Medicare Secondary Payer Penalty
The U.S. Department of Health and Human Services (HHS) has increased the following penalty affecting group health plans: Medicare Secondary Payer (MSP): Violating the prohibition of offering Medicare beneficiaries financial or other benefits as incentives not to enroll in or to terminate enrollment in a group health plan that would otherwise be primary to Medicare will now […]
IRS Guidelines – Indexed for 2022
FICA Social Security Tax is 6.2% on income up to $147,000 Medicare Tax unlimited 1.45% to Unlimited High Deductible Health Plans Minimum Annual Deductible (Individual/Family) $1,400 / $2,800 Maximum Out-of-Pocket Limit (Individual/Family) $7,050 / $14,100 Health Savings Accounts Individual / Family $3,650 / $7,300 Catch-up Contribution $1,000 ACA Plan Limits Out-of-Pocket Limits Individual / Family […]
Employers’ premium surcharges for unvaccinated employees could result in ACA penalties
Employers are considering vaccine incentives and potential penalties for workers who remain unvaccinated against COVID-19. Before adding a premium surcharge, employers will want to consider how they may impact the affordability of an employer’s health plans. While there is an exception for tobacco, there’s nothing currently in the ACA rules that similarly applies to a […]
Many Patients Billed for Preventive Care That Should Be Free
People are being charged for preventive health care, health care that should be at no cost to them. That’s the headline from an article in the US News & World Report by Robert Preidt, HealthDay Reporter. The article stated, “Out-of-pocket charges for preventive care that should be free under the Affordable Care Act can discourage patients […]
CMS warning Hospitals on price transparency failure
(Read EBA’s Health Care Transparency December 8, 2020 blog for background.) Centers for Medicare & Medicaid Services has started issuing warning letters to hospitals not in compliance with the hospital price disclosure rule. The purpose of the rule, effective Jan 1., is to make hospital pricing information readily available to patients to compare costs and […]
COBRA and The American Rescue Plan Act
The American Rescue Plan Act of 2021 (“ARPA”) includes major changes to COBRA administration in 2021. The Act creates an opportunity for free COBRA coverage during a six-month period from April through September 2021 for employees (and their family members) who experience a loss of group health coverage due to involuntary termination or reduced hours […]
No More Surprises
The No Surprises Act, a ban on surprise medical bills, will take effect beginning in 2022. Surprise Medical Bills Surprise medical bills occur when patients unexpectedly receive care from out-of-network health care providers. – A patient goes to an in-network hospital for surgery or emergency care, and an out-of-network doctor is involved in the patient’s […]
Can employers require employees to have the COVID-19 vaccine before returning to work?
Yes, employers can require mandatory vaccinations, as a matter of prior health crises and common law. There will be some industries where it is going to be a mandate, like healthcare. There are however possible exceptions; medical conditions, bona fide religious objection. Two important questions. How can employers enforce this rule? What are alternatives to […]
IRS Guidelines – Indexed for 2021
FICA Social Security Tax is 6.2% on income up to $142,800 Medicare Tax unlimited 1.45% to Unlimited High Deductible Health Plans Minimum Annual Deductible (Individual/Family) $1,400 / $2,800 Maximum Out-of-Pocket Limit (Individual/Family) $7,000 / $14,000 Health Savings Accounts Individual / Family $3,600 / $7,200 Catch-up Contribution $1,000 ACA Plan Limits Out-of-Pocket Limits Individual / Family $8,550 […]
Health Care Transparency
New transparency requirements on group health plans and health insurers in the individual and group markets were issued by the Departments of Labor (DOL), Health and Human Services (HHS) and the Treasury (Departments). The final rule requires plans and issuers to disclose: Price and cost-sharing information for a list of 500 services must be available […]