May 19, 2025
The Centers for Medicare and Medicaid Services (“CMS”) previously released updated Prescription Drugs DataCollection (“RxDC”) reporting instructions related to reporting 2024 data; there are no […]
May 19, 2025
The Centers for Medicare and Medicaid Services (“CMS”) recently released final instructions addressing the Medicare Part D prescription drug benefit redesign changes effective beginning in 2026. The instructions:
Revise the existing Simplified Method for determining the creditable (or non-creditable) status of prescription drug
coverage provided under an employer-sponsored group health plan
Allow group health plans to use the existing Simplified Method or the Revised Simplified Method to determine creditable status of prescription drug coverage in 2026.
May 19, 2025
On April 15, 2025, President Trump issued an Executive Order (EO 14273) directing federal agencies to propose regulations or make recommendations to provide access to […]
April 8, 2025
On March 10, 2025, the Department of Health and Human Services (“HHS”) released the Patient Protection and Affordable
Care Act; Marketplace Integrity and Affordability Proposed Rule (“Rule”). While much of the Rule is focused on individual and small group Marketplaces, a few key changes may indirectly impact employer sponsored plans.
April 8, 2025
Employers offering wellness programs with tobacco surcharges should monitor developments as these lawsuits progress. They should also review their program to ensure it meets the requirements under the HIPAA nondiscrimination rules.
April 3, 2025
On February 21, 2025, the Internal Revenue Service (“IRS”) released Notice 2025-15 (the “Guidance”) providing guidance on an alternative method for furnishing Form 1095-C (and […]
April 3, 2025
On January 14, 2025, the Departments of Labor, Health and Human Services, and the Treasury (“the Departments”) issued FAQ Part 69 to clarify: NSA Background […]
February 25, 2025
The Department of Health & Human Services (“HHS”) recently announced the 2025 federal poverty guidelines which, amongother things, establish the federal poverty line (“FPL”) affordability safe harbor for purposes of the Affordable Care Act (“ACA”) employer mandate.
February 25, 2025
Congress passed two bills to reduce the burden of employer reporting related to the Affordable Care Act that President Biden signed into law on December 23, 2024. While small, these bills pack a big punch as they significantly reduce the employer (and carrier) responsibilities for Form 1095-C (and Form 1095-B) reporting.
December 23, 2024
On October 21, 2024, the Departments of Labor, Health and Human Services, and the Treasury (“the Departments”) issued FAQ Part 68, providing guidance on: *Pre-Exposure […]
December 23, 2024
New Jersey has announced the 2025 contribution rates and benefit level parameters for the Temporary Disability Insurance (“TDI”) and Family Leave Insurance (“FLI”) programs. Compared […]
December 23, 2024
On December 3, 2024, the IRS released Notice 2024-83, announcing that the adjusted applicable dollar amount used to determine the PCOR fee for plan years […]