[Official Guidance]

Text of CMS Look-up Table: ICHRA Employer Lowest Cost Silver Plan Premium

[XLSM file] "To help employers determine whether an ICHRA offer is considered affordable for purposes of validating they are making affordable offers of coverage to their employees and avoiding the employer responsibility payment, CMS is publishing the ICHRA Employer LCSP Premium Look-up Table. The table allows users in states participating in the Federally-facilitated Exchange (FFEs) and State-based Exchanges on the Federal Platform (SBE-FPs) to access individual market Qualified Health Plans (QHP) lowest cost silver plan (LCSP) data by geographic location." [Also available: ICHRA Employer Lowest Cost Silver Plan Premium Look-up Table Data Dictionary (DOCX)]  MORE >>

Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

[Guidance Overview]

Employers with Illinois Employees Must Provide a Comparison of their Health Plan with State-Required Essential Health Benefits

"[The Consumer Coverage Disclosure Act (CCDA)], which became effective immediately, requires employers to disclose to group health plan participants, an easy-to-understand comparison of the group health plan's coverage to the Essential Health Benefits required by the Illinois Department of Insurance for individual and small group (99 or fewer) health insurance coverage."  MORE >>

HUB International

Latest Wave of Healthcare Systems Seeks Direct Sales to Northeast Employers

"The New York metro area is seeing another resurgence in healthcare delivery systems attempting to sell their services directly to employers offering benefits programs. These systems are looking to work with their existing medical insurers or even bypass them entirely -- getting into direct competition for insured members and patients."  MORE >>

EPIC

Big Box Stores Add In-House Health Clinics, Directly Woo Health Plans

"While storefront clinics aren't new, especially in big box stores, health care insiders say the emphasis on selling to plans over consumers is novel, and that health plans may come to see such agreements as an essential benefit."  MORE >>

AISHealth; subscription required to access full article

Employer Group and Mark Cuban-Owned Company Launch Pharmacy Benefit Managers

"A pair of new companies are being launched to tackle high drug costs, the latest sign of employer frustration with the middlemen, known as PBMs, whose job it is to keep down the spending.... The aim of the new pharmacy-benefit managers, their executives said, was to be more transparent about drug costs and share with their clients more of any negotiated savings."  MORE >>

The Wall Street Journal; subscription may be required

[Opinion]

Paid Leave Policies Can Help Keep Businesses Open and Food on Workers' Tables

"Pre-pandemic, 24 percent of US workers did not receive paid sick leave, and 81 percent did not receive paid family leave.... Gaps in paid leave benefits persisted into the pandemic and appear likely to continue even with the present congressional considerations to pass paid leave expansions through budget reconciliation. Legislative efforts to expand paid sick and family leave will be most impactful if they ensure expanded eligibility reaches the lowest-income workers and guarantee minimum benefit amounts."  MORE >>

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A Survival Guide to DOL Group Health Plan Mental Health Parity Audits

Morgan Lewis

HHS Releases Second Interim Final Rule Implementing the No Surprises Act

Holland & Knight

Massachusetts Paid Family and Medical Leave Updates

Mintz