Author Archives: NAHU

By: Jessica Waltman, Principal, Forward Health Consulting On December 23, 2022, the Consolidated Appropriations Act, 2023 (CAA23) was signed into law.  While this legislation does not include as many health provisions as the CAA of 2021, it does include the anticipated relief on telehealth coverage offered through qualified High Deductible Health Plans (HDHPs) that pairContinue reading “Telehealth Relief Included in End-Of-Year Omnibus Bill”

By: Jessica Waltman, Principal, Forward Health Consulting Late in the afternoon on December 23, 2022, the Administration issued Affordable Care Act FAQ #56, and in doing so gave a little holiday gift to all group health plans nationwide.  The guidance establishes limited deadline and enforcement relief for the 2020 and 2021 Prescription Drug Data CollectionContinue reading “Administration Extends RxDC Reporting Deadline and Provides Other Limited Reporting Relief”

By: Megan Diehl, Manager, Compliance Consulting, MZQ Consulting The Department of Health and Human Services has announced the new out-of-pocket (OOP) limits that will apply to group and individual health plans during the 2024 plan year.  To comply with the ACA, non-grandfathered health plans cannot require a participant to pay more out-of-pocket during the planContinue reading “2024 Out-of-Pocket Limits Released”

By: Megan Diehl, Manager, Compliance Consulting, MZQ Consulting The end of the 2022 calendar year is fast approaching, and with it come numerous deadlines that can directly or indirectly impact employer group health plans.  Below is an overview of several items that plan sponsors should be mindful of this season. The Affordable Care Act’s EmployerContinue reading “End-of-Year Compliance Deadlines and Reminders”

By: Megan Diehl, Manager, Compliance Consulting, MZQ Consulting The Patient-Centered Outcomes Research Institute (PCORI) fee established by the Affordable Care Act helps fund research to evaluate and compare health outcomes, clinical effectiveness, risks, and benefits of medical treatment and services.  The fee is currently in place through 2029.  In Notice 2022-59, the IRS announced thatContinue reading “2022-2023 PCORI Fee Released“

By Jessica Waltman, Principal, Forward Health Consulting On October 18, 2022, the Internal Revenue Service issued Revenue Procedure 2022-38 that sets forth various 2023 tax-related limits that have been adjusted for inflation.  The table below identifies updates to the 2023 health and fringe benefit plan limits addressed in the notice. Benefit 2022 2023 Maximum AnnualContinue reading “2023 Health FSA Inflation Adjustments“

By Jessica Waltman The Biden Administration issued a final regulation and a new IRS notice on October 11, 2022, which eliminate the Affordable Care Act’s (ACA) “family glitch” beginning on January 1, 2023.  The “glitch” refers to the fact that the ACA’s current affordability standard is based on what a single person pays for employer-sponsoredContinue reading “Biden Administration Issues Final Rule to End the “Family Glitch”“

By: Lee Spiegel, Director, Compliance, MZQ Consulting The October 14, 2022 deadline by which plan sponsors that offer prescription drug coverage to provide notices of creditable or non-creditable coverage to Medicare-eligible individuals is fast approaching.  Coverage that is deemed creditable is expected to cover, on average, at least as much as the standard Medicare PartContinue reading “Medicare Part D Coverage Notices Due Mid-October”

Many sponsors of fully insured health plans either already have or will soon receive checks from their insurance carriers, along with a notice informing them that the check is a medical loss ratio (MLR) rebate. Plan sponsors should receive these checks by September 30, 2022. The MLR rules implemented as part of health care reformContinue reading “Medical Loss Ratio Rebate Guidelines“

By: Jessica Waltman, Principal, Forward Health Consulting The Consolidated Appropriations Act of 2021 (CAA) introduced numerous protections against surprise billing for plan participants that impact group health plans, health insurance issuers, and providers.  The federal Departments of Health and Human Services, Labor, and Treasury recently released a document discussing frequently asked questions (FAQs) about theseContinue reading “Additional Guidance Issued on Surprise Billing Protections“