Insights

The US Department of Health and Human Services (HHS) has released additional guidance to help plans and insurers navigate independent dispute resolution (IDR) when processing claims covered by the No Surprises Act (NSA) balance billing protections. The NSA passed as part of the Consolidated Appropriations Act, 2021, includes surprise billing protections for emergency services, air ambulance services and non-emergency services delivered by nonparticipating providers at in-network facilities. Par

On August 3, 2022, the IRS issued Notice 2022-33, which extends deadlines for amending nongovernmental qualified retirement plans, 403(b) plans, and IRAs to reflect changes under the SECURE Act and certain provisions of the CARES Act. Absent this relief, the plan amendments would have been required by the last day of the first plan year ending on or after January 1, 2022. Specifically, the notice extends plan amendment deadlines for changes made by the Secure Act until December 31, 2025. Addit

On August 1, 2022, the IRS published Revenue Procedure 2022-34, which provides the 2023 premium tax credit (PTC) table and the employer contribution percentage requirements applicable for plan years beginning after December 31, 2022. The ACA's employer-shared responsibility rules (also known as the "employer mandate") require an employer to provide affordable, minimum value coverage to its full-time employees. The IRS' required contribution percentage is used to determine whether an employer-sp

As we were all looking forward to the weekend on Friday, August 5, 2022, a decision in the West Virginia Supreme Court, Fairmont Tool Inc. v. Opyoke, came down that emphasized the importance of the Family Medical Leave Act's (FMLA) notice requirements. The FMLA requires an employer to provide employees with certain information about FMLA leave, commonly referred to as the notice requirements. Generally speaking, once an employee makes a request for FMLA leave, the employer must provide three se

Coming together to put success into action means establishing a strong base of knowledge. Staying on top of where the market is and where it could be headed for your specialty industry is the first step in making crucial choices that enable your organization to thrive. The Q2 2022 Specialty Claims Journal and Trend Report offers analysis and insight into the second quarter of the year from industry specialists, in addition to key predictions going forward. Discover critical information on where

As you build or update your strategy to be inclusive of benefits, scheduling, work-culture and flexibility, empathy will be your guide to the delicate dance of reflecting on current practices and offerings and then looking outside your previous assumptions about employees' ability and willingness to compartmentalize their life stressors. Here are five things to consider if you want to boost well-being among your employees: 1. Home Access to Care Is a Non-Negotiable Now that more than half of em

You research HR trends and you get to know your employees so you can build a benefits program that truly supports them. You diversify your offerings so every life in your diverse workforce knows their employer is there to partner with them and elevate their work experience. You compete for top talent, win it and retain it with a stellar benefits package. You've worked hard to develop an HR strategy, and that strategy will keep your organize at the top - as long as you're also compliant when it

On July 28, 2022, the DOL, IRS and Department of Treasury jointly issued Part 54, FAQs About Affordable Care Act Implementation. The newly issued guidance includes 14 frequently asked questions related to coverage of preventive services, specifically women's preventive services and contraception. As a reminder, the ACA requires non-grandfathered group health plans to provide coverage for certain preventive care services with no cost-sharing for participants. Please note that male sterilization

Generally, an employer can vary benefits and contributions by bona fide employment classifications. However, even where such classifications exist, the employer should ensure that the variations comply with the applicable nondiscrimination rules. Section 125 nondiscrimination rules apply to benefits and contributions made through a cafeteria plan. Section 105 rules apply to self-insured plans, including HRAs. Both sets of rules are designed to prohibit discrimination in benefits and contributi