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 […]
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 […]
Lifestyle Choices – Creating a Wellness Culture
BenefitsPro ran an article saying… Changing lifestyle choices could cut $730B in annual health care spending and that more than a quarter of all health care spending is due to conditions such as smoking, diabetes and poor diet. “Nearly three-quarters of a trillion dollars in health care spending can be linked to modifiable health risks, […]
What is Creditable Medicare Part D Coverage?
Medicare Part D notices are due before October 15,2020. But what does that mean and how do you know if your coverage is creditable? If you have any type of group health plan the notice is sent to advise plan participants as to whether their prescription drug coverage is “creditable.” What is Medicare D Creditable […]
Let the dogs out!
Surprise medical bill? – Surprise medical billing applies to fully-insured commercial insurance plans. No federal laws exist to prevent surprise medical bills and of the states that do less than half provide comprehensive legislation. Employees are confused when they receive a surprise medical bill and it generally reflects poorly on the company plan […]
COVID-19 Disability Claims
Several clients have asked questions related to COVID-19 and their group disability insurance. Here’s a compilation of how carriers are administering claims. Question: Is someone automatically disabled if he/she is placed under a quarantine related to the Coronavirus? Answer: No. Standard policy language requires that an insured be disabled from his/her own occupation. Therefore, an […]