"Notably, the CAA23 did not include a number of provisions that were discussed prior to its enactment with direct and potentially significant impacts on health care payers, including amendments to the enforcement scheme for the Mental Health Parity and Addiction Equity Act (MHPAEA) and expanded dialysis coverage requirements for group health plans and health insurance coverage.... The most direct impact on plan sponsors and health plan service providers is the extension of the HSA telehealth safe harbor ... for plan years beginning after December 31, 2022 and before January 1, 2025."  MORE >>

"The notice includes important proposed rules and parameters for the operation of the individual and small group health insurance markets in 2024 and beyond. This paper summarizes key provisions of the proposed notice, actuarial value calculator, and maximum out of pocket information recently released by HHS."  MORE >>

"HHS has announced that the maximum annual limit on cost-sharing for 2024 is to increase to $9,450 for self-only coverage and $18,900 for other than self-only coverage (the 2023 limits are $9,100 and $18,200).... [T]he proposed regulations would prohibit mid-year terminations of dependent children who reach the maximum age limit under the ACA or state law (unless termination is otherwise permitted)."  MORE >>

"[Notice 2023-4] provides the indexing factor to be used by group health plans and insurers to calculate the qualifying payment amount (QPA) under the No Surprises Act for items or services provided on or after January 1, 2023, and before January 1, 2024.... Helpful examples of QPA calculations -- including for items and services first furnished after January 31, 2019 -- are provided in the notice."  MORE >>

"With respect to individuals covered under an insured plan, the insurance carrier only needs to make the individual's Form 1095-B available, rather than furnishing the form automatically, provided certain requirements were met. Self-insured employers are allowed the same accommodation with respect to furnishing Forms 1095-C, but only with respect to individuals who had coverage under the self-funded plan during the reporting year but were not ACA full-time employees at any point during that year."  MORE >>

"Vermont joins its neighbor New Hampshire as the second state with such an innovative voluntary program two years after the two states had previously announced a similar joint program. The Vermont Family and Medical Leave Insurance Plan (VT-FMLI) will start being offered to state employees in July 2023, and then will be rolled out to other private employers and employees over the next two years."  MORE >>

"Some of south Louisiana's largest private companies, which together provide health-insurance coverage to some 38,000 employees and family members, are forming a new coalition aimed at controlling the cost of health care without reducing its quality.... For now, the coalition is focused on educating its members about online pricing and transparency tools that can be used to compare what local doctors and hospitals charge for their services and assess which ones offer the best value."  MORE >>