ERISA Lawsuit Alleges Mismanagement of Prescription Drug Benefits

ERISA Lawsuit Alleges Mismanagement of Prescription Drug Benefits

A proposed class action lawsuit filed against Johnson & Johnson (J&J) alleges that the company breached its fiduciary duties under ERISA by mismanaging its prescription drug benefits plan. The complaint asserts that J&J violated ERISA’s fiduciary duty of prudence in multiple ways and that this mismanagement cost the plan and its participants millions of dollars…

Health FSA Limit Increases for 2024

Health FSA Limit Increases for 2024

On Nov. 9, 2023, the IRS released Revenue Procedure 2023-34 (Rev. Proc. 23-34), which includes the inflation-adjusted limit for 2024 on employee salary reduction contributions to health flexible spending accounts (FSAs). For plan years beginning in 2024, the adjusted dollar limit on employees’ pre-tax contributions to health FSAs increases to $3,200. This is a $150…

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

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

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

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

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…

Common Myths of RBP Explained

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…