News & Insights

As health plans and providers navigate the implications and components of the industry-reforming Consolidated Appropriations Act (CAA), federal agencies recently issued a final rule updating fees for the independent dispute resolution (IDR) process established within the CAA’s No Surprises Act. The...

Earlier this year IRS established that employers with an aggregate of 10 or more information returns must submit those returns electronically. This rule is applicable for 1094/1095 B & C returns required under the Affordable Care Act (ACA), which are due April 1. Employee copies must be disbursed...

The Equal Employment Opportunity Commission (EEOC) will begin accepting 2022 EEO-1 Component 1 data reports on October 31, 2023. Each year private employers with at least 100 employees or more are required to file certain data with the Equal Employment Opportunity Commission (EEOC). Federal...

The U.S. Senate recently updated its stance on what can be worn on the senate floor. Traditionally senators were expected to dress strictly in business professional attire, but the Majority Leader has opted to no longer enforce the unwritten dress code. This controversial decision reflects a...

The Employee Retention Tax Credit (ERTC) was spawned to help businesses that continued paying employees even when operations were closed due to a COVID-19 government shut down, or despite experiencing a significant loss in revenue during that period. Since the ERTC creation, bad actors have been...

On November 12, 2020, the Transparency in Coverage Act (TiC) was adopted, with the goal of bringing more transparency to health care costs. Provisions from the final rule are already in effect. As of January 1, 2023, health plans and health insurers were required to provide a self-service,...

Since passage of the Affordable Care Act (ACA), many preventive care services are covered at no cost to health plan participants. An October information request issued by the IRS and two other federal agencies is evaluating whether to expand no-cost preventive care to include over-the-counter (OTC)...

Employers sponsoring a group health plan have a laundry list of limits and thresholds to note each year. Prepare for 2024 by noting these important IRS-set numbers. 

Weight loss trends fade in and out of popularity, but the latest solution has employers looking at the implications on their benefit plan design. GLP-1s are an in-demand, high-cost class of medications that were originally used to treat diabetes, but have garnered attention for their effect on...

In September, a federal judge struck down a 2021 Trump administration rule that gave health plans and pharmacy benefit managers (PBMs) the latitude to exclude the value of drug manufacturer coupons toward a member’s out-of-pocket cost. Plaintiffs in the case argued the practice conflicts with the...