PCORI Fees Due Aug. 1, 2022
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PCORI Fees Due Aug. 1, 2022

The Affordable Care Act (ACA) requires health insurance issuers and self-insured plan sponsors to pay Patient-Centered Outcomes Research Institute fees (PCORI fees). The fees are reported and paid annually using IRS Form 720 (Quarterly Federal Excise Tax Return). Issuers and plan sponsors are generally required to pay the PCORI fees annually by July 31 of…

DOL Issues Guidance on FMLA and Mental Health Conditions
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DOL Issues Guidance on FMLA and Mental Health Conditions

The Wage and Hour Division of the U.S. Department of Labor (DOL) has released new resources on workers’ rights to leave for mental health conditions under the federal Family and Medical Leave Act (FMLA). In a press release, the DOL said it published the new guidance in recognition of Mental Health Awareness Month. Highlights Mental…

Notice of Benefit and Payment Parameters for 2023
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Notice of Benefit and Payment Parameters for 2023

On April 28, 2022, the Department of Health and Human Services (HHS) filed its final Notice of Benefit and Payment Parameters for 2023. This final rule describes benefit and payment parameters under the Affordable Care Act (ACA) that apply for the 2023 benefit year. Finalized standards in the rule include: Updated annual limitations on cost…

Containing Costs of Chronic Health Conditions
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Containing Costs of Chronic Health Conditions

Chronic conditions are health conditions that require ongoing management over an extended period of time. Some have very few symptoms, while others severely limit a person’s ability to perform everyday routine tasks. Regardless, chronic conditions may deeply affect those who suffer from them. Many chronic conditions affect the workforce today, including cancer, diabetes, obesity and…

Study Finds a 7,000% Increase in Telehealth Utilization During Pandemic
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Study Finds a 7,000% Increase in Telehealth Utilization During Pandemic

According to a new report, telehealth usage grew more than 7,000% during the first year of the pandemic. This is the process of communicating with a doctor via an app, or a webcam and computer. FAIR Health’s annual report studies health care indicators, prices and utilization trends. With the latest data, researchers tracked changes from…

Transparency in Health Coverage
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Transparency in Health Coverage

New transparency in coverage requirements apply to group health plans and health insurers in the individual and group markets. These rules require plans and issuers to disclose certain price and cost information to participants, beneficiaries and enrollees. These provisions only apply to non-grandfathered coverage, including both insured and self-insured group health plan sponsors. The requirements…

Telehealth Coverage for HDHPs Extended
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Telehealth Coverage for HDHPs Extended

A spending bill signed into law on March 15, 2022, extends the ability of high-deductible health plans (HDHPs) to provide benefits for telehealth or other remote care services before plan deductibles have been met without jeopardizing health savings account (HSA) eligibility. This extension applies to any telehealth services from April 2022 through the end of…

Women’s Preventive Services Guidelines Updated
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Women’s Preventive Services Guidelines Updated

The Department of Health and Human Services’ (HHS) Health Resources and Services Administration (HRSA) recently updated its preventive services guidelines to expand the list of women’s preventive services that group health plans are required to cover under the Affordable Care Act (ACA). Updated preventive services guidelines generally take effect for plan years beginning on or…

Reminder: Medicare Part D Disclosures due by March 1, 2022 for Calendar Year Plans
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Reminder: Medicare Part D Disclosures due by March 1, 2022 for Calendar Year Plans

Group health plan sponsors are required to complete an online disclosure form with the Centers for Medicare & Medicaid Services (CMS) on an annual basis and at other select times, indicating whether the plan’s prescription drug coverage is creditable or non-creditable. This disclosure requirement applies when an employer-sponsored group health plan provides prescription drug coverage…