What Can We Expect in Terms of Federal Regulations Now That Election Season is Almost Over?

Jessica Waltman – Principal of Forward Health Consulting Since nothing is normal in 2020, Election Day decided to stretch itself out over two seasons this year. We won’t know which political party will control the United States Senate until January. Still, as states move to certify their election results, it is clear that former ViceContinue reading “What Can We Expect in Terms of Federal Regulations Now That Election Season is Almost Over?”

Major New COVID-19 and Transparency Regulations Issued Days Before the Election

Jennifer Spiegel Berman, JD, MBA – CEO of MZQ Consulting Jessica Waltman – Principal of Forward Health Consulting Two substantial new sets of final regulations were released on October 30, 2020, just days before the election.  The first clarifies and refines certain federal policies in response to COVID-19.  The second is the long-awaited transparency rulesContinue reading “Major New COVID-19 and Transparency Regulations Issued Days Before the Election”

Data, Information, and Healthcare Price Transparency

Submitted by Ed Oleksiak, Senior Vice President of Employee Benefits for Holmes Murphy. Used with permission from Holmes Murphy. Despite an election year’s numbing impact on regulatory and legislative healthcare change, one issue that could move forward in 2020 is “healthcare price transparency.” On June 24, 2019, President Trump issued Executive Order 13877 directing federal agencies toContinue reading “Data, Information, and Healthcare Price Transparency”

What is Medical Loss Ratio and How Do You Handle MLR Rebates?

Submitted by Annette Bechtold, Senior Vice President of Regulatory Affairs and Reform Initiatives for OneDigital. Used with permission from OneDigital. The Medical Loss Ratio, or MLR, is the percentage of premium dollars received by a health insurance carrier that is spent on medical claims and quality improvement. The Affordable Care Act (ACA) requires health insurance carriersContinue reading “What is Medical Loss Ratio and How Do You Handle MLR Rebates?”

IRS Expands List of Preventive Care for HSA Participants to Include Certain Care for Chronic Conditions

Today the IRS added care for a range of chronic conditions to the list of preventive care benefits that may be provided by a HSA compatible high deductible health plans (HDHP). Notice 2019-45, lists the new types of medical care that may be treated as preventive care for this purpose. Individuals covered by an HSAContinue reading “IRS Expands List of Preventive Care for HSA Participants to Include Certain Care for Chronic Conditions”

A Detailed Look at Considerations for the New HRA Options

The final rule regarding HRA expansion was released and scheduled to take effect for plan years beginning on or after January 1, 2020. The rule was in response to the October 12, 2017 executive order issued by President Trump to prioritize near-term improvement: association health plans (AHPs), short-term, limited-duration insurance (STLDI), and health reimbursement arrangements.Continue reading “A Detailed Look at Considerations for the New HRA Options”

ACA Affordability – Managing Risk

Submitted by Ken Stevenson, Vice President of Employee Benefits at Earl Bacon Agency Beginning with Plan years that started in 2015 Applicable Large Employers (50 or more fulltime employees including equivalents in the PRECEDING calendar year) had to concern themselves with a little thing called the “Affordability Threshold”.  The original Affordability Threshold was 9.5%.  NotContinue reading “ACA Affordability – Managing Risk”

Update on the Women’s Contraceptive Coverage Regulations

Submitted by Carol Taylor, Account Executive and Compliance Officer, Kirby Employee Benefits, Jupiter, FL Since the passage of the Affordable Care Act in 2010, the coverage for preventive care has been a changing landscape. There have been numerous changes to the U.S. Preventive Services Task Force ratings for A & B recommended evidence-based items orContinue reading “Update on the Women’s Contraceptive Coverage Regulations”

HRA Expansion: An In-Depth Look at the Proposed Rule

Submitted by Annette Bechtold, Senior Vice President of Regulatory Affairs and Reform Initiatives for OneDigital In response to President Trump’s October 12, 2017 Executive Order, the Departments of Health and Human Services, Treasury and Labor issue the proposed rule expanding Health Reimbursement Arrangements. This third and final rule aims to provide employers with additional optionsContinue reading “HRA Expansion: An In-Depth Look at the Proposed Rule”