Consolidated Appropriations Act, 2021: Advance EOB, Patient/Consumer Protections and Reporting

Posted by Matt Schwartz on Mon, Feb 22, 2021 @ 09:02 AM

On December 27, 2020, former President Trump signed the Consolidated Appropriations Act, 2021 (Appropriations Act). The Appropriations Act amends Title XXVII of the Public Health Service Act (PHSA), Part 7 of Title I of the Employee Retirement Income Security Act of 1974 (ERISA), and Chapter 100 of the Internal Revenue Code of 1986 (IRC).

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Topics: Compliance Issues, Affordable Care Act, Employee Benefits

Compliance Recap - January 2021

Posted by Matt Schwartz on Fri, Feb 12, 2021 @ 11:02 AM

January was a busy month in the employee benefits world. President Biden issued a memorandum putting a regulatory freeze on new rules. President Biden also issued an executive order on strengthening Medicaid and the Patient Protection and Affordable Care Act (ACA).

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Topics: Compliance Issues, Affordable Care Act, Employee Benefits

Executive Order on Strengthening Medicaid and the ACA

Posted by Matt Schwartz on Wed, Feb 10, 2021 @ 10:02 AM

On January 28, 2021, President Biden signed an Executive Order on Strengthening Medicaid and the Affordable Care Act (ACA) (Executive Order). The Executive Order instructs the Department of Health and Human Services (HHS) to consider establishing a special open enrollment period (SEP) for individuals to enroll in or change their current coverage under federally facilitated health insurance marketplaces.

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Topics: Compliance Issues, Affordable Care Act, Employee Benefits

Option for Some to Renew Policies That Do Not Fully Meet ACA Standards

Posted by Matt Schwartz on Thu, Feb 4, 2021 @ 11:02 AM

In the fall of 2013, the Department of Health and Human Services (HHS) announced a transitional relief program that allowed state insurance departments to permit early renewal at the end of 2013 of individual and small group policies that do not meet the “market reform” requirements of the Patient Protection and Affordable Care Act (ACA) and for the policies to remain in force until their new renewal date in late 2014.

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Topics: Compliance Issues, Affordable Care Act, Employee Benefits

Final 2022 Benefit Payment and Parameters Rule

Posted by Matt Schwartz on Fri, Jan 29, 2021 @ 11:01 AM

The Centers for Medicare & Medicaid Services (CMS) has released a final rule along with a fact sheet and press release for benefit payment and parameters for 2022.

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Topics: Compliance Issues, Affordable Care Act, Employee Benefits

Compliance Recap - November 2020

Posted by Matt Schwartz on Fri, Dec 11, 2020 @ 11:12 AM

November was a relatively busy month in the employee benefits world. The U.S. Supreme Court (Supreme Court) heard oral arguments in the case of California v. Texas, which is the case challenging the constitutionality of the ACA.

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Topics: Compliance Issues, Affordable Care Act, Employee Benefits

Proposed 2022 Benefit Payment and Parameters Rule

Posted by Matt Schwartz on Wed, Dec 9, 2020 @ 10:12 AM

The Centers for Medicare & Medicaid Services (CMS) has released a proposed rule and fact sheet for benefit payment and parameters for 2022. CMS has also released its draft 2022 actuarial value calculator and draft 2022 actuarial value calculator methodology.

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Topics: Compliance Issues, Affordable Care Act, Employee Benefits

Compliance Recap - October 2020

Posted by Matt Schwartz on Thu, Nov 19, 2020 @ 11:11 AM

October was a busy month in the employee benefits world. The Department of Health and Human Services (HHS) renewed the public health emergency due to COVID-19 which took effect on October 23, 2020.

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Topics: Compliance Issues, Affordable Care Act, Employee Benefits

Updated: HRAs, HSAs and Health FSAs - What's the Difference?

Posted by Matt Schwartz on Fri, Nov 13, 2020 @ 11:11 AM

10/26/20 Update: Updated for the 2021 EBHRA limit, 2021 Health FSA limit, and 2021 QSE HRA limit. Health reimbursement arrangements (HRAs), health savings accounts (HSAs) and health care flexible spending accounts (HFSAs) are generally referred to as account-based plans.

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Topics: Compliance Issues, Affordable Care Act, Employee Benefits

The U.S. Supreme Court and the Future of the Affordable Care Act

Posted by Matt Schwartz on Fri, Oct 30, 2020 @ 11:10 AM

Part One

Amy Coney Barrett was sworn in as President Trump’s third U.S. Supreme Court (Supreme Court) Justice on October 26, 2020, to fill the seat vacated by Justice Ruth Bader Ginsburg’s death. Justice Barrett’s vote could be a deciding factor on whether the ACA remains law.

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Topics: Compliance Issues, Affordable Care Act, Employee Benefits