Aug. 30, 2022. "Marketplaces use Form 1095-A to furnish the required statement to recipients. A separate Form 1095-A must be furnished for each policy, and the information on the Form 1095-A should relate only to that policy.... Statements must be furnished to recipients on paper by mail, unless a recipient affirmatively consents to receive the statement in an electronic format."  MORE >>

"Annual reporting on pharmacy benefits and drug costs will take effect at the end of 2022. In 2023, plans must make available the participant-level price comparison tool for the first 500 shoppable items/services. In 2024, plans must add all remaining shoppable items/service to the participant-level price comparison tool."  MORE >>

"Group health plans are required to report various information about their prescription drug costs and spending ... The reporting deadlines are: December 27, 2022 for 2020 and 2021 calendar-year data; June 1, 2023 for the 2022 calendar-year data.... [P]lan data may be reported to CMS in the aggregate by pharmacy benefit managers (PBMs), insurers or other reporting entities. There may also be multiple entities reporting information on behalf of a single plan."  MORE >>

"Recently, courts vacated parts of last year's interim final rules that related to determining the appropriate payment amount in the independent dispute resolution (IDR) process. These final rules fill in the gaps created by those court decisions.... The regulations go into effect Oct. 25, 2022. For good measure, the Departments ... tossed in numerous FAQs that include details on surprise billing payment calculations, notices and clarifications regarding common scenarios."  MORE >>

"[1] Extension of ACA subsidies ... [2] Medicare prescription drug pricing negotiations ... [3] Manufacturer rebates under Medicare ... [4] HSA safe harbor for insulin."  MORE >>

"In reaching this determination, the Eleventh Circuit concluded that it was irrelevant that the plaintiff was not given actual notice of the limitations provision." [Bakos v. Unum Life Ins. Co. of America, No. 22-11131 (11th Cir. Aug. 25, 2022; unpub.)]  MORE >>

"40% of U.S. workers reported inflation will make them scale back on the employee benefits they choose during open enrollment. In addition, 48% of U.S. workers said inflation is making it difficult for them to pay for their benefits.... Younger workers were more likely to report they would cut back on benefits compared to older peers. More than half of the workers ages 18-34 (51%) reported they are likely to scale back on their benefits compared to those ages 35-54 (41%) and those ages 55+ (25%)."  MORE >>

"[A] mature plan can expect to have about 60% of benefits paid by investment income.... Without prefunding, today's taxpayers are paying for the benefits of current retirees, who may have worked many years ago and possibly under a different benefit structure.... Rating agencies view a funded plan more favorably than an unfunded one."  MORE >>