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MEDICAL LOSS RATIO (MLR) REBATES 2020

Are you an employer that is receiving a rebate check from your group medical insurance carrier? September 30 is the deadline for insurers to issue rebates, if required, under the Affordable Care Act’s medical loss ratio (MLR) rule. It is estimated that insurers will return over a quarter billion dollars to employer groups this year. … Continued

DOL Issues Final Regulations Regarding Association Health Plans | CA Employee Benefits Team

On June 19, 2018, the U.S. Department of Labor (DOL) published Frequently Asked Questions About Association Health Plans (AHPs) and issued a final rule that broadens the definition of “employer” and the provisions under which an employer group or association may be treated as an “employer” sponsor of a single multiple-employer employee welfare benefit plan … Continued

Proposed 2020 Benefit Payment and Parameters Rule | California Benefits Group

The Centers for Medicare & Medicaid Services (CMS) released a proposed rule for benefit payment and parameters for 2020. CMS also released its draft 2020 actuarial value calculator and draft 2020 actuarial value calculator methodology. According to CMS, the proposed rule is intended to reduce fiscal and regulatory burdens associated with the Patient Protection and … Continued

PCORI Fee Increase for Health Plans | California Employee Benefits

On November 5, 2018, the Internal Revenue Service (IRS) released Notice 2018-85 to announce that the health plan Patient-Centered Outcomes Research Institute (PCORI) fee for plan years ending between October 1, 2018 and September 30, 2019 will be $2.45 per plan participant. This is an increase from the prior year’s fee of $2.39 due to … Continued

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