April 2023 Insurance Information & News

April 2023 Insurance Information

Protected: New Compliance Federal Requirement Related To Gag Clauses In Group Health Plan Contracts

The Consolidated Appropriations Act 2021 (CAA-21) forbids group health plans or those who offer group health insurance from taking part in contracts with other health care entities that have certain gag clause language. As of February 23, 2023, the Departments of Health and Human Service, Labor and Treasury collaborated on the FAQ Guidance to clarify issues with CAA-21. Health plans and insurers are required to submit documentation for compliance of the CAA-21 gag clause as per the FAQs. Read more about the latest federal compliance related to gag clauses from Departments jointly issued FAQ guidance.

Is Your Handbook Up To Date? Create Out Of State Handbooks with HR Hero:

A current, updated handbook can be a valuable tool for your organization. It is critical that employers properly develop their employee handbook as employment litigation can often include the employer’s compliance to the legal language of the handbook and whether the language meets legal standards. An updated, properly constructed employee handbook can be a significant line of defense for organizations that find themselves amid litigation.

An employee handbook also can clearly outline your organization’s benefits, culture, and policies. It is an excellent way to communicate and relay information from employer to employees while promoting consistency in policies and practices that are unbiased.

Tools such as the Employee Handbook Builder can enable you to create a fully customized handbook quickly and accurately. These software tools significantly save time and money for your organization. They have the capability to be continuously updated and can be accessed digitally for the developers and the employees. To learn more about building an effective employee handbook or updating your current one, login to HR Hero for more details. If you don’t already have one, contact us to get an HR Hero login!

Important Compliance Dates for 2023

With summer just around the corner, several key compliance dates lay just ahead beginning in June 2023.

The 2022 RxDC reporting data is due on June 1, 2023. While insurance providers, PBMs, and third party claims may submit the data, it is ultimately up to the employer to ensure the data is sent on time.

PCORI fees must be paid by July 31, 2023. Groups that are self-funded, level-funded, and those offering access to health reimbursement arrangements are required to use IRS Form 720 to submit their PCORI fees.

For group health plans of 100 or more employee participants at the first day of the plan year, Form 5500 with the DOL and IRS is required by the last day of the seventh month from the start of the plan year. If your health plan begins on January 1, 2023, the Form 5500 date would then be July 31, 2023.

The last day to notify all medicare-eligible group participants of the Medicare Prescription Drug Creditable Coverage Disclosure Notice is October 15, 2023.

Health plans should update their online participant-specific plan transparency tool by January 1, 2024. This update should include all treatments and services covered.

COVID-19 and End of Public Health Emergency Update:

As of May 11, 2023 the Public Health Emergency (PHE) regarding COVID-19 will end. United Healthcare has worked closely with several government agencies to create a standard approach for COVID-19 following the May 11 decree. United Healthcare’s standard approach is applicable for level-funded, fully insured plans; they are also recommending that self-funded customers follow the same standard coverage. United Healthcare post-PHE standard approach has been developed to return to normal benefit plans in a consistent and timely manner. For more information on the latest PHE information, see Unit Healthcare’s recent update.

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