23 Broker Update

On November 15, 2023

Changes to New Business Enrollment Requirements Applies to: COSE Benefit Plan, Balanced Solutions Note: This does not impact ACA. Midsize (51-99) group business does not require wage and tax documentation at the time of implementation. In the spirit of streamlining our enrollment process and listening to broker feedback, we are making an important change in […]

IRS Releases 2024 Adjustments and Benefit Limits for ACA Affordability and More

On November 10, 2023

With 2024 approaching fast, the IRS has begun to release some of next year’s indexing adjustment and benefit limits for health and welfare plans. One of the most-watched IRS adjustments each year is the required contribution percentage used to determine whether employer-sponsored health coverage is considered affordable under the Affordable Care Act (ACA). The IRS […]

SummaCare Updates

On November 8, 2023

New Information Needed for Large Group Quoting Beginning November 1, 2024 a member level census will be required for all 51+ large group quoting. By including a member level census, SummaCare can review data compiled by our Artificial Intelligence (AI) tool for opportunities to offer your clients more competitive rates. Our quoting department can accept […]

Capturing Employee Attention During Open Enrollment

On November 2, 2023

Open enrollment season is a critical time for employers to communicate and engage with employees regarding their benefits. However, capturing employee attention during this period can be challenging, as individuals may feel overwhelmed or disinterested in the process. Below are some effective strategies to capture employee attention during benefit open enrollment, ensuring that employees make […]

MMO Update

On November 1, 2023

Stop Loss Coverage – Gene Therapy Rider Discontinued For all new and renewing business with an effective date on or after 02/01/24, the gene therapy rider will be removed and the cost for gene therapy will be included in specific stop loss rates. The separate gene therapy rider was originally developed several years ago around […]

Anthem Update

On November 1, 2023

Kettering Health is moving to a new network tier Kettering Health hospitals and doctors are moving from Tier 1 to Tier 2 in your clients’ 3 Tier health plan network on January 1, 2024. As a result, your clients’ employees may pay more for care they receive from Kettering Health doctors and facilities starting on […]

IRS Releases Updated PCORI Fee Rates

On October 31, 2023

The Internal Revenue Service (IRS) has released the amount of the 2023 plan year Patient-Centered Outcomes Research Institute (PCORI) fee, which must be paid by group health insurance plan sponsors and health insurance issuers by July 31, 2024. The fee rate for plan years ending in 2023 are as follows: The PCORI fee was established […]

HHS RELEASES NEW FINE STRUCTURES

On October 30, 2023

The federal Department of Health and Human Services recently released new inflation-adjusted penalty amounts for various federal requirements that impact employers who offer group health insurance coverage and health insurance issuers. The new fine levels relate to compliance with the Health Insurance Portability and Accountability Act’s (HIPAA) privacy and data security requirements, various Affordable Care […]

IRS LOWERS ELECTRONIC FILING THRESHOLD FOR 2023 ACA REPORTING

On October 16, 2023

The Internal Revenue Service IRS issued updated instructions for preparing and submitting ACA health insurance coverage and employer reporting Forms 1094 and 1095 B and 1094 and 1095 C. In previous years, entities filing 250 or more 1095 forms were required to file electronically. Now, entities filing 10 or more of these forms will need to send them into the […]

UPDATE: UPCOMING GAG CLAUSE ATTESTATION REQUIREMENT

On September 25, 2023

The Consolidated Appropriations Act, 2021 (CAA) prohibits the inclusion of “gag clauses” in provider contracts with insurers and group health plans. According to the law, a gag clause is a contract provision that directly or indirectly restricts a plan or issuer from sharing specific cost and quality information with another party. For example, if a […]

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