the ACA imposes modified community rating standards and requires individual and small group policies to cover a comprehensive set of essential health benefits. Late in 2013, millions of Americans received notices informing them that their plans would be canceled because they did not comply with the ACA’s reforms – contrary to government assurances that if individuals had a plan they liked, they could keep it. Responding to pressure from consumers and Congress …

https://www.epicbrokers.com/insights/compliance-alert-cms-extends-transition-policy-for-non-aca-compliant-plans/

Compliance Alert: EEOC Removes Wellness Program Incentive Limits from Regulations

… In response, the EEOC recently removed the limits from its regulations effective January 1, 2019. Wellness program sponsors should be aware, however, that the remaining EEOC wellness rules remain intact, including certain notice requirements and that any wellness program providing incentives must be “voluntary” as defined under the EEOC rules. BACKGROUND The EEOC enforces the ADA and the Genetic Information Nondiscrimination Act (GINA), both of which affect wellness program design. The final ADA rules provided that incentives offered to an employee who answers disability-related questions or undergoes medical examinations as part of a wellness program may not exceed 30%

https://www.epicbrokers.com/insights/compliance-alert-eeoc-removes-wellness-program-incentive-limits-from-regulations/

Compliance Alert: DOL Announces Increased Health Plan Violation Penalties

QUICK FACTS The U.S. Department of Labor (DOL) recently issued its annual inflation-adjusted penalty amounts for certain Employee Retirement Income Security Act (ERISA) violations. The adjusted amounts are intended to create greater incentives to comply with certain federal laws applicable to health and welfare benefit plans. Federal agencies, including the DOL, are required to make annual adjustments to the adjusted civil penalty amounts by January 15 each year. The 2019 adjustments are effective for penalties assessed after January 23, 2019 with respect to violations occurring after November 2, 2015. BACKGROUND Legislation enacted in 2015 requires federal agencies to …

https://www.epicbrokers.com/insights/compliance-alert-dol-announces-increased-health-plan-violation-penalties/

Compliance Alert: Medicare Part D Disclosure to CMS

QUICK FACTS In order to make or receive tax-free contributions to a Health Savings Account (HSA), an individual may not have “disqualifying health coverage.” Disqualifying coverage is coverage that pays for or reimburses medical expenses before an individual meets the minimum deductible for coverage under a High Deductible Health Plan (HDHP). Examples of coverage that may disqualify an individual from making or receiving HSA contributions are general-purpose Health Flexible Spending Accounts (HFSA), Medicare, certain onsite health clinics, and certain telemedicine programs. Employers providing HSA contributions are responsible for determining that employees are not covered by any HSA-disqualifying …

https://www.epicbrokers.com/insights/compliance-alert-medicare-part-d-disclosure-to-cms/

The Path to the Verdict

… S. policies and our master program? Where exactly do defense costs sit in our excess towers? Are we treating defense control as a local administrative task or a global governance priority? Would you like to receive new articles? “*” indicates required fields First Name*Last Name*Email* Company*Area of Interest*– Choose Area of Interest —Employee BenefitsPersonal LinesProperty CasualtySmall BusinessIndustry*– Select Industry –AccountingAccounting FirmAgricultureApparelArchitects/EngineersAuto DealershipAutomotiveAviationBankingBiotechnologyBroker/DealerBusiness ManagementCannabisCaptiveChemicalsCommunicationsConstructionConsultingDentalEducationElectronicsEnergyEnergy – CompressionEnergy – DrillingEnergy – E&PEnergy – Engineering & ConstructionEnergy – IntegratedEnergy – MidstreamEnergy – MiningEnergy – Refining & RetailEnergy – RenewableEnergy – ServicesEngineeringEntertainmentEnvironmentalFinanceFine Art & SpecieFOFood & BeverageFuneral ServicesGamingGovernmentHealthcareHospitalityIndustrial ServicesInsuranceInsurance BrokerInsurance CompanyInvestment AdvisoryLaborLawLaw FirmMachineryManufacturingMarineMediaMedicalMFONot For ProfitOil / Gas / EnergyOtherPest ControlPrivate Equity & Investment BankingProfessional ServicesPublishingReal EstateRecreationRenewableRentalRetailRIASenior LivingShippingSoftwareSolarSports &

https://www.epicbrokers.com/insights/the-path-to-the-verdict/

EPIC Welcomes Nate Wood

We are excited to welcome Nate Wood as our new Principal on the Employee Benefits team in the San Francisco office. Nate brings over a decade of experience to EPIC, specializing in complex national accounts in the not-for-profit, financial institution, and food & beverage industries. Nate’s deep understanding of the benefits technology landscape, claims and cost mitigation techniques and alternative funding strategies uniquely position him to drive results for his clients and enhance our regional Employee Benefits Practice. “We are thrilled to have Nate join the EPIC benefits team in Northern California,” said NorCal President Bill Ferree. “He …

https://www.epicbrokers.com/insights/epic-welcomes-nate-wood/

When the AI Therapist Goes Rogue

… 24/7 availability in a system already strained by provider shortages. For insurers, however, they represent something else entirely: a new and poorly understood class of risk that does not fit neatly into existing underwriting frameworks. As algorithmic mental health tools move from fringe wellness apps to embedded components of employee benefits and care delivery, the risk implications are becoming harder to ignore. What AI Mental Health Tools Actually Are, and Why That Matters AI mental health platforms span a broad and often confusing spectrum. At one end are regulated digital therapeutics that operate under FDA oversight and are used …

https://www.epicbrokers.com/insights/when-the-ai-therapist-goes-rogue/

Why U.S. Subsidiaries Need a Specialized U.S. Insurance Broker — Now More Than Ever

… Pillars—Not One Global brokers provide strategy, governance, and cohesion. Specialized U.S. brokers, in partnership with the global brokers, ensure that strategy survives contact with U.S. litigation, regulation, and operational nuance. For global executives responsible for certainty, predictability, and cost discipline, the question is no longer: “Why would we add a U.S. broker?” The real question is: “Why would we face the U.S. market without one?” Would you like to receive new articles? “*” indicates required fields First Name*Last Name*Email* Company*Area of Interest*– Choose Area of Interest —Employee BenefitsPersonal LinesProperty CasualtySmall BusinessIndustry*– Select …

https://www.epicbrokers.com/insights/why-us-subsidiaries-need-specialized-us-insurance-broker/