June 2023 Insurance Information & News

New PA Law Mandates Coverage for Cancer Screenings

Pennsylvania Governor Josh Shapiro enacted S.B. 8 into law on May 1, 2023, mandating that health insurers providing fully insured coverage in the state must cover certain cancer screenings without any additional charges. This legislation, named Act One of 2023, received unanimous approval from both the House and the Senate. It eliminates the need for individuals to pay out-of-pocket expenses for genetic testing aimed at detecting hereditary cancers. Furthermore, it ensures that women at a high risk of breast cancer receive first-dollar coverage for supplementary breast screenings, such as MRIs or ultrasounds. Act One will come into effect on June 30, 2023, and will be applicable to policies issued or renewed 180 days after that date. Therefore, all fully insured major medical policies issued in Pennsylvania after December 27, 2023, must adhere to these regulations. Learn more about Act One.

IRS Explains High Standards for Substantiating FSA Claims

The recently released Chief Counsel Advice (CCA) by the IRS addresses the substantiation of claims under health flexible spending accounts (FSAs) and dependent care FSAs. The CCA clarifies that if expenses reimbursed by an FSA are not properly substantiated, they must be included in the employee’s gross income. Proper substantiation procedures for FSAs maintain tax-favored treatment. Employers are advised to review and ensure compliance with existing guidance on substantiation procedures for reimbursement claims. For examples of situations that meet or fail to meet substantiation requirements, contact Precision Benefits Group.

PCORI Filing Due Dates and Applicable Rates (Most Groups Due July 31st)

The Patient-Centered Outcomes Research Institute (PCORI) fee, mandated by the Affordable Care Act, is imposed on applicable self-insured health plans, including HRA plans, to support PCORI’s research. The fee, reported annually on the second quarter Form 720, is due by July 31, 2023. The IRS has announced that the adjusted PCORI fee for policy or plan years ending between October 1, 2022, and October 1, 2023, will be $3.00. The fee for HRAs is calculated based on the average number of enrolled employees (excluding dependents) during the plan year, multiplied by the applicable dollar amount. OCA employs the “actual count method” to determine the average number of lives covered.

COBRA – End of National Emergency Extensions

Following the end of the COVID-19 National Emergency, the temporary pause on COBRA election and payment deadlines is coming to an end. The tolling of COBRA time frames will cease on July 10, 2023, returning to pre-pandemic rules. CCS will make necessary modifications to Qualifying Event letters, Non-Payment letters, and End of Election Period letters to reflect the updated COBRA time frames, at no additional cost. A one-time letter will be sent to individuals in their COBRA election period and those with lapsed payments, informing them of the revised election and payment due dates. CCS will provide a list of recipients and copies of the letters via MyEnroll360. For any inquiries, contact Cobra Control Services at [email protected] or 1.888.887.6187.

New Jersey Enacts Temporary Workers’ Bill of Rights

New Jersey Governor Phil Murphy signed the Temporary Workers’ Bill of Rights into law, aiming to promote pay equity. The law requires that temporary workers receive the same average compensation rate and benefits as permanent employees. This will have significant implications for employers and staffing agencies in the state, as they will be responsible for providing additional compensation, benefits, and protections to temporary workers. The law also requires staffing agencies to register with the New Jersey Department of Labor and Workforce Development for compliance purposes. The bill has faced opposition from employer advocacy groups, citing concerns about fairness and flexibility, while worker rights advocates have praised it for addressing issues of underpayment and lack of benefits for temporary workers.

Compliance Corner!

Did you know? ERISA Wrap Documents must be updated every 5 year’s.


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