Insights

On May 10, 2023, the Department of Commerce and Insurance issued Bulletin 2023-03 to remind Tennesseans of the potential effect of the state’s cost-sharing requirements on HSA eligibility.   Tennessee requires insurers to apply all cost-sharing amounts toward the enrollee’s contribution to any applicable cost-sharing requirements regardless of whether they are paid by an enrollee or on behalf of the enrollee by another person. The bulletin summarizes IRS guidance which provides that an HDH

FSAs and HSAs come with a myriad of compliance rules. In this webinar, the Benefits Compliance team provided a review of the basic rules and nuanced issues surrounding these reimbursement arrangements. Agenda Health Flexible Spending Account (FSA) and Health Savings Account (HSA): Overview Eligibility Contributions Distributions FAQs and Compliance Nuances (throughout) Final Takeaways Key Takeaways FSA Compliance Takeaways FSAs can provide significant tax savings to employees and employers.

Explore 12 core wealth transfer and charitable planning strategies.

Health and welfare plans subject to ERISA's Form 5500 reporting requirements (generally, plans with 100 or more participants) must report certain information to the DOL. For plans with fully insured coverage, this reporting obligation includes specific information about each insurance policy using the form's Schedule A ('Insurance Information'). Insurers are statutorily required to provide Schedule A information to plans, and although most insurers generally do so, mistakes, miscommunications,

On April 27, 2023, CMS published the 2024 Notice of Final Benefit and Payment Parameters and an accompanying fact sheet. The final rule is primarily directed at health insurers and the ACA marketplace but includes information that may indirectly impact group health plans. Generally, the annual parameters update the ACA requirements and uniform standards for marketplace coverage. Among other items, the 2024 changes are designed to improve network adequacy (e.g., by requiring provider networks fo

The CMS has released the latest update regarding the federal Independent Dispute Resolution (IDR) portal. Established just over one year ago on April 15, 2022, the portal allows providers, facilities, group health plans, health insurance issuers, and Federal Employee Health Benefits Program carriers to determine the appropriate out-of-network payment rate for items and services subject to the surprise billing protections in the No Surprises Act through an IDR process. CMS reported 334,828 dispu

On May 1, 2023, Gov. Shapiro signed Act 1 of 2023 into law. The law requires health insurance carriers in Pennsylvania to cover preventative breast and ovarian cancer screenings for high-risk women at no cost. As of June 30, 2023, the law applies to policies renewed or issued in the state. Employers sponsoring health plans in Pennsylvania should be aware of this development and contact their carriers for further information. 2023 Act 1 - PA General Assembly »

On April 25, 2023, the DOL's Employee Benefits Security Administration (EBSA) issued Field Assistance Bulletin No. 2023-01, providing guidance to multiemployer plans on how they can comply with ERISA annual funding disclosure requirements when they receive special financial assistance (SFA) under the American Rescue Plan Act. The EBSA presents the guidance as 11 Q&A's, which are explained in order below. The EBSA states that multiemployer plans should not consider any SFA they receive when

On April 13, 2023, in celebration of Autism Awareness Month, the DOL's Employee Benefits Security Administration (EBSA) Assistant Secretary, Lisa M. Gomez, publicly reaffirmed the agency's commitment to ensuring access to autism treatment benefits. Under the Mental Health Parity and Addiction Equity Act (MHPAEA), group health plans and health insurers that offer mental health benefits must not impose financial requirements (e.g., deductibles, copays, coinsurance, or out-of-pocket maximums), qua