July 10, 2020

MLR Reporting and Rebates Deadline Extended due to COVID-19

The Centers for Medicare and Medicaid Services (CMS) have extended the deadline for insurers to report Medical Loss Ratio (MLR) annual reports and rebates from July 31 to August 17, 2020. The MLR reflects the portion of insurance premium revenue spent by the insurer for enrollee health services related to the total premium revenue. If… Continue Reading

June 29, 2020

FAQs Part 43: Additional Health Plan Guidance Re: COVID-19 Regulations

On June 23, 2020, the Departments of Labor, HHS, and Treasury (Departments) published additional guidance on how the Families First Coronavirus Response Act (the FFCRA) and the Coronavirus Aid, Relief, and Economic Security Act (the CARES Act) apply to health plans. Under the FFCRA, plans and issuers must provide benefits for certain items and services… Continue Reading

June 25, 2020

“PrEP Test” to be required as Preventive Service for Persons at risk of HIV Acquisition

On June 11, 2019, the The United States Preventive Services Task Force (USPTF) added pre-exposure prophylaxis (“PrEP”) for persons at high risk of HIV acquisition as a “preventive care” service health plans must provide. Under the ACA, non-grandfathered health plans are required to provide coverage for preventive care at 100% without cost sharing. Health plans… Continue Reading

June 15, 2020

Don’t Forget: PCORI Fee Due Next Month

As COVID-19 has brought numerous changes to the world of health benefits, the Internal Revenue Service (IRS) published Notice 2020-44 to remind us that the PCORI fee is still due by July 31. The Notice announced the updated fee rate that applies to policy or plan years that end on or after October 1, 2019,… Continue Reading

May 15, 2020

IRS Provides Relief to Cafeteria Plans in Response to COVID-19

The IRS recently issued new guidance for cafeteria plans and high deductible health plans (HDHPs) pursuant to Notice 2020-29, which is specifically related to circumstances created by the COVID-19 pandemic. It provides for: Expanded opportunities to make mid-year cafeteria plan election changes during 2020. Modification of the grace period rules for cafeteria plans (including health… Continue Reading

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