Preparing Employers and Employees for 2021 Benefit Plans Decisions
On Dec. 11, 2024, the OIG issued a Special Fraud Alert (Alert) related to certain fraud and abuse risks associated with marketing arrangements between Medicare Advantage Organizations (MAOs) and health care professionals...more
Over the past several months, numerous large employers and their health plan fiduciaries have faced lawsuits regarding their health plan’s tobacco surcharge. A tobacco surcharge wellness program typically charges a higher...more
On November 26, 2024, Centers for Medicare & Medicaid Services (“CMS”) released a proposed rule revising the Medicare Advantage (“MA”) Program (Part C), Medicare Prescription Drug Benefit Program (Part D), Medicare Cost Plan...more
As our readers know, the Centers for Medicare & Medicaid Services (“CMS”) prohibits certain marketing communications, materials, and activities. With Medicare’s open enrollment period nearing an end, now is a good time to...more
With Medicare’s open enrollment period (October 15, 2024 – December 7, 2024) in full swing, now is a good time to discuss the many nuances of Medicare marketing that exist both during and outside of the open enrollment...more
It’s hard to keep up with all the recent changes to labor and employment law, especially since the law always seems to evolve at a rapid pace. In order to ensure you stay on top of the latest changes and have an action plan...more
On October 17, 2024, the IRS published Notice 2024-75 (Notice), expanding preventive care benefits that can be provided under a high deductible health plan (HDHP) before an individual reaches the applicable minimum HDHP...more
With Medicare’s open enrollment commencing on October 15, 2024, now is a good time to discuss the Centers for Medicare & Medicaid Services’ (“CMS”) marketing rule changes for the 2025 contract year. In addition to complying...more
There are important new rules this year relating to prescription drug coverage which may be relevant to your Medicare plan beginning January 1, 2025. The “Open Enrollment” period this year during which eligible individuals...more
The 2025 open enrollment season for employee benefits is swiftly approaching. With newly released IRS guidance, employers should review the cost of their group health plan(s) to ensure affordability. Companies that rely on...more
Open enrollment season can put a spotlight on the many complex rules applicable to employer-sponsored health and welfare plans. As you announce your benefit offerings for the upcoming plan year and tirelessly work to inform...more
Employees increasingly request (and expect) choice in their benefits. The Internal Revenue Service (IRS) recently released Private Letter Ruling 202434006 (PLR), which approved an employer's program allowing employees to...more
The U.S. Department of Labor (DOL) announced two settlements with major insurance companies this month that highlight the importance of employers avoiding the collection of group life insurance premiums from employees until...more
Last week, the Biden-Harris administration (the Administration) announced a new rule simplifying the process for enrolling in Medicaid, the Children’s Health Insurance Program (CHIP), and the Basic Health Program (BHP)....more
The Centers for Medicare & Medicaid Services (CMS) updated its guidance on the Inflation Reduction Act of 2022’s (P.L. 117-169) (IRA) Medicare Prescription Payment Plan (M3P) with its release of the Final Part One Guidance on...more
This post was updated on February 6, 2024, to reflect the 2024 Federal Poverty Level announced in January 2024. On August 23, 2023, the Internal Revenue Service issued Rev. Proc. 2023-29, announcing that the Affordable...more
Inevitably, an employee will wake up from their holiday food coma and realize that they made a mistake in open enrollment. “But I didn’t mean to elect family coverage! My spouse is covering the kids this year!” Employers are...more
Your Health, Your Choice: A Guide to Medicare Open Enrollment - The Medicare open enrollment period runs through December 7th, 2023. Medicare adjusts costs, coverage, and accepted providers on an annual basis. If you have...more
The Medicare open enrollment period runs through December 7th, 2023. Medicare adjusts costs, coverage, and accepted providers on an annual basis. If you have received “Evidence of Coverage,” or an “Annual Notice of Change,”...more
On November 2, 2023, the Centers for Medicare and Medicaid Services (CMS) issued its 2024 Physician Fee Schedule final rule (Final Rule) for calendar year 2024 that will, in part, implement some of the most important changes...more
Anyone responsible for the administration of a 401(k) retirement plan probably has a “to-do” list that never ends. For example, as soon as a plan administrator files the Annual Report Form 5500 for the prior year, it is time...more
Open enrollment is rapidly approaching for employers with calendar-year employee benefit plans. Following are ten important issues for employers to consider for the 2024 open enrollment season...more
Most employers that operate health plans on a calendar-year basis kick-off open enrollment in November – which means you’re likely gearing up now for the annual influx of questions, benefit changes, and associated tasks....more
Employers, this is your annual reminder that the Centers for Medicare & Medicaid Services (CMS) requires sponsors of group health plans to notify eligible individuals whether the employer’s prescription drug coverage is...more
On August 23, the Internal Revenue Service issued Rev. Proc. 2023-29, announcing that the Affordable Care Act (ACA) affordability threshold will be 8.39% for plan years beginning in 2024, a substantial decrease from the 9.12%...more