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If your company administers a self-funded medical plan, you need to be aware of benefit changes that should be made in 2017 to comply with Section 1557 of the Affordable Care Act. Section 1557 prohibits discrimination on the basis of sex, age, race, color, national origin, and disability. 
 
The regulations were released by the Department of Health and Human Services (HHS), and specific requirements were laid out for health insurance coverage for transgender individuals. 
Published in Healthcare Legislation

Employers that offer partially self-funded medical plans are subject to the Transitional Reinsurance fee established by the Patient Protection and Affordable Care Act (PPACA). 

This fee was imposed over a three year period, with 2016 being the third and final year. The fee in 2016 is $27 per average covered life (both employees and dependents) covered on the health plan in 2016.  

Partially self-funded plans need to take action soon by reporting their average number of covered lives for the first 9 months of 2016 to The Department of Health and Human Services (HHS) by the deadline of November 15th, 2016.

Published in Compliance

The annual Kaiser Family Foundation/Health Research & Education Trust Employer Survey is always a great source of information about the trends in employer-sponsored health coverage.  This year’s big conclusion is that while final premium increases were not that high, the average was markedly reduced by even more movement to cost-saving High Deductible Health Plans (HDHPs), which means employees likely have less rich benefits than before.

Published in Industry Trends

On January 1, 2017, new wellness program rules from the Equal Employment Opportunity Commission (EEOC) go into effect. These rules differ a bit from those under HIPAA and the ACA, so we recommend every employer review and revise their wellness program to ensure compliance, including new rules around incentives, new limitations on the types of info gathered in Health Risk Assessments on family members, and newly required notices you must provide to employees.

Published in Wellness
Monday, 26 September 2016 20:35

Ready for Amendment 69?

Amendment 69: Know Before you Vote

 

By now you’ve most likely heard of Amendment 69, but maybe don’t know much about it.  Amendment 69 will be the first option on the November ballot, so now’s the time to educate yourself and your employees about this important healthcare bill!

The Amendment proposes that Colorado implement the first single-payer healthcare system in the nation, called ColoradoCare.  This universal healthcare system would cover all Colorado residents and provide the same benefit level to everyone, regardless of taxpayer or citizenship status.  To finance the plan, a new 10% payroll tax would be created, with employers paying 6.7% and employees paying 3.3%.  Self-employed persons would pay

Published in Healthcare Legislation

Employers spend approximately 18-20% of their healthcare costs on prescription drugs, and the rapidly increasing cost of specialty drugs is causing this to inch ever up.  To offset these cost hikes, we’re always keeping our eyes on expensive drugs that are coming off patent and facing cost-slashing competitors soon. There are eight blockbuster drugs (those with a billion dollars or more in sales) coming off patent in 2016.  

Published in Industry Trends
Tuesday, 06 September 2016 20:08

Important Medicare Part D Deadline October 15th

The Medicare Modernization Act (MMA) requires Employers with prescription drug coverage to complete two items each year regarding Medicare Part D.  The first deadline is October 15th annually, and the other is 60 days from the beginning of each new plan year.  
The only employers exempt from this requirement are those that are small enough to be certain that their plan does not cover anyone eligible for Medicare such as employees or spouses over 65, anyone in end stage renal failure, or any disabled individuals. If you’re not positive – we recommend you comply to be safe.  

Published in Compliance
On July 11, 2016, the Department of Labor (DOL) and Internal Revenue Service (IRS) announced a proposal to implement significant changes to the forms and regulations that govern annual employee benefit plan reporting on Form 5500. 
 
Most notably, the revisions would require companies of any size or funding arrangement to file a Form 5500 as well as add a new Schedule J (Group Health Plan Information) to the Form 5500. 
 
The proposed changes, which were published in the Federal Register on July 21, 2016, would considerably increase the annual reporting obligations for nearly all health and welfare plans. The revised reporting requirements, if adopted, would apply for plan years beginning on and after January 1, 2019.  
Published in Healthcare Legislation
On June 1, 2016, Colorado Governor John Hickenlooper signed the Colorado Pregnant Workers Fairness Act.  This new provision provides clear standards that employers should follow when employing pregnant workers, as well as a new notice requirement.
 
Effective August 10, 2016, Colorado employers of all sizes will commit an unfair employment practice if they fail to provide reasonable accommodations for an employee, or an applicant for employment, for health conditions related to pregnancy or physical recovery from childbirth, absent an undue hardship.  
Published in Compliance
Sunday, 28 August 2016 17:37

Handling ACA Subsidy Notifications and Appeals

By now many employers have received notices from CMS stating that they are subject to a penalty under the Employer Mandate (for groups over 50) created by the ACA.  If you are one of them, you may be wondering why you’re getting these and what your next steps are.
 
Remember that The Centers for Medicare and Medicaid Services (CMS) and the IRS are using your 1094 and 1095 forms submitted earlier this year to verify individual subsidy eligibility, and to enforce the Individual and Employer Mandates.  
Published in Healthcare Legislation
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