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Employers ‘Unwavering’ in Providing Group Health Benefits: Research

InterWest Insurance Services

The poll of 26 health benefits decision-makers at large firms, carried out by The Commonwealth Fund and the Employee Benefits Research Institute (EBRI), found that despite rising premium and health care costs, they felt obligated to offer health insurance instead of shunting employees to exchanges.

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New Health Plan Prescription Drug Reporting Mandate

AssuredPartners

For fully insured plans, health insurance carriers will be responsible for making the necessary reporting from a legal standpoint. Employers who sponsor self-funded health plans should coordinate with their self-funded TPA and pharmacy benefit manager (PBM) to ensure timely reporting of the required data.

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Departments Provide Relief for 2020 and 2021 Prescription Drug Reporting

Benefits Notes

In addition, plans and issuers now have until January 31, 2023 to provide a good faith submission of 2020 and 2021 data through the Health Insurance Oversight System. The prescription drug and health care spending reporting obligation falls on the group health plan.

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Healthcare Must be Focused on the Patient Journey 

HR Professionals Magazine

Insulin prices have increased 600 percent over the last 20 years causing many consumers to be at risk of non-adherence due to cost. 4 Solving the Affordability Issue – Legislation Influence The Inflation Reduction Act , a spending package Congress approved in 2022, capped insulin out-of-pocket costs at $35 for Americans with Medicare.

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March HR News Worth Review

Higginbotham

Transparency in Health Coverage. As we discussed in our CAA webinar last July and our January compliance update, new transparency in coverage requirements apply to group health plans and health insurers in the individual and group markets. Transparency in coverage FAQs were released on Aug. Machine-readable Files.

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New Transparency Requirements for Health Plans

AssuredPartners

Departments of Health and Human Services, Labor and the Treasury (together, the Departments) issued a final rule under the Patient Protection and Affordable Care Act (PPACA) and in furtherance of an executive order issued in 2019.

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The Consolidated Appropriations Act: 2021’s Employee Benefits Provisions

McNees

In addition, any assets previously transferred to a health benefits account which are not used by the effective date of the election shall be returned to the pension plan. Choice of Health Care Professional. Strengthening Parity in Mental Health and Substance Abuse Disorder Benefits. Preventing Surprise Medical Bills.