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Health & Welfare Plans Newsletter

December 22, 2021

4 New Job Opportunities 4 New Job Opportunities

 

[Official Guidance]

Text of CMS Guidance on Good Faith Estimates and the Patient-Provider Dispute Resolution Process for Providers and Facilities (PDF)

24 pages. "This guidance is intended to help providers and facilities better understand what information they must include in the good faith estimate and the PPDR process. More specifically, this guidance includes information on: [1] Good Faith Estimates for Uninsured (or Self-Pay) Individuals; [2] Patient-Provider Dispute Resolution (PPDR) Process; [3] Summary of the PPDR Process."  MORE >>

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

[Official Guidance]

Text of CMS Guidance for Selected Dispute Resolution Entities: Required Steps to Making a Payment Determination Under the Patient-Provider Dispute Resolution Process (PDF)

25 pages. "The purpose of this document is to provide guidance to [Selected Dispute Resolution (SDR)] entities on various aspects of the [Patient-Provider Dispute Resolution (PPDR)] process. This document includes information about how uninsured (or self-pay) individuals may initiate the PPDR process and the general requirements of the PPDR Process. It also provides information about the selection process and criteria for SDR entities, the requirements SDR entities must follow when making payment determinations, guidance on confidentiality standards, record keeping requirements, the revocation of certification, as well as how parties should request an extension of time periods for extenuating circumstances."  MORE >>

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

[Official Guidance]

CMS Overview of the Good Faith Estimate and the Patient-Provider Dispute Resolution Process for Individuals (PDF)

15 pages. "If the uninsured (or self-pay) individual is billed for an amount at least $400 above the estimate, the individual may be eligible to start a Patient-Provider Dispute Resolution (PPDR) process by submitting a request to HHS and paying a small administrative fee.... This document contains specific requirements and information about the 'Good Faith Estimate' and PPDR process."  MORE >>

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

[Official Guidance]

Text of CMS Guidance: Patient-Provider Dispute Resolution Administrative Fee (PDF)

"This document details the administrative fee that uninsured (or self-pay) individuals must submit to participate in the process. For 2022, the cost to initiate a PPDR case is $25."  MORE >>

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

[Guidance Overview]

Finally, Final Instructions: Due Date for Furnishing Form 1095-C Extended

"[T]he instructions provide that the due date for furnishing Form 1095-C to individuals is extended to March 2, 2022.... Form 1095-C has been modified to add new codes 1T and 1U for individual coverage HRAs offered to the employee and spouse but not dependents."  MORE >>

Seyfarth

[Guidance Overview]

New Prescription Drug and Health Care Spending Reporting Requirements from a Carrier and Plan Service Provider Perspective

"Data required to be included in the reports falls into two categories: [1] information that cannot be aggregated and must be provided for each plan or insurance coverage, and [2] information that can be aggregated across plans or insurance coverage in the same state and market segment."  MORE >>

Foley & Lardner LLP

Upcoming Deadline icon 2021 Year End Benefit Plan Reminders

"[1] Health and dependent care flexible spending account (FSA) changes ... [2] Outbreak period of relief continues ... [3] ARPA COBRA subsidy ... [4] Nondiscrimination testing ... [5] Form 5500 obligation ... [6] 2022 San Francisco healthcare expenditure rates."  MORE >>

HealthEquity

Just 1 in 2 Adults Say It's Easy to Access Mental Health Care Where They Live

"Adults were much less likely to say it's easy to access mental health services than either primary or emergency care near where they live. They were about as likely to say it's easy to access long-term care nearby, with roughly half of adults saying it's easy to access mental health or long-term services and 1 in 5 saying it's difficult."  MORE >>

Morning Consult

Benefits in General

[Official Guidance]

Hurricane Ida Tax Relief Extended to February 15 for Part or All of Six Qualifying States (PDF)

"Victims of Hurricane Ida in six states now have until Feb. 15, 2022, extended from Jan. 3, to file various individual and business tax returns and make tax payments ... The updated relief covers the entire states of Louisiana and Mississippi, as well as parts of New York, New Jersey, Connecticut and Pennsylvania.... The updated relief postpones various tax filing and payment deadlines that occurred starting on dates that vary by state: [1] Aug. 26, 2021 for Louisiana, [2] Aug. 28, 2021 for Mississippi, [3] Aug. 31, 2021 for Pennsylvania and [4] Sept. 1, 2021 for New York, New Jersey and Connecticut....[A]ffected individuals and businesses will have until Feb. 15, 2022, to file returns and pay any taxes that were originally due during this period."  MORE >>

Internal Revenue Service [IRS]

Employee Benefits Jobs

View job as DB / DC Plan Consultant
for Small NY Actuarial TPA Firm DB / DC Plan Consultant

Small NY Actuarial TPA Firm

Remote / CT / NJ / NY

View job as DB / DC Plan Consultant
for Small NY Actuarial TPA Firm

View job as Plan Administrator
for Southern Pension Services Plan Administrator

Southern Pension Services

Remote / Tampa FL

View job as Plan Administrator
for Southern Pension Services

View job as Retirement Plan Consultant
for Long Island Employee Benefits Group Ltd. Retirement Plan Consultant

Long Island Employee Benefits Group Ltd.

Remote / Huntington NY

View job as Retirement Plan Consultant
for Long Island Employee Benefits Group Ltd.

View job as Regional Director
for Employee Benefits Security Administration [EBSA] Regional Director

Employee Benefits Security Administration [EBSA]

Remote / Kansas City MO

Press Releases

TRA Completes Acquisition of The Law Offices of R. David Danziger, P.C.

The Retirement Advantage [TRA]

Last Issue's Most Popular Items

Text of IRS Notice 2022-04: Updated PCORTF Fee Payable for 2021 by Insured and Self-Insured Health Plans (PDF)

Internal Revenue Service [IRS]

Preparing for the No Surprises Act: Considerations for Providers and Health Plans Before the January 2022 Effective Date

Moss Adams LLP

Washington State Announces Moratorium on Long Term Care Act Payroll Tax

Seyfarth

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BenefitsLink Retirement Plans Newsletter, ISSN no. 1536-9587.

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