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Departments Propose Rule to Help Plans Maintain Grandfathered Status

The U.S. Departments of Labor, Health and Human Services, and the Treasury (collectively, the Departments) today issued a proposed rule to amend the requirements for grandfathered group health plans and grandfathered group health insurance coverage to preserve their grandfather status. First, the proposed rule would clarify that grandfathered group health coverage that is a high-deductible health plan (HDHP) may increase fixed-amount cost-sharing requirements, such as deductibles, to the extent necessary to maintain their status as an HDHP without losing grandfather status. This change would ensure that participants and beneficiaries enrolled in that coverage remain eligible to …

https://www.epicbrokers.com/insights/departments-propose-rule-to-help-plans-maintain-grandfathered-status/

Flight to Quality

For more of our coronavirus coverage, visit epicbrokers.com/coronavirus  Viewpoints from Adam Okun On March 23, 2010, when the Affordable Care Act was signed into law, I remember my initial sense of resignation. There was so much uncertainty as to what its impact would be on our industry. Putting aside the broader social debate over whether the law would be beneficial for the country (hint: it varied based upon your economic and employment position), as a young actuarial healthcare consultant, I was looking at the 30-year+ career ahead of me and wondering if this would change everything – perhaps …

https://www.epicbrokers.com/insights/flight-to-quality/

2021 Healthcare Cost Trends Are Rising

The EPIC actuarial team and many others have projected 2020 employer-based medical cost trends to be relatively unscathed by the COVID-19 pandemic. However, we highlighted the potential bounce-back of costs due to deferred medical care. While we haven’t been as specific with 2021, trends are starting to emerge. For more of our coronavirus coverage, visit epicbrokers.com/coronavirus  Viewpoints from Craig Hasday A recent PwC report expects costs to rise by 4% to 10% in 2021, a sharp increase from recent years. The survey points to mental health utilization and specialty drugs as two big drivers …

https://www.epicbrokers.com/insights/2021-healthcare-cost-trends-are-rising/

Covering Coronavirus: Risk Considerations Volume 1, Issue 17

EPIC Risk Advisory Bulletin Volume 1, Issue 17 The global COVID-19 (coronavirus) pandemic remains both dynamic and fluid. We continue to see unprecedented disruptions at home and abroad. In this issue, we take a focused look at: General Information on Coronavirus Supply Chain and Business Risks Checking Idle Properties for Legionnaire’s Disease FMCSA Update Insurance Products and Coverage Information New Pandemic Market Report Medical Liability Risk News of Note Human Resources and Employee Benefits Managing Injury Risks for Remote Workers OSHA’s New Guidance for Employers Do Employers Have to Pay for Coronavirus Testing? How Coronavirus is Impacting …

https://www.epicbrokers.com/insights/covering-coronavirus-risk-considerations-volume-1-issue-17/

Final 2021 Notice of Benefit and Payment Parameters

Quick Facts Recently, the Department of Health and Human Services (HHS) issued its Final Notice of Benefit and Payment Parameters for 2021 (Final Rule). Under the Final Rule, the Affordable Care Act’s (ACA’s) out-of-pocket maximum limit will increase to $8,550 (self-only coverage) and $17,100 (family coverage) in 2021. The required contribution percentage for the individual mandate’s affordability exemption will increase for 2021. The Final Rule clarifies that issuers, including employer-sponsored health plans, are permitted but not required to count the value of a manufacturer coupon discount toward the ACA’s annual …

https://www.epicbrokers.com/insights/final-2021-notice-of-benefit-and-payment-parameters/

The Truth About Weight: Why Weight-Based Health Programs Can Cause More Harm Than Good

Viewpoints from Craig Schmidt Wellness programs, challenges and social media influencers focus on weight as if it’s a true indicator of health. Hate to break it to you (and them) – it’s not. Health is more than a number on a scale, it’s a way of life that should be as diverse in its evaluation and outlook as people are. Let’s quickly define health; according to the World Health Organization (WHO) health is the state of complete physical, mental and social wellbeing – not merely the absence of disease. I don’t see weight in there, do you …

https://www.epicbrokers.com/insights/the-truth-about-weight-why-weight-based-health-programs-can-cause-more-harm-than-good/

Healthcare Is at the Crossroads Again

Viewpoints from Craig Hasday In a largely symbolic effort, House Democrats introduced a bill to modify healthcare laws. It’s too bad this one has no chance – some of the changes look pretty good and what we might get after the election power shift could end up much worse. The bill expands and protects Medicaid and reduces or eliminates premiums for the lowest earners and most vulnerable populations. It also clears up a technical error in the Affordable Care Act (ACA) that eliminated subsidies for spouses and children in the event the employee is eligible for employer-sponsored coverage (despite …

https://www.epicbrokers.com/insights/healthcare-is-at-the-crossroads-again/

DOL Clarifies FFCRA and CARES Act COVID-19 Testing Coverage Requirements

… today issued another set of FAQs that address employers’ ongoing obligations to cover certain testing expenses under their group health plans; however, return-to-work COVID-19 testing is not required to be covered by a group health plan. COVID-19 Testing FFCRA generally requires group health plans to provide benefits for certain items and services related to diagnostic testing to detect SARS-CoV-2 or diagnose COVID-19. Plans must cover these costs with no cost sharing (including deductibles, copayments and coinsurance), prior authorization or any other medical management requirement, when furnished on or after March 18, 2020 (FFCRA …

https://www.epicbrokers.com/insights/covid-19-testing-coverage-requirements/