May 2023 Insurance Information & News

ACA Preventive Care Coverage Stricken Down:

A US District Court Judge has issued a final judgment striking down portions of the Affordable Care Act’s (ACA) preventive care coverage mandate, which mandates health insurance issuers and group health plan sponsors cover certain preventive care services without applying cost-sharing. The ruling specifies new limits on enforcing the mandate, which does not eliminate first-dollar coverage of all preventive care services but may reimpose cost-sharing for some services, depending on how the case goes. The Biden Administration will appeal the decision, and if not successful, there may be a limited cost-sharing impact for some plans, but change is not mandatory. The decision does not affect preventive service requirements for qualified High-Deductible Health Plans (HDHPs) eligible for use with health savings accounts (HSAs) since the law creating HDHPs and HSAs pre-dates the ACA.

CMS Released 2022 Reporting Instructions:

The Centers for Medicare and Medicaid Services (CMS) have released the 2022 instructions for the prescription drug and healthcare spending data collection (RxDC) effort, which affects individual and group health insurance plans. Reports for calendar year 2022 must be submitted through the CMS Health Insurance Oversight System (HIOS) by June 1, 2023. Employers must ensure all plan RxDC files are accurate and complete, but may have multiple vendors submit data files on their behalf. The reporting requirements do not apply to retiree-only group health plans and “good faith” compliance is no longer accepted. The deadline for 2022 reports appears to be firm. Find the full set of RxDC reporting instructions for the 2022 Reference Year.

UPMC Health Plan Electronic Bill Review:

Starting in April 2023, UPMC Health Plan will require all commercial group accounts to receive and review bills through Employer OnLine. The process is secure and fast, and bills will automatically be uploaded to the platform for easy payment. Accounts that are already registered with Employer OnLine can log in and click “View & Pay Premium Invoices” to access their bills. Those who have not yet registered should contact their UPMC Health Plan account manager to request a form and complete the registration process. If there are any questions, account managers are available to provide assistance. Read the announcement here.

COVID is Over

President Biden signed a resolution ending the COVID-19 national emergency on April 10, 2023, which had been in place since 2020. The public health emergency (PHE) is still scheduled to end on May 11, 2023. The “outbreak period” that disregarded certain employee benefit plan deadlines will end on June 9, 2023, as a result of the national emergency’s termination. Health plans can then return to their normal, non-extended deadlines. The Department of Labor has provided guidance on the COVID-19 pandemic related health plan requirements changes when the emergency periods come to an end, and plan sponsors must clearly communicate any changes to participants and beneficiaries.

Horizon to Add a Surcharge for Premium Payments Made With Credit Cards

Horizon will add a surcharge for credit card payments for Small Group customers starting in June, now that the COVID-19 Public Health Emergency has ended. However, Small Group customers can still choose from several no-cost payment options, such as auto pay, one-time payments, mailing a check, or calling the IVR. Customers can also initiate a wire or Ebox payment through their bank, but their bank may charge a fee. Horizon remains committed to making it easy for customers to do business with them. Customers can contact their Horizon sales executive or account manager for questions.

Are Your Employees ‘Splitters’ vs. ‘Blenders’:

A recent Gallup report identifies two types of workers: “splitters,” who want to separate work from their personal lives, and “blenders,” who want to integrate the two. Gallup’s research shows that there is a 50-50 split between these two preferences, so employers need to understand which employees prefer which work style. The report also found that both preferences can be productive and fulfilling, but blenders are slightly more likely to be looking for another job and to report burnout. Employers need to be aware of the pressure to retain talent and consider older workers, reduce or eliminate college degree requirements, and provide upskilling opportunities for employees.

Harry Bickel Has Joined The Board of Durand, Inc.

A little about Durand, Inc. “Durand gives individuals with autism and other intellectual in developmental disabilities the skills and support to thrive, with lifelong services from early childhood through adulthood. Person centered thinking is at the core of everything we do with a focus on individualized plans for living as independently as possible and achieving one’s full potential. As an established and growing agency, we have provided vital services to southern New Jersey since 1972 – and we are committed to serving our community for many more decades you will find us forward thinking and continuously improving, delivering care that is efficient, accessible, and compassionate.”

“I am looking forward and excited to being part of such a great organization. I enjoyed visiting and learning all of what Durand offers and the clients they serve. I have wanted to get involved with a board to take my career experiences and give back to the community. Thrilled to be nominated by Durand, Inc. and helping the organization continue their mission,” says Harry Bickel

Dedicated, Different, Durand!

Harry received his bachelor’s degree in marketing and management information Systems from Philadelphia University School. Harry lives in Cherry Hill, New Jersey with his wife.

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