Agencies Issue Guidance on Coverage of OTC COVID-19 Tests
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Agencies Issue Guidance on Coverage of OTC COVID-19 Tests

On Jan. 10, 2022, the Depts. of Labor, Health and Human Services (HHS), and the Treasury issued FAQ guidance regarding the requirements for group health plans and health insurance issuers to cover over-the-counter (OTC) COVID-19 diagnostic tests. At-home COVID-19 tests must be covered even if they are obtained without the involvement of a health care…

Employee Benefit Plan Limits for 2022
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Employee Benefit Plan Limits for 2022

Many employee benefits are subject to annual dollar limits that are periodically updated for inflation. The IRS typically announces the dollar limits that will apply for the next calendar year well before the beginning of that year. This gives employers time to update their plan designs and ensure that their plan administration will be consistent…

COVID-19 Vaccine Coverage and Premium Discounts FAQs
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COVID-19 Vaccine Coverage and Premium Discounts FAQs

On Oct. 4, 2021, the Departments of Labor (DOL), Health and Human Services (HHS) and the Treasury (Departments) issued FAQs addressing rules regarding premium incentives for COVID-19 vaccinations and rapid coverage of preventive services for COVID-19. Highlights Premium discounts for COVID-19 vaccination generally must be offered as part of a wellness program. These wellness programs…

Affordability Percentages Will Decrease for 2022
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Affordability Percentages Will Decrease for 2022

On Aug. 30, 2021, the IRS issued Revenue Procedure 2021-36 to index the contribution percentages in 2022 for determining affordability of an employer’s plan under the Affordable Care Act (ACA). For plan years beginning in 2022, employer-sponsored coverage will be considered affordable if the employee’s required contribution for self-only coverage does not exceed: 9.61% of…

Medicare Part D Notices Are Due Before Oct. 15, 2021
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Medicare Part D Notices Are Due Before Oct. 15, 2021

Each year, Medicare Part D requires group health plan sponsors to disclose to individuals who are eligible for Medicare Part D and to the Centers for Medicare and Medicaid Services (CMS) whether the health plan’s prescription drug coverage is creditable. Plan sponsors must provide the annual disclosure notice to Medicare-eligible individuals before Oct. 15, 2021—the…

Open Enrollment 2022—Benefit Notices
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Open Enrollment 2022—Benefit Notices

Employers that sponsor group health plans should provide certain benefit notices in connection with their plans’ open enrollment periods. Some of these notices must be provided at open enrollment time, such as the summary of benefits and coverage (SBC). Other notices, such as the Women’s Health and Cancer Rights Act (WHCRA) notice, must be distributed…

Results-Oriented Wellness Programs
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Results-Oriented Wellness Programs

When implemented successfully, workplace wellness programs can reduce health care costs, increase employee productivity and reduce absenteeism. While some wellness programs encourage participation, others are results-oriented, meaning employees are encouraged to meet certain health goals or metrics. At American Health & Wellness, health coaches and integrated nutritionists design wellness strategies tailored to meet the needs…

The Time Is Now to Kick-start Open Enrollment Efforts
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The Time Is Now to Kick-start Open Enrollment Efforts

Over the course of the pandemic, many employees refrained from changing jobs due to high levels of uncertainty, along with mental and physical health issues. Now, as things return to normal, experts predict a massive wave of turnover in the second half of 2021. Open enrollment this year provides a fantastic opportunity for organizations to…

PCORI Fee Amount Adjusted for 2021
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PCORI Fee Amount Adjusted for 2021

The Affordable Care Act (ACA) imposes a fee on health insurance issuers and self-insured plan sponsors in order to fund comparative effectiveness research. These fees are widely known as Patient-Centered Outcomes Research Institute (PCORI) fees, and were originally scheduled to expire for plan or policy years ending on or after Oct. 1, 2019. However, a…