Priority Health - SaveOnSP Pharmacy Program Changes
SaveOnSP, a service that helps participating members enroll in manufacturer copay assistance programs for specialty prescription drugs...
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Karl J. Ruth Jr.
Feb 263 min read
ACA: Electronic Filing Hardship Waiver
The Taxpayer First Act of 2019 authorized the IRS to issue regulations to reduce the threshold for electronically filing Affordable Care...
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Karl J. Ruth Jr.
Jan 231 min read
Federal: DOL Exchange Notice Updated for a Fourth Time
The Affordable Care Act (ACA) requires employers to notify all workers, regardless of their benefits eligibility status, about the...
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Karl J. Ruth Jr.
Oct 16, 20232 min read
(CMS) updates cost-sharing requirements for the various parts of Medicare
On October 12, 2023, CMS released the updated figures for 2024. Here’s what beneficiaries need to know. MEDICARE PART A COST-SHARING...
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Karl J. Ruth Jr.
Aug 3, 20232 min read
Protect Summer Travel with Short-Term Plan Coverage
By the end of the month, back-to-school reminders and end-of-season sales will have us all thinking fall is almost here. Resist the urge...
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Karl J. Ruth Jr.
Jun 19, 20232 min read
New Consent Requirement For ACA Enrollments
Health and Human Services (HHS), the regulating body for the Individual and Family Plans (IFP), aka ACA, released their annual guidance...
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Karl J. Ruth Jr.
Jun 12, 20232 min read
IRS Addresses Claims Substantiation Requirement for FSAs
The IRS recently issued a Chief Counsel Advice Memorandum that provides important reminders about the claims substantiation requirements...
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Karl J. Ruth Jr.
May 24, 20234 min read
First Gag Clause Attestations Due December 31, 2023
The Consolidated Appropriations Act of 2021 (CAA) prohibits employer-sponsored group health plans from entering into agreements that...
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Karl J. Ruth Jr.
Feb 22, 20232 min read
Marketplace Special Enrollment Period (SEP) - Medicaid Unwinding
The Centers for Medicare & Medicaid Services (CMS) has announced a Marketplace Special Enrollment Period (SEP) for qualified individuals...
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Karl J. Ruth Jr.
Feb 9, 20232 min read
White House announces COVID-19 PHE and National Emergency will be allowed to expire
On January 30, 2023, the White House announced its plan to allow the COVID-19 Public Health Emergency (PHE) and National Emergency...
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Karl J. Ruth Jr.
Jan 24, 20232 min read
Important Update on Medicaid Unwinding
Millions of consumers may soon be eligible for Marketplace coverage. If you or a loved one are impacted by the loss of eligibility,...
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Karl J. Ruth Jr.
Dec 29, 20221 min read
CAA 2021 Drug Reporting Requirement Update
The Consolidated Appropriations Act, 2021 (CAA), Title II, Division BB included a new reporting requirement for group health plans and...
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Karl J. Ruth Jr.
Dec 20, 20221 min read
Federal: Minimal Essential Coverage Reporting Regulations Finalized
Effective December 15, 2022, the IRS’s regulations were finalized and published in the Federal Register. They provide an automatic...
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Karl J. Ruth Jr.
Oct 18, 20221 min read
New Guidance on Health Care Transparency
On August 19, 2022, federal agencies released a final rule and FAQs regarding the ban on surprise medical billing and other health care...
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Karl J. Ruth Jr.
Aug 25, 20221 min read
HHS Announces Proposed Rule to Strengthen Nondiscrimination in Health Care
On July 25, 2022, the U.S. Department of Health and Human Services (HHS) announced a proposed rule implementing Section 1557 of the...
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Karl J. Ruth Jr.
Aug 12, 20221 min read
Federal: ACA Affordability Threshold Decreases
On July 25, 2022, the IRS announced that the Affordable Care Act’s (ACA) affordability threshold will be 9.12 percent, reduced from 9.61...
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Karl J. Ruth Jr.
Aug 11, 20221 min read
Inflation Subsidy Act - ACA Subsidy Extension
On Sunday August 7th, the U.S. Senate passed the Inflation Reduction Act of 2022. This bill contains a $64 billion, 3-year extension of...
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Karl J. Ruth Jr.
Jul 19, 20225 min read
Employee Benefit Trends That Are Shaping 2022
The COVID-19 pandemic shifted just about every aspect of our lives – including how we work, where we work, and what we want from our...
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Karl J. Ruth Jr.
Jun 27, 20225 min read
Employer Considerations for Coverage of Abortion Benefits
In anticipation of the U.S. Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization that overturned Roe v. Wade, states...
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Karl J. Ruth Jr.
Jun 13, 20223 min read
Distributing Required Notices: What You Need to Know
There are a lot of notices and materials that employers are required to distribute to their employees each year. The requirements for...
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