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Biden-Harris Administration Issues Third Rule To Implement No Surprises Act | California Employee Benefits Group

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  WASHINGTON – The Biden-Harris administration – through the departments of Labor, Health and Human Services, Treasury and the Office of Personnel Management – today issued an interim final rule with comment period to continue implementation of the No Surprises Act, a consumer protection law that helps curb the practice known as “surprise billing” for medical care. … Continued

The Affordability Test for 2022 Health Plans | CA Employee Benefits Agents

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The Affordable Care Act’s employer shared responsibility provision — often called the employer mandate or “play or pay” — requires large employers to offer health coverage to their full-time employees or face a potential penalty. (Employers with fewer than 50 full-time and full-time-equivalent employees are exempt.) Large employers can avoid the risk of any play … Continued

MEDICAL LOSS RATIO (MLR) REBATES 2020

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Are you an employer that is receiving a rebate check from your group medical insurance carrier? September 30 is the deadline for insurers to issue rebates, if required, under the Affordable Care Act’s medical loss ratio (MLR) rule. It is estimated that insurers will return over a quarter billion dollars to employer groups this year. … Continued

DOL Issues Final Regulations Regarding Association Health Plans | CA Employee Benefits Team

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On June 19, 2018, the U.S. Department of Labor (DOL) published Frequently Asked Questions About Association Health Plans (AHPs) and issued a final rule that broadens the definition of “employer” and the provisions under which an employer group or association may be treated as an “employer” sponsor of a single multiple-employer employee welfare benefit plan … Continued

Proposed 2020 Benefit Payment and Parameters Rule | California Benefits Group

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The Centers for Medicare & Medicaid Services (CMS) released a proposed rule for benefit payment and parameters for 2020. CMS also released its draft 2020 actuarial value calculator and draft 2020 actuarial value calculator methodology. According to CMS, the proposed rule is intended to reduce fiscal and regulatory burdens associated with the Patient Protection and … Continued

PCORI Fee Increase for Health Plans | California Employee Benefits

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On November 5, 2018, the Internal Revenue Service (IRS) released Notice 2018-85 to announce that the health plan Patient-Centered Outcomes Research Institute (PCORI) fee for plan years ending between October 1, 2018 and September 30, 2019 will be $2.45 per plan participant. This is an increase from the prior year’s fee of $2.39 due to … Continued

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