Time to Comply with Health Plan Transparency Rules

| posted in Newsletter

July 1 was the deadline for health plans to make public their in-network negotiated rates, out-of-network billed charges, and more. While health plans will be required to post this information, employers who sponsor their group health insurance for their employees will need to take steps to ensure that their plans comply with the law, if they have not already done so. The transparency rules taking effect were ushered in by the Consolidated Appropriations Act of 2021 and rulemaking from the 2020 Transparency in Coverage Rules by the Centers for Medicare and Medicaid Services. The rules require that non-grandfathered insured and…
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What You Need to Know About New Health Plan Transparency Rules

| posted in Newsletter

Regulations are slated to take effect over the next few years that will greatly increase the transparency requirements for group health plans. The regulations issued under the Trump administration will require health insurers in the individual and group health markets to disclose cost-sharing information upon request, make cost-sharing information available on their websites and disclose negotiated rates with in-network providers. The rules are designed to help health plan enrollees choose the plan that is best for them and their family, as well as to give them a full picture of what they can expect to pay for services as part…
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Rules Allowing Mid-Year Health Plan, FSA Changes Will Sunset

| posted in Newsletter

A temporary rule that allowed covered employees to make mid-year election changes to their health plans and revisit how much they set aside into their flexible spending accounts (FSAs) will sunset at the end of the year. The rules gave employers the option to allow their employees to make changes to their health plans, including choosing a new offering, but it did not require that they allow them to make these changes. The more relaxed rules were the result of provisions in the Consolidated Appropriations Act, 2021, which was signed into law in December 2020 by President Trump, and subsequent…
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IRS Lets Employers Give Workers a Break on FSA Contributions, Health Plan Rules

| posted in Blog, Newsletter

A number of changes in recent months have given employees extra benefits and flexibility when it comes to utilizing Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSAs). The newly signed American Rescue Plan Act of 2021 raised FSA contribution limits and the COVID relief bill signed in late 2020 gave employees additional flexibility in the use of funds and making election changes. The IRS recently released additional guidance, in response to the COVID-19 pandemic, that allows employees to make changes to their health plans outside of the traditional open enrollment period. The COVID relief bill signed into law at…
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How a New Law Affects Group Health Plans & Cost Transparency

| posted in Blog, Newsletter

The newly enacted Consolidated Appropriations Act, 2021 contains a number of provisions that will affect group health plans, with most changes aimed at helping insured workers with flexible spending accounts (FSAs), cost transparency and surprise billing. Some of the provisions are permanent while others are temporary, slated to run through the anticipated end of the COVID-19 pandemic. Highlights of The Consolidated Appropriations Act FSA carryover rules loosened The new law authorizes employers to amend their cafeteria plans and FSAs to either: Allow participating staff to carry over unused amounts from the 2020 plan year to the 2021 plan year (and…
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Employees Satisfied with Plans, but Health Plan Costs a Burden

| posted in Blog, Newsletter

While health insurance premiums aren’t going up as much as they have in past years, both employers and their workers are still struggling with higher health care costs. Whether it’s higher deductibles or out of pocket maximums, health plan costs continue to be a financial burden on American families. According to the “2018 Health and Voluntary Workplace Benefits Survey,” published by the Employee Benefit Research Institute together with Greenwald & Associates, roughly half of all workers experienced an out-of-pocket cost increase in their workplace health insurance plans. That’s roughly the same percentage as in 2017, but lower than the 61%…
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Many Employees Choosing the Wrong Health Plans

| posted in Blog, Newsletter

A new study has found that many people in employer-sponsored health plans are enrolling in plans that are costing them more than they ought to be paying. Many employees choose pricey plans with low deductibles, which force them to spend more up front on premiums to save just a few hundred dollars on their deductible. As result, many employees are spending hundreds, if not thousands of dollars more on their health care/health coverage than they need to. A study by Benjamin Handel, a U.C. Berkeley economics professor, found that the majority of employees at one company he studied were in…
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Crackdown on Employers Who Shunt Employees onto Medicare

| posted in Blog

The Centers for Medicare and Medicaid Services (CMS) is stepping up efforts to root out employers who have improperly put workers who were eligible for the company’s group health plan into Medicare. Under the law, employers are prohibited from offering incentives of any kind to a Medicare-eligible individual to enroll in Medicare instead of the employer’s health plan. Companies with 20 or more employees may not encourage covered employees and/or dependents to make this change in coverage. The fine for encouraging an employee or dependent to take Medicare is $5,000 per situation, but that’s not the largest potential penalty. The…
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