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[Official Guidance]
Text of CMS Manual for Reconciliation of the Cost-Sharing Reduction Component of Advance Payments for Benefit Year 2017 (PDF)
49 pages. "CMS is releasing this final manual to all issuers offering a qualified health plan (QHP) through a health insurance Exchange. The manual provides information on the process for reconciling the cost-sharing reduction component of the advance payments that QHP issuers have been paid through the September 2017 payment cycle against the cost-sharing reduction amounts those issuers provided to eligible Exchange enrollees for the entire 2017 benefit year to determine any charges owed to CMS. The manual also provides QHP issuers with general instructions on using the standard, simplified, and actuarial value (AV) methodologies ... for the purpose of determining the value of cost-sharing reduction amounts provided to eligible Exchange enrollees, and describes the data elements issuers are required to submit when the annual cost-sharing reduction reconciliation process begins
April 2, 2018." Final CSR Reconciliation Issuer to MIDAS package for Benefit Year 2017 and Benefit Year 2016 Restatements also includes:
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]
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Decision Support Tools Can Help Employees Make More Meaningful Benefits Choices
"Forty-six percent of employees bought the medical plan that was recommended to them. Of those who didn't buy the recommended plan, 32% bought a more expensive plan, while 22% bought a less expensive plan.... About two-thirds of employees who were recommended to buy HSA-qualified plans did so, compared with 40% who purchased an HSA-qualified plan when they didn't receive a recommendation.... Generations X and Y were more likely to follow recommendations concerning the purchase of life insurance."
Willis Towers Watson
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GAO Review of the Audit of the Patient-Centered Outcomes Research Institute Financial Statements for Fiscal Year 2017
"This report presents the results of GAO's review of PCORI's fiscal year 2017 financial statement audit.... PPACA requires PCORI to obtain an annual financial statement audit from a private entity with expertise in conducting financial audits. PPACA also requires the Comptroller General of the United States to annually review the audit of PCORI's financial statements and report the results to the Congress." [GAO-18-423R, Mar. 30, 2018]
U.S. Government Accountability Office [GAO]
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Benefits in General
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EBSA Continues to Shrink
"The Employee Benefits Security Administration employed 869 people in late 2017, down about 17 percent from its Obama-era peak of 1,043 workers in September 2012. The agency lost employees in each of the past five quarters ... EBSA's workforce hasn't been this small at any recorded point since September 2001, when it employed 855 people."
Bloomberg BNA
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David Rhett Baker, J.D., Editor and Publisher
Holly Horton, Business Manager
BenefitsLink Health & Welfare Plans Newsletter, ISSN no. 1536-9595. Copyright 2018 BenefitsLink.com, Inc. All materials contained in this newsletter are protected by United States copyright law and may not be reproduced, distributed, transmitted, displayed, published or broadcast without the prior written permission of BenefitsLink.com, Inc., or in the case of third party materials, the owner of those materials. You may not alter or remove any trademark, copyright or other notices from copies of the content.
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