Medicare Part D Notices Are Due Before Oct. 15, 2023
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Medicare Part D Notices Are Due Before Oct. 15, 2023

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, 2023—the…

DOL Releases Updated Model Employer CHIP Notice
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DOL Releases Updated Model Employer CHIP Notice

The Department of Labor (DOL), through its Employee Benefits Security Administration (EBSA), has released a new model Employer CHIP Notice with information current as of July 31, 2023. As a reminder, the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) imposes an annual notice requirement on employers that maintain group health plans in states…

Pay or Play Affordability Percentage Will Decrease for 2024
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Pay or Play Affordability Percentage Will Decrease for 2024

On Aug. 23, 2023, the IRS issued Revenue Procedure 2023-29 to index the contribution percentage in 2024 for determining the affordability of an employer’s plan under the Affordable Care Act (ACA). For plan years beginning in 2024, employer-sponsored coverage will be considered affordable under the ACA’s pay or play rules if the employee’s required contribution…

What You Should Know About Newborn Health Coverage
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What You Should Know About Newborn Health Coverage

Welcoming a newborn into your family is a joyous occasion. It also comes with significant responsibilities, such as ensuring your infant’s health and properly using your health care benefits. Securing health insurance for your newborn is a crucial step toward making sure they receive the medical treatment they need, safeguarding their health, and providing you…

Draft Forms for 2023 ACA Reporting Released
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Draft Forms for 2023 ACA Reporting Released

The IRS has released draft 2023 forms for reporting under Internal Revenue Code Sections 6055 and 6056. Draft instructions for these forms have not yet been released. No major substantive changes were made to the draft forms for 2023 reporting. However, certain changes may be made once these forms are finalized or when draft or…

HSA/HDHP Limits Will Increase for 2024
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HSA/HDHP Limits Will Increase for 2024

On May 16, 2023, the IRS released Revenue Procedure 2023-23 to provide the inflation-adjusted limits for health savings accounts (HSAs) and high deductible health plans (HDHPs) for 2024. The IRS is required to publish these limits by June 1 of each year. These limits include: These limits vary based on whether an individual has self-only…

Common Myths of RBP Explained
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Common Myths of RBP Explained

Employers are getting creative in an effort to reduce their healthcare costs, including looking for alternatives to the typical preferred provider organization (PPO) plan. Many are choosing self-insurance coupled with reference-based pricing (RBP), which is the assessment and payment of medical claims based on Medicare reimbursement data or the provider’s self-reported cost to deliver the…

How Reference-based Pricing Works
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How Reference-based Pricing Works

A full-service health plan solution with the savings of reference-based pricing (RBP) built-in provides savings that could never be achieved with a PPO, and more freedom too. And with those cost savings, employers are laying the groundwork to be more competitive. The reference-based pricing (RBP) model starts at the bottom with an actual cost amount,…