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Compliance Recap October 2023 | San Diego Benefits Group

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ADJUSTED CIVIL PENALTIES The U.S. Department of Health and Human Services (HHS) has recently announced adjustments to civil penalties related to violations of the Health Insurance Portability and Accountability Act (HIPAA), the Affordable Care Act (ACA), and the Medicare Secondary Payer (MSP) rules. These penalty adjustments take into account inflation and are applicable to violations … Continued

Compliance Recap August 2023 | CA Employee Benefits Advisors

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IRS DECREASES 2024 ACA AFFORDABILITY TO 8.39% The IRS has announced a reduction in the Affordable Care Act (ACA) affordability percentage for plan years starting in 2024, lowering it from 9.12% in 2023 to 8.39%. This affordability percentage determines the maximum portion of an employee’s household income that can be spent on self-only coverage while still complying … Continued

Compliance Recap August 2023 | CA Employee Benefits Team

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IRS DECREASES 2024 ACA AFFORDABILITY TO 8.39% The IRS has announced a reduction in the Affordable Care Act (ACA) affordability percentage for plan years starting in 2024, lowering it from 9.12% in 2023 to 8.39%. This affordability percentage determines the maximum portion of an employee’s household income that can be spent on self-only coverage while still complying … Continued

Compliance Recap July 2023 | CA Employee Benefits Advisors

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PROPOSED CHANGES TO SHORT-TERM, LIMITED-DURATION INSURANCE On July 7, 2023, the U.S. Department of Health and Human Services (HHS), the Department of Labor (DOL), and the Department of the Treasury proposed changes to modify the definition of short-term, limited-duration insurance (STLDI) and the conditions for fixed indemnity insurance to be considered an excepted benefit. The … Continued

Compliance Recap June 2023| California Benefits Advisors

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PCORI FEE DUE DATE APPROACHES Employers offering self-funded medical plans, including health reimbursement arrangements (HRAs) must report and pay fees to the Patient-Centered Outcomes Research Institute (PCORI) by July 31. If the plan was fully insured, employers can rely on their insurance carriers to handle the fee payment. The current annual fees are: For plan years … Continued

Compliance Recap May 2023 | San Diego Benefits Team

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CLAIMS SUBSTANTIATION FOR PAYMENT OR REIMBURSEMENT OF MEDICAL AND DEPENDENT CARE EXPENSES A memorandum released by the IRS Chief Counsel responds to a request for assistance regarding the reimbursement of medical and dependent care expenses. Addressed is whether reimbursements of medical expenses from a health flexible spending arrangement (FSA) provided in a cafeteria plan should … Continued

Compliance Recap – April 2023 | California Benefits Advisors

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2024 BENEFIT PARAMETERS FOR MEDICARE PART D CREDITABLE COVERAGE DISCLOSURES ANNOUNCED The Centers for Medicare and Medicaid Services (CMS) released a Fact Sheet announcing the 2024 benefit parameters for Medicare Part D. These factors are used to determine the actuarial value of defined standard Medicare Part D coverage under CMS guidelines. Each year, Medicare Part D requires … Continued

Kids and Body Image | San Diego Benefits Agents UBA

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Growing up can be tough. The challenges of school, relationships with friends, sports and other activities can be stressful for children. Peer pressure, along with what they see and hear daily via social media, TV, movies and video games, can cause them to stress out about how they look. Comparing themselves with their friends—or, worse, … Continued

CMS Publishes 2020 Benefit Payment and Parameters Final Rule | CA Benefits Group UBA

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The Centers for Medicare and Medicaid Services (CMS) published its final rule and fact sheet for benefit payment and parameters for 2020. Although the final rule primarily affects the individual market and the Exchanges, the final rule addresses the following topics that may impact employer-sponsored group health plans: The 2020 maximum annual limitation on cost sharing is $8,150 for … Continued

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