May 2024 Insurance Information & News

Why Your Company Should Be High On High-Deductible Health Plans

High-deductible health plans (HDHPs) with Health Savings Accounts (HSAs) can be a good option for companies to offer their employees. HDHPs typically have lower premiums than traditional plans and HSAs allow employees to save money on qualified medical expenses on a pre-tax basis. HDHPs can help employees become more cost-conscious about their healthcare spending.

Some of the benefits of HDHPs for companies include:

  • Lower healthcare costs
  • Increased employee engagement in healthcare decisions

Some of the benefits of HDHPs for employees include:

  • Lower premiums
  • Tax-advantaged savings for healthcare costs

IRS Addresses Nutrition, Wellness, and General Health Expenses

The IRS warns taxpayers about using HSAs, FSAs, or HRAs to pay for general wellness or nutritional expenses. These plans are meant to cover medical expenses to diagnose, treat or prevent a specific disease. Examples of non-reimbursable expenses include gym memberships, weight loss programs not treating a specific disease and groceries. The IRS advises employers to ensure their plans only reimburse qualified medical expenses and claims are properly documented. Employers should be cautious of vendors promoting pre-tax payments for wellness expenses with doctor’s notes for a fee.

REMINDER: 2024 RxDC Reporting Deadline

Employers offering group health plans or those with health insurance coverage need to be aware of annual reporting requirements for prescription drug and healthcare spending data (RxDC). By June 1st each year, insurers and group health plans must submit this data to the government. There have been recent updates to the reporting process, including how average premiums are calculated and how pharmacy data is submitted.

A significant change impacting employers is the enforcement of a new rule. Previously, employers could submit aggregated data. Now, they are required to submit data at the plan level. This may mean additional work for employers, as they might need to provide separate data to different vendors by specific deadlines to ensure complete reporting. To navigate these changes and meet RxDC deadlines, employers should consult with their vendors about data collection and reporting processes.

PID Issues Guidance Incenting Coverage of OTC Contraceptive

Pennsylvania will require insurance companies to cover new OTC birth control pills like Opill. This is to make contraception more affordable for women in the state. Insurers who don’t cover it will need to provide justification.

Compliance Corner: Compliance Updates for 2024

Employers offering health insurance need to be aware of new reporting requirements in several states, as well as federal regulations for Medicare Part D, contraception coverage, and cybersecurity. Precision Benefits Group can help you navigate these updates and ensure compliance.

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