Insights

Note the focus of this FAQ is on Medicare coverage for individuals age 65 or older, not those who may be Medicare-eligible due to disability. This addresses the effective dates of Part A (inpatient hospital and skilled nursing facilities) and Part B (physician’s visits, outpatient hospital services, durable medical equipment, etc.); however, it does not cover the effective date of Part D (prescription drug coverage) or Part C (also known as Medicare Advantage). Generally, Medicare coverage begi

New technologies are being integrated into the built environment at an unprecedented pace. Within the energy sector, the adoption of new technologies into its built environment portfolios is urgently needed. The global economy is accelerating its journey to ween itself off of fossil fuel energy sources and replace them with sources that bring little to no carbon emissions: renewables. The game is simple – transition fossil fuel energy sources to renewable energy sources as quickly as possible a

Staying on track to meet annual goals means keeping a watchful eye on current market trends and understanding what they could mean for your organization now and moving forward. Having an idea of what today’s trends could mean for tomorrow can be the difference between making a costly error or the right move. With the right information, you’re better positioned for success. As we move into the second half of 2023, the Midyear 2023 Specialty Claims Journal and Trend Report offers a recap on marke

Employers that offer Group Term Life Insurance (GTLI) have several compliance obligations related to this popular employee benefit. Whether the premium for GTLI is entirely employer-paid or employee-paid (referred to as supplemental, voluntary, or optional life policies), GTLI benefits must follow applicable ERISA fiduciary, disclosure, and reporting requirements and IRC Section 79 rules on nondiscrimination and imputed income. In this webinar, the Benefits Compliance team reviewed the complian

“Point solution” programs are specific services that add value to an employer’s major medical plan or benefits program. Point solution programs are generally provided through third-party vendors. They often target benefit plan enhancements that range from specific condition management to digital solutions and apps to overall benefit program simplification. Some common examples of services provided through point solution programs include fertility, musculoskeletal, developmental disability, and

On June 23, 2023, the Office of Superintendent of Insurance (OSI) released Bulletin 2023-017 which provides interim guidance on MEWA registration.  The guidance is directed at what it calls “employee leasing contractors” (otherwise known as professional employee organizations (PEOs)) seeking to register as MEWAs under New Mexico’s new law that codifies employee leasing contractors as MEWAs.   Generally, the guidance acknowledges that the MEWA application requirements as presently writ

Massachusetts enacted the new Behavioral Health Access and Crisis Intervention Trust Fund surcharge, which is a surcharge on certain payments made to Massachusetts acute hospitals and ambulatory surgical centers (ASCs). The surcharge requirement is applied to both fully insured and self-insured plans. The insurers for fully insured plans and TPAs for self-insured plans where a TPA makes payments to ASCs are directly responsible for administering the payments with the Massachusetts Executive Off

On June 14, 2023, the CMS launched a dedicated website with resources and customer service information to educate patients, providers and insurers about the No Surprises Act surprise billing rules that protect patients from unexpected out-of-network medical bills. The website also has a link to connect to the national customer service hotline, where patients can get answers about their medical billing issues or file a complaint if they believe surprise billing protections apply to them. CMS No

On July 7, 2023, the DOL, HHS and IRS (the departments) issued a proposed rule (with an accompanying fact sheet) to amend certain requirements regarding limited duration insurance and excepted benefits coverage. The proposed rule also clarifies the tax treatment of fixed amounts received from accident and health coverage. Additionally, the departments are requesting comments regarding specific disease policies and level-funded plans. The proposed rule follows several Biden Administration Execut